SOUTH WESTERN DEANERY - South West Peninsula Deanery
SOUTH WESTERN DEANERY - South West Peninsula Deanery
SOUTH WESTERN DEANERY - South West Peninsula Deanery
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Specialty Training (ST4 – ST6)<br />
GENERAL ADULT AND OLD AGE PSYCHIATRY<br />
Job Description<br />
February 2013
Contents<br />
PAGE<br />
Schedule of Posts 2<br />
Introduction 3<br />
Research 4<br />
Special Interest Sessions 5<br />
Training Centres 7<br />
Specific Posts 10<br />
NOTE:<br />
The information contained in this document may be subject to change long term. Any applicant<br />
successfully appointed to a Specialty trainee post is advised to see up to date information of this kind<br />
from the Trust to which they are appointed and from the Trusts to which they subsequently rotate.<br />
2
SCHEDULE OF POSTS<br />
Speciality<br />
Page<br />
No<br />
Centre Trainers Old Age Adult (Core) Adult<br />
Specialty<br />
Devon Partnership NHS Trust<br />
10 Dr Aitken (Liaison)<br />
12 Dr Bora<br />
15 Dr de Warren-Penny <br />
17 Dr Dickinson (U&I)<br />
19 Dr Dixon (U&I)<br />
20 Dr Dorkins (Forensic)<br />
22 Dr Dunn <br />
23 Dr Feller (LD)<br />
24 Dr Freer <br />
25 Dr Lovett (U&I)<br />
27 Dr Lynch <br />
29 Dr Mizen (Psychthrpy)<br />
30 Dr Montgomery <br />
31 Dr Moore <br />
32 Dr Nelson/Dr Salvi <br />
33 Dr Noble (U&I)<br />
34 Dr Owens (Liaison)<br />
36 Dr Pearson <br />
37 Dr Rowlands (Sub Mis)<br />
39 Dr Somerfield <br />
42 Dr Thekkepalakkal <br />
Plymouth Teaching Primary Care Trust<br />
43 Dr Buttan (U&I)<br />
45 Dr Cunningham <br />
46 Dr Cooper<br />
48 Dr Dinniss <br />
49 Dr Ford <br />
50 Dr Murphy <br />
52 Dr Payne (Rehab)<br />
Cornwall Foundation Partnership Trust<br />
53 Dr Altaan <br />
55 Dr Bernal (LD)<br />
56 Dr Bowers <br />
58 Dr Cameron <br />
60 Dr Flynn (Liaison)<br />
61 Dr Hunter <br />
62 Dr Kusterman <br />
64 Dr Laugharne <br />
65 Dr Mackintosh <br />
67 Dr Mather
69 Dr Metcalfe (E.I.S)<br />
71 Dr Naylor <br />
72 Dr Richards <br />
74 Dr Shankar (neuropsych)<br />
75 Dr White (Sub Mis)<br />
4
INTRODUCTION<br />
The Scheme offers posts in all Trusts providing psychiatric care in Devon and Cornwall, with experience ranging<br />
from cities to suburban and dispersed rural areas. There is a range of models of service provision on inpatient,<br />
outpatient and community based care. The rotational scheme affords placement in several branches of<br />
psychiatry; liaison psychiatry; substance misuse, general psychiatry, psychiatry of old age; Forensic Psychiatry,<br />
Home Treatment, Early Intervention in Psychosis, Eating Disorders and Psychotherapy. Training occurs in a<br />
number of different settings; psychiatry hospitals, community units and academic departments. As there are<br />
more approved training opportunities than funded posts Specialty Trainees have considerable choice and<br />
flexibility in planning an individually tailored training programme.<br />
The training in each of the training posts have been planned to give each Specialty Trainee a broad experience<br />
as well as providing scope to develop research and pursue a special clinical interest.<br />
The basic plan of each one year training post is:<br />
Eight clinical sessions with the principal Consultant Trainer<br />
One special interest session, which may be with the Consultant Trainer or with another Consultant. The<br />
special interest sessions will be arranged after discussion with the Programme Director.<br />
One research session supervised by a member of the Academic Department or a supervisor approved by<br />
the Programme Director.<br />
The training scheme is based around main centres in Bodmin, Redruth, Exeter, Plymouth, Barnstaple and<br />
Torbay. Each centre has its own on-call arrangements. Specialty trainees on the scheme are employed by one<br />
of three NHS Trusts: Cornwall Partnership NHS Trust, Devon Partnership Trust and Plymouth Primary Care<br />
Trust. The Regional Postgraduate Dean is Dr Martin Beaman, <strong>Peninsula</strong> Medical School, John Bull Building,<br />
Research Way, Tamar Science Park, Derriford, Plymouth.<br />
Allocation of posts is made by the Programme Director in the light of discussions with individual Specialty<br />
Trainees, initially directly after appointment and then a few months prior to each rotation point in July of each<br />
year. Specialty Trainees are strongly encouraged to meet with the Consultant trainers for their preferred<br />
placements prior to the final allocation.<br />
There are 15 posts on the rotation. Four NTN’s exist in Old Age Psychiatry and eleven in Adult Psychiatry. It is<br />
possible to apply to dual accredit in Old age and General Adult Psychiatry. Of the sixteen posts, four are<br />
allocated to Cornwall Partnership Trust, four to Plymouth Primary Care Trust and seven to Devon Partnership<br />
Trust.<br />
Throughout his/her tenure, each Specialty Registrar is entitled to one session per week for research as part of<br />
the core training programme in psychiatry and this does not constitute study leave. Specialty Trainees are<br />
entitled to an additional study leave and this is not used for the day per week for research as part of core<br />
training. The Specialty Trainees are also encouraged to meet monthly for informal support and specific<br />
educational activities.<br />
The Programme Director runs a regular training surgery in each locality and trainees are encouraged to make<br />
use of this facility. The scheme has a well established ARCP (Annual Review Competency Progression) process<br />
which is highly regarded by trainees.<br />
5
RESEARCH<br />
Specialty Trainees are encouraged to conduct research. Each Trust has modern library facilities and access to<br />
internet facilities.<br />
Opportunities exist within the <strong>Peninsula</strong> Medical School for undertaking MSc degrees in clinical research and<br />
education and trainees are actively encouraged to undertake a higher degree. In addition, opportunities exist<br />
within the academic department of mental health, Exeter University for working collaboratively on research<br />
projects in the field of mental health.<br />
SPECIAL INTEREST SESSIONS<br />
Specialty Trainees are encouraged to make full use of their special interest sessions which may be used to<br />
pursue a higher qualification that is relevant to their training.<br />
6
TRAINING CENTRES<br />
Cornwall<br />
Cornwall has a population of approximately 486,000. It represents the second largest county in the area but<br />
has the lowest population density.<br />
The county has the longest coastline of any English county, some 570 km; the river Tamar forms a physical and<br />
cultural divide with the rest of Great Britain for all but 18km of its length. The Isles of Scilly lie 45km off Lands<br />
End. The distance between the north and south coast varies from 72km in the east of the county to as little as<br />
8km at the western end.<br />
Much of the county’s identity has been maintained in traditions and culture and it possesses distinctive<br />
physical features in its peninsular form with stunning coastlines, moorlands and a temperate climate. A past<br />
history of mining has been subsumed by the growth as a holiday area together with some recent<br />
manufacturing industry. The area remains however largely rural in character and farming and fishing in the<br />
west is still the mainstay of economy.<br />
There is a wide scatter of small towns and villages. Only 31% of the population live in towns of over 10,000<br />
inhabitants (Penzance, Camborne, Redruth, Falmouth, Truro, Newquay, St Austell, Bodmin and Saltash).<br />
Cornwall’s renowned temperate climate allows for such activities as sailing, wind surfing, swimming, and<br />
walking. There are also several Golf Courses in the county. Leisure Centres are provided throughout the<br />
county. The attractive cathedral city of Truro is the sub-regional centre and offers extensive shopping and<br />
leisure facilities. Performing arts are catered for at the Hall for Cornwall, Truro and a range of other venues<br />
including the spectacular Minack theatre in Carrick. There is a thriving artistic community and the centre for<br />
modern and contemporary art is at the St Ives Tate Gallery in the west of the County. There are also a number<br />
of impressive restaurants throughout the county providing a wide choice of cuisine. The County offers excellent<br />
primary and secondary education through state and public schools, coupled with a comprehensive choice of<br />
adult education classes.<br />
Major national and international tourist attractions such as Heligan Gardens and the Eden Project attract<br />
visitors throughout the year.<br />
A choice of properties including waterfront, smallholdings, traditional and new build are all available within<br />
county.<br />
Plymouth<br />
Plymouth is a major centre of population with large industrial, residential and leisure sectors and as such its<br />
population has a wide range of health care needs. Plymouth Primary Care NHS Trust is responsible for<br />
providing secondary mental health, rehabilitation medicine and geriatric services plus a range of primary<br />
community services including community nursing, reablement teams, dental services and remedial therapies.<br />
In addition the Trust manages two community hospitals, located at Tavistock and Kingsbridge. The Plymouth<br />
Primary Care NHS Trust provides services to acute general adult psychiatry, rehabilitation and old age<br />
psychiatry for the catchment area. There is a specialist Community Drugs Service and a developing Community<br />
Alcohol Service. Child and Adolescent Psychiatry care is now also provided by the Trust. Glenbourne also<br />
houses an ECT suite, administrative offices and meeting and conference rooms.<br />
7
Almost 60% of the population served live in the city itself and services must therefore cater for a large inner<br />
city population. Unlike some other areas of the SW Region, Plymouth does not have an unusually high number<br />
of elderly people in its population. The age structure is similar to the national pattern with 19% under 15 years<br />
and 17% over 64 years. Projections show that although the population will grow by only 3% during the next 10<br />
years, there will be a 36% increase in those over 75 years of age. There are good road and rail links to central<br />
southern England and flights from Plymouth Airport at Derriford to London and other major cities. To the<br />
north-east is the rugged and virtually unpopulated Dartmoor national park. The <strong>South</strong> Hams area to the east of<br />
Plymouth boasts many charming villages and fishing ports. The area has a full range of educational and leisure<br />
facilities.<br />
A large part of Wednesday mornings is devoted to the academic programme for the training of junior doctors.<br />
Under the supervision of the Clinical Tutor, the Specialty Trainees are involved in organising and participating in<br />
this training. There is a weekly case presentation and Journal Club, where Specialty Trainees are expected to<br />
be active participants in organising, delivering and teaching. In addition, Dr Montgomery runs a regular<br />
research clinic to support trainees undertaking research projects. From September 2009, the <strong>Peninsula</strong><br />
MRCPsych course will be coordinated and delivered from Plymouth run by Drs Cooper, Dinniss and Bickerton.<br />
Higher trainees are actively encouraged and supported to involve themselves in delivering the teaching.<br />
Devon Partnership Trust<br />
The Devon Partnership NHS Trust was created on 1 April 2001. From July 2002 the Trust provided Mental<br />
Health, Learning Disability and Social Services to the majority of the Devon population apart from those living<br />
in Plymouth, who continue to receive those services from Plymouth Primary Care Trust and Plymouth Social<br />
Services.<br />
The Devon Partnership Trust offers a comprehensive range of mental health and social care provision with<br />
services to adults, older people, people with learning disability, children and adolescents, adults with<br />
physical/sensory disability and people with drug and alcohol problems. Across the Trust there are specialist<br />
services for Forensic Psychiatry and Psychotherapy. There are strong academic links with our main research<br />
partner, the <strong>Peninsula</strong> Medical School, through the Mental Health Research Group based in Exeter.<br />
Exeter<br />
Exeter is a Cathedral city and is the regional centre and county town of Devon. The Devon Partnership Trust<br />
headquarters are at Wonford House Hospital, Dryden Road, Exeter. Wonford House Hospital is adjacent to the<br />
Royal Devon and Exeter Hospital on the same site. The Wonford site is within its own grounds, a mile from the<br />
city centre. Devon Partnership Trust provides services to Exeter and the surrounding area through the Exeter<br />
and East Devon locality. The Exeter and East Devon locality serves a population of 243,000 in total; 21% of that<br />
population are aged 65 plus; 57% lie between 20 and 64; and 22% between 0 and 19.<br />
Wonford House Hospital houses the Specialist Eating Disorders Unit, Older Persons Psychology facilities for<br />
Exeter City, and district Psychiatric Rehabilitation Services. The Cedars, a purpose-built unit, adjacent to<br />
Wonford House, provides acute admission facilities for Exeter, East Devon and Exmouth localities, Delderfield<br />
Ward; and the Tiverton/Okehampton localities, Coombehaven Ward. The Liaison Psychiatry service to the<br />
Royal Devon & Exeter Hospital, and the Mental Health Group of the Institute of Health and Social Care<br />
Research, <strong>Peninsula</strong> Medical School, (www.ex.ac.uk/dmh/) are co-located in Wonford House Hospital. The<br />
Department of Clinical Psychology is also on the Wonford site, adjacent to other medical academic<br />
departments of the <strong>Peninsula</strong> Medical School.<br />
The library situated in Wonford House is specialist and stocks a wide range of books covering all aspects of<br />
mental health. It is part of the University of Exeter library service and the catalogue can be accessed on<br />
8
www.ex.ac.uk/library/eml/whh/html. There is a range of periodicals and journals for reference. The library is<br />
staffed during weekdays except Wednesdays. The librarian can arrange inter-library loans. There is access to<br />
online databases and literature searches. Additional specialist journals are held in the department of clinical<br />
psychology.<br />
Within Wonford House there are regular, well organised, activities supporting training and continuing<br />
professional development:<br />
Torbay<br />
Case conferences are held over Tuesday lunchtime from 12.30 in the Bucknill Conference Room. Journal<br />
club runs on Wednesday lunchtime in the junior doctor’s common room from 12.30.<br />
Audit meetings are held monthly on Mondays from 12–1pm. There is support from the audit department<br />
for trainee projects.<br />
Wonford House Hospital hosts the Exeter Part 1 and Part 2 MRC Psych course on Thursdays and Fridays,<br />
attended by trainees from across the <strong>Peninsula</strong>.<br />
Torbay incorporates the areas of Torquay, Paignton and Brixham and extends from Dartmouth in the south to<br />
Dawlish and Moretonhampstead in the north.<br />
The district is mainly rural in nature, with small towns and a major urban conurbation on the bay. It provides<br />
extensive holiday facilities which produce a large increase in population in the summer months and holiday<br />
periods of the year. The main industries are tourism, leisure and residential care. The area has an extensive<br />
range of leisure facilities from water sports to moorland walking. There are good schools in the area including<br />
both boys and girls grammar schools. Torbay is an attractive centre with a favourably mild climate and easy<br />
access to Dartmoor National Park and the coast. The county’s two major cities, Exeter and Plymouth, are both<br />
less than an hour away by road. There are good rail links with Bristol and London (less than four hours away).<br />
The teaching programme is organised by the Clinical Tutor (psychiatry). There is a weekly session for<br />
postgraduate education with a tutorial held by the Clinical Tutor and a weekly tutorial held by the Specialty<br />
Trainee and/or Consultants in the Department of Psychiatry. The postholder would be expected to contribute<br />
to the educational session, tutorials and examination practice sessions.<br />
Clinical audit is co-ordinated by the Consultant responsible for audit, who is supported by a secretary. The<br />
postholder will be expected to present at audit at least once in the academic year. The postholder will be<br />
expected to contribute to audit and training sessions with the non-medical clinical staff.<br />
<strong>Peninsula</strong> Medical School<br />
The <strong>Peninsula</strong> Medical School is the first new medical school for 30 years. Within the PMS Institute of Health<br />
and Social Care, the Mental Health Research Group conducts health services research and has a strong track<br />
record of publication and grant income generation. Details of research activity is available at<br />
www.ex.ac.uk/dmh. Specialty Trainees are encouraged to become involved. Many recent Specialty Trainees<br />
have been involved in research through the department and have published successfully in the peer-reviewed<br />
literature. There are opportunities for training in research methodology and statistics through the <strong>Peninsula</strong><br />
Medical School. There are a number of research-based courses available from workshops through taught<br />
masters degrees to MD or PhD. Full details are available at www.pms.ac.uk. PMS medical students began their<br />
training in 2002 in both Exeter. Plymouth and Truro. The <strong>Peninsula</strong> MRCPsych course is hosted in Plymouth.<br />
Specialty Trainees are actively encouraged to become involved in postgraduate teaching on the course.<br />
9
SPECIFIC POSTS<br />
These timetables and descriptions are indicative only and subject to change with service development and<br />
will be tailored to meet individual trainees learning needs after discussion and agreement from individual<br />
educational supervisors.<br />
10
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
Liaison Psychiatry<br />
Dr Peter Aitken<br />
Devon Partnership NHS Trust<br />
Wonford House Hospital, Dryden Road, Exeter, EX2 5AF<br />
JOB DESCRIPTION: This integrated mental health and wellbeing service will maintain and improve current<br />
mental health care provision to RD&E hospital. All service user presentations to the RD&E that are referred to<br />
the service will be seen and assessed by an integrated clinical team, who can deliver sophisticated assessments<br />
and interventions shaped to the needs of patients of the RD&E, draw on all three functions in any of the<br />
Mental Health Networks or arrange care out of county. The team uses bio-psycho-social assessment,<br />
signposting, brief intervention, or brokerage depending on identified level of need. The team conducts<br />
environmental risk assessment & management, mediation, group and team work, anxiety management, care<br />
planning, contingency planning, education, training, mentoring and medico-legal advice. The team uses a brief<br />
intervention tool kit based on motivational interviewing toward engagement with the care plan, problem<br />
solving or CBT based sessions at the bedside or in outpatient follow up.<br />
The team was commissioned three years ago to provide to adults of working age 0900 – 1700 Monday to<br />
Friday. (The same model of service is offered from the Exeter Crisis Team as the ‘Hospital At Night Team’<br />
between 0000 – 0900.The SHO on call service provides from 5pm - midnight) The liaison team provides a<br />
service within one hour to the Emergency Department of the RD&E and a same day service to the 650 inpatient<br />
beds on the Wonford and Heavitree sites. Its performance is measured against 650 assessed annually,<br />
admissions avoided, action against delay to discharge, actions to avoid repeated admission, compliance with<br />
the 4 hour wait, suicide reduction.<br />
Health and Neuropsychology<br />
The service has been developed over many years to meet the psychological needs of inpatients in the RD&E,<br />
and to provide a neuropsychology service to adults with acquired neuro-disability.<br />
The health psychology team uses psychological assessment, brief interventions, short term psychotherapy<br />
(CBT, CAT) and multidisciplinary multimodal group work in outpatients. The team conduct care planning,<br />
education, training, supervision for psychological interventions and leadership of bio-psychosocial group<br />
interventions. The health psychology service is currently provided to specialist services- pain management,<br />
respiratory medicine; cancer care, kidney unit; otolaryngology. The service also provides rapid response to<br />
referrals from any department, where psychological distress impedes medical or surgical treatment.<br />
The neuropsychology service offers psychological assessment; neuropsychological assessments; brief<br />
interventions; neuro-rehabilitation; short term psychotherapy (CBT, CAT) and couple therapy with adjustment<br />
issues in outpatients. The team conduct care planning; coordination of bio-psychosocial intervention and<br />
support packages; education & training; support, coaching and supervision with enablers. The median number<br />
of individual therapy sessions delivered is 6. Integrated multi-professional group sessions up to a maximum of<br />
6. The service is currently provided to neuro-reablement inpatient and community units, including Mardon.<br />
The health and neuropsychology services are available 0900-1700 Monday to Friday.<br />
Research Innovation and Improvement<br />
The department of psychological medicine is co-located with the Directorate of Research & Development<br />
where there is an MRC NIHR funded program of research into suicide prevention and harm minimisation from<br />
self harm, a research support service, an innovation group developing novel uses of information management<br />
11
for the prevention of suicide and harm minimisation, and an improvement (Patient safety) group driving<br />
toward safer mental health services.<br />
Training and Development<br />
The department hosts students from all disciplines at all stages of training including Foundation doctors at level<br />
1 and 2 on rotation to the Royal Devon and Exeter Hospital.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
Wednesday<br />
A.M.<br />
Liaison Psychiatry<br />
RD&E Wards<br />
Team Meeting<br />
Academic Programme<br />
Liaison Psychiatry<br />
RD&E Wards<br />
P.M.<br />
Liaison Psychiatry<br />
RD&E<br />
OPD<br />
1.30 – 2.30 Supervision with<br />
Consultant<br />
Liaison Psychiatry<br />
RD&E Wards<br />
Thursday TBA Research<br />
Friday TBA Special Interest<br />
On-call<br />
1 in 14, Consultant Rota with Consultant Cover<br />
12
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
StR in Psychiatric Rehabilitation and Recovery,<br />
Dr Rani Bora, MRCPsych MB BS<br />
Devon Partnership NHS Trust<br />
Wonford House Hospital, Exeter<br />
JOB DESCRIPTION<br />
The Service: 20 years ago, Exeter psychiatric rehabilitation services were well organised and well thought of<br />
but subsequently fell into decline and became either isolated and unsupported or were dispersed. With the<br />
inception of the Devon Partnership Trust and pursuit of the implementation of the NSF for Adult Mental Health<br />
(1999), coupled with thinking of clinical services as interactive systems, there was a renewed emphasis on<br />
developing a comprehensive and responsive rehabilitation service. This was both to meet the needs of its core<br />
patient group and through that the needs of a service as a whole. The appointment of a full time rehabilitation<br />
consultant in 2003 was a significant step in consolidating and taking forwards service developments that began<br />
2 years previously. The service continued to grow and develop by adding a linked community team and then<br />
by growing connections with residential care providers. The service has been a leading area in Devon for the<br />
development of recovery orientated practice.<br />
The service currently comprises of two separate but connected areas of work – an inpatient, residential<br />
rehabilitation service for Devon and a community rehabilitation team for Exeter. Medical and psychology staff<br />
are shared across both teams and there are aspects of joint work and planning. The teams have separate<br />
nursing and OT staff and have different managers. The service is going through a process of re-provisioning<br />
currently, moving towards an integrated Residential and Community team.<br />
The StR Role: The StR is an apprenticeship role, learning rehabilitation psychiatry and at the present stage of<br />
service development, participating also in how to redesign a service shape and remodel it, taking advantage of<br />
new service developments and the complex process of re-commissioning existing ones. The StR would shadow<br />
the consultant clinically and in service development and planning processes. He or she would also take up<br />
specific projects and areas or responsibility as available. There will be ample opportunities to develop the<br />
whole range of specialist competencies in line with the specialist curriculum and the post holder will work<br />
across inpatient, community and out of area environments.<br />
Facilities: Russell Clinic is an inpatient ward (16 beds) at Wonford House Hospital, linked to a dedicated<br />
community rehabilitation team for Exeter. The ward is the main provider of residential rehabilitation for<br />
Devon. We also work with providers of residential care and have close relationships with providers in Exeter.<br />
Russell Clinic has the unique distinction within the trust of being awarded the AIMS (Accreditation of Inpatient<br />
Mental Health Services) by the Royal College of Psychiatrists in July 2011; AIMS is a standards based<br />
accreditation service designed to improve quality of care in psychiatric wards.<br />
Structures: There are a number of organisational structures though which clinical leadership, service<br />
governance and guidance on service developments and design are conducted. This included the Psychosis &<br />
Recovery Forum, the Rehabilitation Core Group, Multidisciplinary team supervision, referral and concerns<br />
meeting and 3 times a week inpatient hand-overs on Russell Clinic. In addition both residential and community<br />
teams have regular team and service development away days and we have close networking relationships with<br />
MIND and Rethink and particularly with Recovery Devon. We also have close working links with service user<br />
and carer groups.<br />
Population: Russell Clinic serves the same area as Devon Partnership Trust, i.e. 850,000.<br />
Community Rehabilitation Team serves only Exeter, with a population of 150,000 approximately.<br />
The Exeter<br />
13
Number of Consultants for the service: 1 WTE for rehabilitation.<br />
Multidisciplinary Team including junior staff: Full-time Secretary, SHO, Occupational Therapists, RMNs,<br />
Nursing Assistant; Service Core Leadership Team also includes Nurse Team Manager, Clinical Psychologist and<br />
local Operations Manager.<br />
Teaching opportunities: These are substantial; we see ourselves as a teaching and training resource for<br />
rehabilitation and for recovery orientated practice. We are part of an ambitious training strategy to increase<br />
recovery awareness and skills across the Trust and have rich connections with regional and national<br />
rehabilitation and recovery initiatives. All of these generate teaching needs and opportunities which can<br />
incorporate the post holder.<br />
Research interests: Dr Rani Bora is an enthusiastic trainer and accredited life coach. She is passionate about<br />
bringing her coaching skills into the work place and has trained several teams on application of coaching skills<br />
in routine practice. Her research interest is centred around mental well-being promotion, personal<br />
development and self-management. Another key research interest is around promoting physical health and<br />
looking at ways to increase motivation, especially for people with mental health difficulties. Her recent<br />
research project about implementing 5 ways to well-being has been cited as an example of good practice in the<br />
NHS Confederation’s national review of the implementation to Five Ways to Well-being. She and her<br />
colleagues produced a number of resources including a comprehensive report, self-help booklet, promotional<br />
film and power-point presentation all of which are freely available to download from the Devon Partnership<br />
Trust website http://www.devonpartnership.nhs.uk/Looking-After-Yourself.342.0.html or from the Recovery<br />
Devon website http://www.recoverydevon.co.uk/.<br />
Dr Bora is a member of the steering group for the Trust IMROC (Implementing Recovery Oriented Practise)<br />
project, which is a national initiative led by the NHS Confederation and the Centre for Mental Health Services<br />
Development aimed at developing recovery orientated mental health services. She is an active member of at<br />
least 3 of the work-streams focussing on transforming workforce, redefining engagement with people using<br />
services and promoting well-being within the wider community.<br />
Educational programme: The Specialty Trainee would be in an apprenticeship role, learning rehabilitation<br />
psychiatry through joining both an inpatient and community team and taking a responsible clinical role. The<br />
service itself is being actively redesigned and redeveloped and the trainee would participating in learning how<br />
to engage with shaping and remodelling practice and services, incorporating new developments and the<br />
complex process of recommissioning existing ones. The Specialty Trainee would shadow the Consultant<br />
clinically and in service development and planning processes and would be supported to take up specific<br />
projects when ready. There will be ample opportunities to develop the whole range of specialist competences.<br />
There are substantial opportunities for teaching and in developing organisational and leadership skills<br />
depending on trainee's interests and availability. We are the specialist service for Devon and aspire to being<br />
the core resource for teaching and training in rehabilitation and recovery locally and to provide a national<br />
model. We are also engaged with projects focusing on the well-being of the workforce to support practitioners<br />
developing their personal experience as expertise in recovery-focused practice. We are also working on the<br />
routine use of recovery outcome measures, supporting the development of peer support, recovery coaching,<br />
person-centred medicines management and supporting self management – and other Trust-wide<br />
developments. Each trainee’s personal programme will be built on gaining core specialty competencies and<br />
pursuing their particular interests and needs.<br />
14
Weekly Timetables<br />
TRAINEE TIMETABLE:<br />
am<br />
pm<br />
Monday Tuesday Wednesday Thursday Friday<br />
9:00-12:00 9:00 Handover<br />
9.00 Handover<br />
Community Work<br />
(Russell Clinic)<br />
9:00 Handover (Russell<br />
Clinic)<br />
1:30-2:30 (1 st , 3 rd Mondays<br />
of the month):<br />
Multidisciplinary clinical<br />
supervision (facilitated by<br />
clinical psychologist)<br />
3:00-4:00 Clinical<br />
Supervision with Dr Bora<br />
12:30-1:30 Case<br />
Conference/Journ<br />
al Club<br />
2:00-4:00 Clinical<br />
Reviews<br />
10:00-12:00 CORE<br />
group (4 th Weds of<br />
every<br />
month)/FORUM<br />
(3 rd Weds of every<br />
2 months)<br />
1:00-3:30<br />
Community team<br />
Meeting<br />
Study/ Research<br />
Day<br />
Russell Clinic ward<br />
work<br />
Work with<br />
community<br />
team/assessments/<br />
admin<br />
ON CALL:<br />
1:14 with Consultant Cover<br />
TRAINER TIMETABLE:<br />
am<br />
pm<br />
Monday Tuesday Wednesday Thursday Friday<br />
8.00 Admin time<br />
8.00 Admin 8.00 Admin time Not at work. 1 8.00 Admin time<br />
time<br />
SPA off-site.<br />
9.00 Handover (Russell<br />
Clinic)<br />
1:30-2:30 (1 st , 3 rd<br />
Mondays of the month):<br />
Multidisciplinary clinical<br />
supervision (facilitated by<br />
clinical psychologist)<br />
2-5pm Client<br />
Reviews<br />
(Russell Clinic)<br />
9.00 Handover<br />
10-12 CORE group (4 th<br />
Weds of every<br />
month)/FORUM (3 rd<br />
Weds of every 2<br />
months)<br />
1-3.30 Community team<br />
Meeting<br />
(Clinical cover by<br />
Dr Mary<br />
Rowlands)<br />
9.00 Handover<br />
(Russell Clinic)<br />
Loose ends and<br />
appointments<br />
3:00-4:00 Trainee<br />
Supervision<br />
15
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
General Adult Psychiatry<br />
Dr Phil de Warren-Penny<br />
Devon Partnership NHS Trust<br />
The Cedars, Wonford House Hospital, Exeter<br />
JOB DESCRIPTION: Dr Phil de Warren-Penny is Consultant Psychiatrist for Mid Devon Urgent & Inpatient Care,<br />
relating to Community Team bases in Tiverton and Crediton, affording the trainee the opportunity of following<br />
patient’s transition between Crisis/Home Treatment and Inpatient services. The ST4-6 trainee will work with<br />
him in providing clinical, diagnostic and risk management of individuals admitted to the Cedars under his care<br />
and under the auspices of the Crisis/ Home Treatment Team; proactive liaison with multidisciplinary teams<br />
regarding individuals using services; undertaking Mental Health Act Assessments; the provision of reports for<br />
and attendance at Mental Health Review Tribunals and Managers’ Hearings (under supervision); chairing CPA<br />
and 117 meetings; chairing ward rounds; clinical supervision and training of junior doctors; and participation in<br />
the Consultant on-call rota. The St4-6 trainee will be encouraged to take an active part in Audit.<br />
As relatively newly appointed consultant, having trained in <strong>Peninsula</strong> <strong>Deanery</strong> as an ST4-6 in the aftermath of<br />
MTAS, Dr de Warren-Penny is well aware of the tensions placed on Higher Specialist Trainees, and the need to<br />
gain experience in a variety of domains outside the clinical for ARCP progression, gaining CCST, and obtaining a<br />
Consultant post. He has previously been the Chair of the <strong>Peninsula</strong> Psychiatry SpR/ST4-6 group, and Chair of<br />
the Regional Junior Doctor’s Committee for the BMA.<br />
There is significant opportunity for exposure to Management and Leadership activities both within the Urgent<br />
& Inpatient Care Governance structure, and with other activities Dr de Warren-Penny undertakes. At present<br />
he is involved in working groups for: Medicines Management regarding injectable prescribing and rapid<br />
tranquilisation; a review of Mental Capacity Act and Deprivation of Liberty Safeguards arrangements in the<br />
Trust with a view to developing an Improvement plan; Mental Health Act Committee for Devon Partnership.<br />
Trainee participation in these activities, and others as they develop, would be both encouraged and welcomed.<br />
He currently is Chair of the Local Negotiating Committee for Devon Partnership, and an Executive Member of<br />
the BMA <strong>South</strong>west Regional Council.<br />
Dr de Warren-Penny also undertakes medico-legal work independent from his role within Devon Partnership<br />
Trust. Whilst not a core part of the role of any trainee with him, opportunities for developing this as a special<br />
interest whilst a trainee (as he did) would be supported.<br />
The post is supported by a CT1 trainee covering the ward, providing the opportunity for both teaching and<br />
mentoring. Regular placements of 3 rd and 5 th year medical students from <strong>Peninsula</strong> Medical School also<br />
provide teaching opportunity.<br />
Full secretarial support is provided. The post holder has timetabled regular consultant supervision and access<br />
to an SpR office within Wonford House Hospital.<br />
Weekly Timetables (see point 4 in Notes for Guidance)<br />
TRAINEE TIMETABLE:<br />
Please complete the proposed timetable for the trainee. This timetable must indicate the arrangements for<br />
Clinical and Educational Supervision<br />
16
Monday Tuesday Wednesday Thursday Friday<br />
a.m.<br />
9am Ward MDT 9am Ward MDT<br />
Meeting Meeting<br />
10 am Clinical 10am UIC Clinical<br />
Reviews Governance<br />
Meeting<br />
Special<br />
9am Ward MDT<br />
Interest/Research Meeting<br />
(Day subject to 10am Ward Round<br />
negotiation)<br />
9am Ward MDT<br />
Meeting<br />
10am Clinical<br />
Reviews / CRS<br />
Assessments<br />
p.m. Ward Round 12:30 – 1.30 Case<br />
Conference<br />
1.30 – 2.30 ST4-6<br />
Supervision<br />
Special<br />
Crisis Team<br />
Interest/Research assessments<br />
(Day subject to<br />
negotiation)<br />
Clinical Admin<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision<br />
1:14 On Call, non-resident, with consultant cover as “First on” the Consultant rota<br />
Clinical supervision available from Consultant on call, or through discussion with trainer afterwards.<br />
TRAINER TIMETABLE:<br />
Please complete the timetable for the trainer. This should show:<br />
1. regular scheduled Consultant supervision of one hour per week<br />
2. a substantial overlap with that of the doctor in training<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m.<br />
8am Clinical Admin 8am Clinical Admin 8am Clinical Admin 10-2 SPA for CPD/ 8am Clinical Admin<br />
9am Ward MDT<br />
Meeting<br />
9am Ward MDT<br />
Meeting<br />
9am Ward MDT<br />
Meeting<br />
Revalidation 9am Ward MDT<br />
Meeting<br />
10 am Clinical<br />
Reviews<br />
10am UIC Clinical<br />
Governance<br />
Meeting<br />
10am Ward Round<br />
10am Clinical<br />
Reviews<br />
p.m. Ward Round 12:30 – 1.30 Case<br />
Conference<br />
1.30 – 2.30 ST4-6<br />
Supervision<br />
12-1pm F2<br />
Supervision<br />
1pm crisis team<br />
assessments<br />
Management SPA<br />
(Management<br />
Supervision/Apprai<br />
sals/Job Planning)<br />
17
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
CRS/Home Treatment/Acute Inpatient Psychiatry<br />
Dr Tim Dickinson<br />
Devon Partnership NHS Trust<br />
Haytor Unit, Torbay Hospital<br />
JOB DESCRIPTION: The ST4-6 will provide medical input to both the Crisis Resolution/Home Treatment Team<br />
and the Acute Inpatient Service. Elements of these teams have integrated to provide a seamless service for<br />
people in mental health crisis in the community, through admission (if required) and back to community care<br />
providers (Primary Care/CMHT).<br />
The weekly timetable is flexible with little adherence to fixed clinical sessions, the Consultant and ST4-6<br />
providing input to the teams activities when and where needed. Each morning a one hour Acute Services<br />
meeting plans the activities for the day which ensures medical time is used most efficiently. There are nominal<br />
fixed sessions to allow multidisciplinary team meetings with community colleagues and these will usually be<br />
chaired either by the Consultant or ST4-6, depending on clinical need.<br />
Time will be provided for the ST4-6 to undertake supporting professional activities as well as protected time for<br />
a special interest or research. There is a rotational (4 monthly) F2 junior doctor attached to the team and we<br />
also provide <strong>Peninsula</strong> Medical School Year 5 placements (Specialities Block). The ST4-6 will be encouraged to<br />
participate in the teaching and assessment of these junior colleagues.<br />
The service locally is undergoing a substantial redesign and there will be opportunity for the ST4-6 to gain<br />
experience in the management of this process.<br />
Office space will be provided in the Crisis Resolution/Home Treatment Team office with administrative support<br />
from the Consultant’s secretary.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
Wednesday<br />
TRAINER A.M. P.M.<br />
9am-10am Acute Services Meeting<br />
10-12pm Flexible<br />
Clinical/Supporting<br />
12-1pm Supervise ST4-6<br />
9-10am Acute Services Meeting<br />
10-12am Flexible<br />
Clinical/Supporting<br />
12-1pm Supervise F2<br />
9am-10am Acute Services Meeting<br />
10-1pm Flexible Clinical/Supporting<br />
1-5pm Multidisciplinary Team<br />
Meetings<br />
1-2pm Flexible Clinical/Supporting<br />
2-5pm Local Academic Programme<br />
1-5pm Multidisciplinary Team<br />
Meetings<br />
Thursday<br />
Friday<br />
9am-10am Acute Services Meeting<br />
10-1pm Flexible Clinical/Supporting<br />
9am-10am Acute Services Meeting<br />
10-1pm Multidisciplinary Team<br />
Meetings<br />
10-1pm Flexible Clinical/Supporting<br />
1-5pm Flexible Clinical/Supporting<br />
18
TIMETABLE:<br />
Monday<br />
TRAINEE A.M. P.M.<br />
9-10am Acute Services Meeting 1-5pm Multidisciplinary Team<br />
10-1pm Flexible Clinical/Supporting Meetings<br />
Tuesday<br />
Wednesday<br />
9-10am Acute Services Meeting<br />
10-1pm Flexible Clinical/Supporting<br />
9-10am Acute Services Meeting<br />
10-1pm Flexible Clinical/Supporting<br />
1-2pm Flexible Clinical/Supporting<br />
2-5pm Local Academic Programme<br />
1-5pm Multidisciplinary Team<br />
Meetings<br />
Thursday Research/Special Interest Research/Special Interest<br />
Friday<br />
9-10am Acute Services Meeting<br />
10-1pm Multidisciplinary Team<br />
Meetings<br />
1-5pm Flexible Clinical/Supporting<br />
19
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
East Devon Crisis Team and Inpatient Consultant Psychiatrist<br />
Dr Charles Dixon<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION:<br />
The Urgent and Inpatient Care network look after the most acutely mentally ill people for a short time during<br />
their crisis. This can occur at home with support from the Crisis Resolution Team or may require a stay on the<br />
inpatient unit. This post involves working across these two areas with clients who live in East Devon. The post<br />
is based in Exeter with the Crisis Resolution Team located within the inpatient unit at The Cedars in the grounds<br />
of Wonford House Hospital. The trainee would have the opportunity to work with the inpatient team and the<br />
Crisis Team and follow the patient’s journey across services.<br />
Dr Dixon is a popular dynamic young Consultant who trained as an SpR in the <strong>Peninsula</strong> and understands the<br />
training needs of ST4-6’s and can help them on their path to a CCT and Consultant job. As well as being the<br />
Clinical Tutor for Exeter, East & Mid Devon, he is also heavily involved in undergraduate teaching with the<br />
<strong>Peninsula</strong> College of Medicine and Dentistry and leads psychosis week and a fifth year psychiatry pathway<br />
among other things. Any trainee would have the opportunity to be involved with this teaching.<br />
The post comes with full secretarial support, a spacious office and a GP trainee covering the ward. There is a<br />
well attended clinical education meeting with lively discussion every week which is led by Dr Dixon.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
A.M.<br />
Planning Meeting<br />
Review new admissions<br />
Planning Meeting<br />
Medical Students welcome<br />
Clinical Education Meeting<br />
P.M.<br />
Crisis Team Assessments<br />
Ward Round<br />
Crisis Team Assessments<br />
Wednesday Planning Meeting<br />
Crisis Team Assessments<br />
Crisis Team Assessments<br />
Ward Round<br />
Thursday Special Interest Research<br />
Friday<br />
Planning Meeting<br />
Inpatient Reviews / CRS as needed<br />
Medical Students teaching<br />
Crisis Team Assessments<br />
ST4-6 Supervision<br />
On-Call 1: 20 with Consultant Cover<br />
20
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Forensic<br />
Dr Eluned Dorkins<br />
Devon Partnership Trust<br />
ONE YEAR FORENSIC PLACEMENT (RUNNING FROM AUGUST TO JULY)<br />
This post is designed for specialist trainees who wish to gain a broad experience of what forensic mental health<br />
services can offer. In particular, it aims to help trainees develop their risk assessment and management skills<br />
through a structured approach and by exposure to a variety of different clinical environments, (where the<br />
elements of structural, relational and procedural security all vary). The aim is to develop skills which will have a<br />
broad applicability in whatever context trainees will work in the future.<br />
Langdon Hospital has an established track record in providing forensic training and is the base of the <strong>Peninsula</strong><br />
<strong>Deanery</strong> Forensic Training Scheme for ST4 to ST6. There are already three forensic trainees on the site so that<br />
trainees from the general scheme will automatically have a peer group based at Langdon during the year’s<br />
attachment.<br />
The year is divided into two x six month placements, the first starting in the medium secure environment,<br />
followed by a placement in open/low secure settings which serve different a different population. e.g Owen<br />
House (open complex care and rehabilitation),<br />
There is a separate on line guide describes each of these placements in detail. This includes induction, a brief<br />
description of the units, a timetable for the trainee, the competencies which can be achieved, particular<br />
training opportunities and the kind of objectives that can be set. A variety of special interest sessions are also<br />
described, although it is anticipated that the general psychiatric trainee may have other interests they wish to<br />
pursue, granted that they may not be heading for a career in forensic psychiatry. The documentation also<br />
includes a map of general and specific knowledge and skills which can be obtained during the placement,<br />
mapping out how these could be achieved through a variety of different mechanisms.<br />
There is also an academic programme that runs throughout the year, which takes place on a Thursday<br />
afternoon, which includes a lunchtime multidisciplinary case conference, followed by a medical academic<br />
programme. The trainees will take part in this; this includes journal club, medico legal presentations, and<br />
challenging cases. There is also clinical governance programme, that runs through the hospital site and again<br />
trainees will be anticipated to take part in this in whatever setting they find themselves.<br />
There are sessions in psychodynamic psychotherapy related to forensic patients which general adult trainees<br />
are also welcome to attend.<br />
The trainee will have one supervisor for each placement who will provide both clinical and educational<br />
supervision. However, to ensure continuity, the trainee will meet with the training programme director shortly<br />
after starting the year, at six months and then at the ARCP. Trainees can also meet with the training<br />
programme director informally throughout the year. Trainees who are considering undertaking this placement<br />
can contact the training programme, Dr Eluned Dorkins, at any point during the year and can make an<br />
appointment to discuss their specific training needs. Contact details: Jenny Peterson – 01626 884423 –<br />
jenny.peterson@nhs.net or eluned.dorkins@nhs.net<br />
First placement August-January Dewnans centre Dr John Parker<br />
Second placement February-July Owen House Dr Eluned Dorkins<br />
21
There are plans to include training in the low secure units on site as an alternative to one of the units above<br />
pending the approval of other trainers. This can be discussed with Dr Dorkins. The job description will be<br />
amended to reflect this in due course.<br />
FIRST PLACEMENT : AUGUST-JANUARY<br />
Cofton Ward (rehabilitation and recovery wards in medium security), Dewnans Centre, Langdon Hospital<br />
Supervisor :Dr John Parker<br />
Monday<br />
AM LUNCH PM<br />
9am admin, ward work and<br />
assessments<br />
MHT’s, Managers Hearings,<br />
ward work, assessments.<br />
Tuesday<br />
9.30am Care Review<br />
meeting.<br />
3.00 p.m. Supervision with<br />
consultant.<br />
Wednesday<br />
Thursday<br />
MHRT’s, manager hearings,<br />
ward work, assessments<br />
9am Referrals meeting<br />
10am<br />
Governance/Management<br />
meetings<br />
11:45am MDT meetings<br />
1:30pm – 5pm CPA’s on<br />
alternate Wednesdays<br />
otherwise assessments<br />
1pm - 4 pm Academic<br />
programme<br />
Friday Research/special interest Research/special interest<br />
SECOND PLACEMENT : FEBRUARY-JULY<br />
Owen House (Open complex care unit), Langdon Hospital<br />
Supervisor :Dr Eluned Dorkins<br />
Monday<br />
Tuesday<br />
a.m. Lunch p.m.<br />
Assessments, reports, MHTs<br />
Supervision 11.30<br />
Ward work/mental health review<br />
tribunals/governance project work<br />
Care review meeting 9.30 to<br />
Assessments/report writing<br />
12.30<br />
Cluster governance meeting<br />
1st Tuesday of month 13.30 to15.30<br />
Wednesday CPA meetings Ward work<br />
Thursday 9 a.m. Referral meeting 11.45 multidisciplinary<br />
10 a.m.<br />
Administration/HCR20/Case<br />
summary preparation, etc<br />
site wide Case<br />
Conference.<br />
1 – 5 p.m.<br />
Doctors meeting including Journal<br />
Club, Medico-legal presentations.,<br />
management meetings, etc<br />
Friday<br />
Special Interest/ Research sessions as agreed in advance with measurable goals<br />
22
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Old Age Psychiatry, Estuary House, Newton Abbot<br />
Dr John Dunn<br />
Devon Partnership NHS Trust<br />
This post offers the opportunity for a Specialty Trainee to gain experience in a mainly community based Old<br />
Age Psychiatry service but fitting the job to their stage of development on the scheme. The core service is a<br />
multi-disciplinary community team. There has also been the development of an Early Detection and<br />
Intervention in Dementia service (EDI) under a newly appointed consultant Dr Deepak Sachdeva which is<br />
connected to the Community team. The area whilst primarily described as rural has a good road network and a<br />
population concentration in a few small towns and large villages. Thus apart from the memory clinic,<br />
assessment and treatment is largely by home visits though outpatient space is available if needed at<br />
Sherbourne House, Newton Abbot. However opportunities to work in inpatient settings, EDI service and<br />
prescription of cholinesterase inhibitors are available. The post could also offer the opportunity to act in the<br />
capacity of ‘Consultant’ in part of the patch enabling the Specialty Trainee at the end of their rotation to<br />
experience the demands of the future in a supervised way. Considerable flexibility is envisaged in the<br />
timetable to allow specific educational needs to be met. Experience with the Consultant being responsible for<br />
ECT is also possible. The Specialty Trainees have a major part in the educational sessions and audit in the<br />
locality.<br />
With recent reconfiguration and growing interagency working there are a number of avenues to gain<br />
experiences in service development, committee work and guideline development.<br />
TIMETABLE (flexible):<br />
Monday<br />
A.M.<br />
9-11am ECT clinic (Torbay Gen<br />
Hospital)<br />
11-12pm Administration<br />
12-2pm Memory Clinic Feedback<br />
Meeting<br />
P.M.<br />
2-3pm Supervision with Consultant<br />
3-5pm Community visits<br />
Tuesday<br />
9-11am Community Team Meeting<br />
11-1pm Liaison and supervision<br />
with team<br />
1-5pm Supporting activities –<br />
educational meeting monthly,<br />
audit bimonthly, management<br />
meetings monthly. CPD,<br />
educational supervision<br />
Wednesday Special Interest Session Special Interest Session<br />
Thursday<br />
Friday<br />
On-Call 1: 10 with Consultant Cover<br />
9-11pm ECT clinic (Torbay Gen<br />
Hospital)<br />
11-1pm Community visits<br />
[EDI clinic day]<br />
9-1pm Outpatients or community<br />
visits/work<br />
[EDI clinic day]<br />
1-5pm Flexible time for CPD,<br />
management, training<br />
1-5pm admin/community work<br />
23
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Learning Disabilities<br />
Dr Rolf Feller<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION: The StR post for higher training in adult Psychiatry of Learning Disabilities is a unique<br />
opportunity to gain experience in the assessment and treatment of individuals who suffer from a whole range<br />
of psychiatric disorders in the context of impaired and arrested development of their intellectual and cognitive<br />
function. Communication difficulties are one of the main problems for individuals with LD in particular in the<br />
context of Autistic Spectrum Disorders, specific syndromes and severe and profound LD. All this can lead to<br />
extreme distress and maladaptive behaviour and is often complicated by underlying physical illness, epilepsy,<br />
pre-senile dementia. These issues are addressed by multidisciplinary teams in the community and in the two<br />
regional in-patient units located in Exeter. Special interest sessions in Genetics and Neuropsychiatry are<br />
available locally and there are excellent research facilities and opportunities within this speciality.<br />
TIMETABLE:<br />
This timetable is flexible to a degree and can be negotiated according to the needs of the StR trainee.<br />
A.M.<br />
P.M.<br />
Monday ASU and Knightshayes inpatient unit Outpatient clinic, Franklyn House<br />
Tuesday<br />
Allocation meeting, Franklyn House<br />
Ward round, Knightshayes<br />
Admin/Supervision<br />
Wednesday Home visits<br />
Special Interest Session<br />
Admin/New Referrals<br />
Thursday Outpatient clinic, Franklyn House Ward round at ASU<br />
Friday Admin and Emergencies Research Session<br />
ASU – Additional Support Unit, Whipton Hospital, Whipton, Exeter<br />
Knightshayes – Inpatient unit, Whipton Hospital, Whipton, Exeter<br />
Frankly House – Learning Disabilities Community Team Base, StR base, Franklyn Drive, St. Thomas, Exeter,<br />
EX2 9HS. Secretary: Tracy Austin 01392 208741.<br />
On-Call 1: 10 with Consultant Cover<br />
24
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Adult Psychiatry<br />
Dr Tegwedd Freer<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION: The Specialty trainee will be a valued member of Exmouth CMHT, having a clinical role both<br />
within the Wellbeing and Access team and the Recovery and Independent Living team, both based at Danby<br />
Terrace CMHT. In the absence of the Consultant, the teams will look to the trainee for a medical viewpoint and<br />
guidance. The trainee is expected to attend and contribute to the weekly team meetings and regular team<br />
educational meetings and case discussions. There will be opportunities to take on a managerial role within the<br />
teams if so wished.<br />
Trainees will be on call approx 1 in 14 on the consultants On Call rota. This includes section 12 work. On Call<br />
responsibility is from 5pm to 9am weekdays and 9am Saturday to 9am Monday on weekends. Part timers will<br />
be pro rata.<br />
Academic activities include attendance at the weekly Journal Club and Case Conference at Wonford House.<br />
There are also ample opportunities for research projects within the Research and Development Department in<br />
the Trust.<br />
Learning outcomes will be identified at the beginning of your placement and the clinical content of the weekly<br />
timetable adjusted to ensure these can be met.<br />
TIMETABLE:<br />
A.M.<br />
P.M.<br />
Monday MAC Meeting Consultants Meeting Supervision with Consultant<br />
Tuesday Team meeting<br />
W & A client medical assessments<br />
Case Conference<br />
Wednesday Clinical administration<br />
RIL client CPA Reviews<br />
Journal Club<br />
Thursday TBA Special Interest<br />
Friday TBA Research<br />
On Call: 1:14 with Consultant Cover<br />
25
TRAINING POST IN:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
Community Psychiatry<br />
Dr Kate Lovett<br />
Devon Partnership NHS Trust<br />
Estuary House, Newton Abbot<br />
JOB DESCRIPTION: This post provides excellent training in community psychiatry through an integrated<br />
experience of working with an assertive outreach team, assessment and short intervention team and longer<br />
term recovery team. Trainees will have the opportunity to gain experience in modern community psychiatry<br />
with significant opportunities for involvement in service development. The overall psychiatric service focuses<br />
on effective gate-keeping of inpatient beds and facilitation of early discharge. The post gives the opportunity<br />
to gain competencies in acute psychiatric care in the community by gaining experience in looking at<br />
alternatives to hospital admission and effective home treatment. The focus throughout is on providing<br />
effective treatment and care that makes it safe for patients to recover.<br />
The service covers the Teignbridge area of <strong>South</strong> Devon which serves a population of approx. 130,00 centred<br />
around the towns of Teignmouth, Newton Abbot, Totnes and Dartmouth and surrounding rural villages. This<br />
post serves 6 GP practices in the Newton Abbot area providing good opportunities for primary care liaison.<br />
In addition to support from the consultant the service is supported by a part time staff grade and CT1-3 trainee.<br />
Torbay hospital has a well-established academic and audit programme and it is expected that the ST4-6 trainee<br />
would take an active role within this. There is access to appropriate IT and library facilities within the hospital<br />
site.<br />
Dr Lovett has been a consultant for 12 years. She trained in Manchester, obtaining a Distinction in Psychiatry<br />
at finals. Her MSc thesis was on the role of ovarian steroids in the development of postnatal depression. She<br />
has worked for the last 6 years in Urgent and Inpatient Psychiatry having worked as a sector psychiatrist prior<br />
to reconfiguration. Her involvement in training has been longstanding. She was formerly Lead for<br />
Undergraduate Psychiatry in the Plymouth locality for the <strong>Peninsula</strong> College of Medicine and Dentistry. She<br />
obtained a Postgraduate Certificate in Clinical Education with Distinction in 2008, the same year in which she<br />
became a Fellow of the Royal College of Psychiatrists. She has now trained 5 SpRs and has been Training<br />
Programme Director for General and Old Age Psychiatry in the <strong>Peninsula</strong> <strong>Deanery</strong> since 2009. She is elected to<br />
the Central Education, Training and Standards Committee of the Royal College of Psychiatrists and is an<br />
examiner for the CASC exams. In January 2012 she was appointed as Head of School of Psychiatry for the<br />
<strong>Peninsula</strong> <strong>Deanery</strong>.<br />
WEEKLY TIMETABLES<br />
TRAINEE TIMETABLE:<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m. AOS meeting<br />
ST supervision<br />
Clinic<br />
Recovery Team<br />
Meeting<br />
Research/Special<br />
Interest<br />
Clinic<br />
p.m. Clinic Academic<br />
Teaching<br />
Emergency<br />
Assessments<br />
Research/Special<br />
Interest<br />
Admin<br />
26
On Call is currently 1:14. Involves Section 12 assessments at Torbay police station, Alternative Place of Safety<br />
Unit based in inpatient unit and community assessments as necessary. Involves advice to first on call CT1-3<br />
doctor and is supported by on-call consultant who is available for advice.<br />
TRAINER TIMETABLE:<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m. AOS Meeting Clinic Recovery Team<br />
Meeting<br />
Referral Meeting<br />
Referral Meeting SPA<br />
p.m.<br />
Clinic<br />
ST supervision<br />
Academic<br />
Teaching/<br />
Consultant<br />
Meeting<br />
Admin Clinic SPA<br />
27
POST:<br />
TRAINER:<br />
RESEARCH INTERESTS:<br />
EMPLOYING TRUST:<br />
Adult and Community Psychiatry, Exeter<br />
Dr Sean Lynch<br />
Chronic Fatigue Syndrome and Somatoform Disorders<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION: This post offers experience in assertive outreach approaches (including outreach with the<br />
homeless mentally ill) or community psychiatry.<br />
The community psychiatry component (general adult psychiatry) is based in Exeter and involves the Recovery<br />
and Independent Living Team (formerly CMHT) with opportunities for new patient reviews, community and<br />
hospital reviews (with the team). The service operates within a ‘New Ways of Working’ model, with reviews<br />
being largely planned jointly with care co-ordinators and other staff on the team. The team also receives new<br />
patient referrals (triaged by the Wellbeing and Access team). About 45-50,000 adults of working age in Exeter<br />
are covered by this part of the Recovery and Independent Living Team. The team is multidisciplinary with<br />
nursing, social work, occupational therapy and recovery/support workers. Dr Saluja (consultant psychiatrist)<br />
and Dr Pieczora (Associate Specialist) and a core trainee at CT2 level, work alongside the trainer, covering the<br />
remaining areas of the Recovery and Independent Living Team. Cross-cover arrangements are well-established<br />
between medical staff (it is anticipated that an additional core training post will be allocated to the service in<br />
February 2010).<br />
The Wellbeing and Access service, a new service with a primary care liaison function and which co-ordinates<br />
and triages referrals and assessments, has been developed. This is multidisciplinary and based in Exeter. It has<br />
close relationships with primary care services and can offer brief working and also assessment of referrals. This<br />
might also offer training opportunities of interest to specialty trainees.<br />
The Assertive Outreach component is based in Mid-Devon with the AOT base being in Crediton. This is a rural<br />
area and offers experience of this model of assertive outreach. The team consists of nursing and occupational<br />
therapy disciplines. This is a wide geographical area with two major clinical bases at Hillbank in Crediton and<br />
Silverlea at Tiverton. It has a caseload of about 39 patients, three care co-ordinators and a support worker.<br />
Care is delivered by a team-based approach. Regular clinical review meetings are held as well as planning and<br />
feedback meetings as per the Policy Implementation Guidelines for AOT services.<br />
The Outreach service for the homeless mentally ill of Exeter is based at the Clocktower Surgery in Exeter. The<br />
mental health workers in the service consist of two CPN’s and a social worker. The service links closely and<br />
seamlessly with the primary care team for the homeless and SHOT team (housing and accommodation<br />
outreach and support). About 70 patients are on the caseload of the mental health workers who have complex<br />
needs and co-morbidities in addition to severe mental illness. Due to their complex needs liaison with the<br />
Exeter AOT and ENDAS/EDP (alcohol and substance use services) frequently occurs. The service offers<br />
experience of outreach approaches for this patient group within in an inner urban area and of multi-agency<br />
working. There are regular Clinical Team / Review meetings and the team is moving towards a team-based<br />
model of working for more complex clients.<br />
Additional training opportunities include the special interest of the trainer in chronic fatigue syndrome and<br />
related disorders. The trainer has a wide range of interests and experience in medical education and research<br />
and can offer supervision opportunities in these areas.<br />
28
TIMETABLES<br />
TRAINER A.M. P.M.<br />
Monday<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT),<br />
Exeter<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT),<br />
Exeter<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
Friday<br />
Team Meeting Recovery and<br />
Independent Living Team (CMHT),<br />
Exeter<br />
CFS / ME Clinic, Whipton Hospital,<br />
Exeter<br />
Mid Devon Assertive Outreach<br />
Team Clinical Meeting. Crediton<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT),<br />
Exeter<br />
4pm Clinical Supervision<br />
Clocktower Surgery, Exeter<br />
(Outreach Service for Homeless<br />
Mentally Ill)<br />
4 pm Educational Supervision<br />
Patient reviews with Mid, Devon<br />
AOT, Tiverton<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT)<br />
or Wellbeing and Access Team<br />
(primary care liaison)<br />
4pm Educational Supervision<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT)<br />
or Mid Devon AOT<br />
TRAINEE A.M. P.M.<br />
Monday<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT),<br />
Exeter<br />
Patient reviews with Recovery and<br />
Independent Living Team (CMHT),<br />
Exeter<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
0915-1115 Team Meeting Recovery<br />
and Independent Living Team<br />
(CMHT), Exeter<br />
1130-1345 Clinical Education<br />
Programme (Case Conference and<br />
Journal Club)<br />
Special Interest Session or Patient<br />
reviews with Recovery and<br />
Independent Living Team (CMHT)<br />
Mid Devon Assertive Outreach<br />
Team Clinical Meeting. Crediton<br />
4pm Clinical Supervision<br />
Clocktower Surgery, Exeter<br />
(Outreach Service for Homeless<br />
Mentally Ill)<br />
4 pm Educational Supervision<br />
Special Interest Session or Patient<br />
reviews with Mid-Devon AOT<br />
Patient reviews with Mid-Devon<br />
AOT<br />
4pm Educational Supervision<br />
29
Friday<br />
Research<br />
Research<br />
On-Call 1: 14 with Consultant Cover<br />
30
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Psychotherapy<br />
Dr C Susan Mizen<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION: The Psychotherapy department at Wonford House is a busy outpatient service offering a<br />
range of therapies and with an emphasis on the treatment of patients with severe and enduring mental illness.<br />
The population served by the service is 243,000 and it is available to adults between the ages of 18 and 65. The<br />
service receives around 160 referrals per year from Exeter, East Devon and Mid Devon. There is a full time<br />
Consultant Psychiatrist in Psychotherapy in post, Dr C S Mizen. The service offers long term psychodynamic<br />
psychotherapy and gestalt therapy once weekly, a number of short term intervention, group analytic<br />
psychotherapy and systemic family and couple therapy. A new service for patients with severe personality<br />
disorders offering teams has been developed. A proposal is under discussion for incorporating this service for<br />
people with personality disorder into a therapeutic community day service. The service operates as part of a<br />
co-ordinated psychological therapies service with psychology and creative therapies services locally.<br />
The Specialty Trainee would be offered an opportunity to run a group for patients with Borderline Personality<br />
Disorder with Dr Mizen and to participate in the liaison with psychiatric teams which takes place alongside this<br />
service. This would include offering consultation under supervision to psychiatric wards about management of<br />
PD patients who are frequently admitted to hospital. In addition the trainee would have the opportunity to see<br />
patients under supervision for long term or brief individual psychodynamic therapy, cognitive analytic therapy<br />
or cognitive behaviour therapy. There would also be opportunities to become involved in family therapy and<br />
to gain experience in assessing patients for psychotherapy under supervision. There are regular opportunities<br />
for teaching in the department to SHOs and medical students as well as to trainee therapists. There are<br />
opportunities to participate in the new MSc in Psychotherapy being run in conjunction with Exeter University.<br />
This can lead to UKCP accreditation in systemic, dynamic or cognitive therapies, for interested trainees.<br />
The Psychotherapy department occupies spacious facilities, recently refurbished within the main hospital<br />
building at Wonford House with a number of rooms available for individual and group therapy as well as a<br />
family therapy suite with two way screen and video equipment. The Specialty Trainee would have access to<br />
office pace throughout the week. The service has a full time secretary.<br />
TIMETABLE<br />
A.M.<br />
P.M.<br />
Monday<br />
9.30 Individual Patient<br />
10.30 Psychotherapy Assessment<br />
Audit, Teaching, Supervision,<br />
Clinical Work<br />
12.00 - 1.00 Supervision with<br />
Consultant<br />
Tuesday TBA Special Interest<br />
Wednesday<br />
Thursday<br />
9.30 - 11.00 Group for borderlines<br />
with Dr Mizen<br />
11.00 - 1.00 Patient/Admin<br />
9.30 Patient<br />
11.00 - 1.00 Supervision of PD<br />
Projects, Academic Programme,<br />
Departmental Meeting<br />
Friday TBA Research<br />
On-Call 1: 14 with Consultant Cover<br />
Monthly Specialty Trainee Meeting<br />
2 nd Monday of month<br />
Academic Afternoon<br />
31
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Early Intervention in Psychosis<br />
Exeter<br />
Dr Charles Montgomery<br />
Devon Partnership NHS Trust<br />
This post is based at Wonford House Hospital in Exeter. STEP is a relatively new specialty service within the<br />
access and well-being network providing tailored psychosocial and pharmacological interventions for first<br />
episode clients. We work with young people aged 14-35 in an assertive befriending model of care for up to<br />
three years. The trainee would gain experience in to how to engage troubled young people who are often<br />
ambivalent about seeking help. The trainee would become adept at distinguishing symptoms of psychosis from<br />
adolescent angst and would learn to work with diagnostic uncertainty often in the context of recreational drug<br />
use. There is ample opportunity to gain experience of working with families and to input into our carers<br />
support group. CBT and psycho-education are the bread and butter of EI work and the trainee would learn lots<br />
from the skilled clinical team employing these skills. Positive risk management is a regular feature of the work<br />
which the trainee would learn about. There are regular teaching and training opportunities at the PMS, in GP<br />
outreach seminars and in a number of youth settings.<br />
The team welcomes Specialty trainees and takes pride in sharing the positive and forward looking EI ethos that<br />
has been fostered over recent years. We are highly motivated to making a real difference to client’s lives and<br />
this makes for a fun and enthusiastic working atmosphere. The team comprises two administrators, one<br />
Clinical team lead, one psychologist, one occupational therapist, and seven nurse practitioners.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
A.M.<br />
Consultant Meeting<br />
MAC Meeting<br />
Home visits<br />
Specialist trainee supervision<br />
P.M.<br />
Home visits<br />
Case Conference WHH<br />
Home visits<br />
Wednesday<br />
STEP clinical meeting.<br />
STEP Supervision<br />
Journal Club (Consultants and<br />
trainees)<br />
.<br />
Thursday Research Session Special Interest<br />
Friday Home visits Clinic at YES, Exeter.<br />
On-call<br />
1 in 17, Consultant Rota with Consultant Cover<br />
32
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
General Adult Community Psychiatry<br />
Dr Andrew Moore<br />
Devon Partnership NHS Trust<br />
North Devon District Hospital (NDDH), Raleigh Park, Barnstaple, EX31 4JB and<br />
The Gables, 1 Belmont Rd, Ilfracombe, EX31 8DR<br />
JOB DESCRIPTION: This post offers both a broad-based general adult psychiatry experience, and experience in<br />
management and leadership, in a beautiful part of Devon. The post involves training and working with<br />
Wellbeing &Access, and Recovery & Independent Living community teams based at Riverside (Barnstaple) and<br />
The Gables (Ilfracombe) covering a population of c52,000. We also provide medical input to the STEP (Specialist<br />
Team for Early Psychosis) and Assertive Outreach Teams, as well as liaising with the CRHTT and Acute IP wards.<br />
There is a new Liaison service in NDDH with opportunities for training/experience if desired. Dr Moore is the<br />
Clinical Director for the Adult Directorate (covering the whole Trust), so there is ample opportunity to gain<br />
experience in management and clinical leadership. Thus the post is an excellent one for trainees wishing to<br />
develop their overall "generic" clinical skills whilst being able to still focus on specialist areas too, and gain<br />
wider management/leadership skills. Inpatient/CRHTT work is led by Dr Gilhooly and his team, and there are 3<br />
other community based Consultants (one of whom, Dr Kerry Jonsson, is p/t in Dr Moore’s team) making up a<br />
small but friendly locality.<br />
Dr Moore has interests in Medical Management, Teaching/Medical Education and Spirituality in Mental<br />
Health, but trainees will be equally supported to pursue their own interests. There are good relationships with<br />
local GPs so trainees will be encouraged to build on this, e.g. with practice visits. There is also an active<br />
Postgraduate Training programme with weekly meetings and a Journal Club which trainees of all grades are<br />
expected to contribute to.<br />
On call experience can be arranged to suit the individual trainee. Section 12 training/approval is encouraged,<br />
and plentiful experience can be gained in Community Mental Health Act Assessments, CTO’s (including CTO<br />
Tribunals) and S136 work.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
Wednesday<br />
A.M.<br />
9-1 pm OPC Riverside(Dr Jonsson)<br />
Or management work with Dr Moore<br />
9.30-11am Consultant &SpR meeting,<br />
NDDH<br />
11-1pm Postgraduate seminar, NDDH<br />
9-11am CMHT meetings, R’side, adhoc<br />
appts/CPA’s<br />
11.30-12.00 (once monthly) STEP,<br />
R’vale<br />
P.M.<br />
Admin/SPA time<br />
Or management work with Dr<br />
Moore<br />
1-2pm Journal club NDDH<br />
2-5pm Flexible: Adhoc<br />
appointments, CTO managers<br />
hearings, clinical admin, DVs<br />
12-1.30pm CMHT<br />
educational/business meet<br />
(alternate fortnightly)<br />
2.30-5pm OPC Gables, Ilfracombe<br />
Thursday Special Interest Special Interest<br />
Friday 9.30-1.00 OPClinic, Gables 1-2 PM Supervision<br />
2-5PM Admin/audit<br />
33
Training Post in<br />
Training Base<br />
Trainer<br />
Psychiatry<br />
The Cedars, Exeter<br />
Dr Giovanni Salvi (the role of trainer will be rotated with Dr Tanya Nelson yearly)<br />
Weekly Timetables<br />
TRAINEE TIMETABLE:<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m.<br />
CRS<br />
Inpatient ward<br />
Research/special<br />
interest<br />
Inpatient ward<br />
CRS<br />
ST4-6 supervision<br />
Academic<br />
programme<br />
p.m. CRS Inpatient ward<br />
Research/special<br />
interest<br />
Inpatient ward<br />
CRS<br />
F2 supervision<br />
The final timetable and the nature of the work undertaken will be determined by the educational objectives<br />
and training needs of the Specialty Trainee, in discussion with Dr Salvi and Dr Nelson. As far as the clinical<br />
commitments are concerned, the guiding principle will be that time will be spent with both the ward and the<br />
crisis team.<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervisio<br />
On-Call 1: 10 with Consultant Cover<br />
TRAINER TIMETABLE:<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m.<br />
Ward meeting<br />
Ward meeting<br />
Ward meeting<br />
Ward meeting<br />
Ward meeting<br />
ST4-6 supervision<br />
The Cedars<br />
governance<br />
meeting<br />
Ward round<br />
Ward round<br />
Review of new<br />
admissions<br />
Academic<br />
programme<br />
34
p.m.<br />
Review of new<br />
admissions<br />
CPD<br />
Ward round Ward round Urgent ward work<br />
F2 supervision<br />
CPD<br />
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
INTERESTS:<br />
General Adult Psychiatry (Urgent and Inpatient Care)<br />
Mid Devon Crisis Team and Inpatients at The Cedars<br />
Dr Peter Noble<br />
Devon Partnership NHS Trust<br />
Service development, Electronic patient records, Philosophy of Psychiatry<br />
JOB DESCRIPTION: This post is based at Wonford House and The Cedars in Exeter. The Cedars contains two<br />
wards for inpatients from Exeter, East and Mid Devon. Dr Noble is Consultant for Mid Devon inpatients and the<br />
crisis team There is an unified crisis team covering all three areas working with Dr Tanya Nelson (Exeter) and<br />
Dr Charles Dixon (East Devon) as well as Dr Noble. The details of the focus of the post and the day (or days) of<br />
protected time can be adapted according to the preferences of the trainee for crisis or inpatient work, or a<br />
combination of the two. One possibility would be to mainly be based in the crisis team and to work with the<br />
team for patients in East and Mid Devon (working also with Dr Charles Dixon). Full secretarial support is<br />
provided. The post holder has timetabled regular consultant supervision and access to an SpR office. The post<br />
is supported by a CT1-3 trainee. Please feel free to contact Dr Peter Noble at any time to discuss the post<br />
further. The trainee will take part in the Exeter consultant on call rota with supervision by a named consultant.<br />
The rota is currently approximately 1 in 16.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
A.M.<br />
9-10 am Ward meeting or CRS<br />
handover<br />
CRS assessments<br />
9-10 am Ward meeting or CRS<br />
handover<br />
Teaching students/ward work<br />
P.M.<br />
1.30 CRS handover<br />
3.30-5.00 pm Governance meeting<br />
1.30 CRS handover<br />
CRS assessments<br />
Wednesday Special interest and SpR meetings Special interest and SpR meetings<br />
Thursday<br />
9-10 am Ward meeting or CRS<br />
handover<br />
CRS assessments<br />
1.30 CRS handover<br />
2.00-3.00 pm Educational<br />
supervision<br />
3.00-5.00 pm Clinical admin<br />
Friday Research Research<br />
On-Call 1: 16 with Consultant Cover<br />
35
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
Old Age Liaison Psychiatry<br />
Dr Colm Owens<br />
Devon Partnership NHS Trust<br />
Wonford House Hospital Exeter/ Royal Devon and Exeter Hospital<br />
JOB DESCRIPTION: The Older People’s Liaison Psychiatry Service was set up in July 2010 it is provided by the<br />
Devon Partnership Trust but hosted by the Royal Devon & Exeter acute trust. All patients aged over 65 (or<br />
patients of any age where a dementia is present) who require psychiatric input are eligible to be assessed by<br />
the service. Patients with both functional and organic problems are seen.<br />
The work is hugely varied and involves everything from advice on placement and psychotropic medications to<br />
complex neuropsychiatric assessments and brief psychotherapies. Team members also attend ward based<br />
multi-disciplinary meetings and are involved in teaching nursing and medical staff about mental health and<br />
related matters.<br />
The team consists of a full time consultant psychiatrist, a band 7 Clinical Team Leader, three band 6 specialist<br />
nurses, a part time foundation doctor and full time admin and secretarial support.<br />
Medical SpRs join the team for attachments, as well as medical students.<br />
The OPMH Liaison Service is co-located with the younger adults’ liaison service and the Research and<br />
Development team at Wonford House Hospital in Exeter. Patients are seen in the Emergency Department,<br />
Acute Admissions unit and inpatient wards at the Royal Devon and Exeter Hospital which is next door to<br />
Wonford House.<br />
This post would suit either an old age trainee or a trainee who was considering working in Liaison Psychiatry.<br />
In addition to the allocated sessions for educational and clinical supervision, there will be regular clinical<br />
contact with the consultant for discussion of cases etc. The timetable for the ST4-6 trainee is flexible and will<br />
depend on the training needs of the doctor. It is anticipated that the workload will consist of a mixture of<br />
reviews, consultation advice and support to the team and acute medical staff, together with single handed and<br />
multi-disciplinary assessments.<br />
The cornerstone of liaison psychiatry work is education and it is expected that the higher trainee would take<br />
part in teaching programmes in the general hospital for junior doctors and nursing staff.<br />
Any pre-existing special interest sessions and research projects would be fully supported. Dr Owens would be<br />
extremely happy to work with the trainee to develop special interests and research projects. The team have<br />
close links with both the trust Research and Development department and medical consultants and teams in<br />
the acute trust. Audit projects would be strongly encouraged and fully supervised.<br />
There is a well attended journal club and education meeting every week. The trainee may also wish to consider<br />
attending medical grand rounds in the acute trust.<br />
Dr Owens has been a consultant for three years and is familiar with the training needs of ST4-6s and the<br />
preparation required for consultant interviews and transition. He is currently the clinical director for Older<br />
People’s Mental Health and there would be opportunities for exposure to and project work in management<br />
and service development. He has interests in psychodynamic psychotherapy, neuropsychiatry and medical<br />
education.<br />
36
TRAINEE TIMETABLE: (Flexible, with variable amounts of teaching, med student supervision and audit and<br />
management projects, dependent on needs of trainee)<br />
am 9-9:30:<br />
Clinical Team<br />
Meeting/<br />
Boardround<br />
pm<br />
Monday Tuesday Wednesday Thursday Friday<br />
9-9:30:<br />
Research/<br />
Clinical Team Meeting/<br />
Special<br />
Boardround<br />
Interest<br />
Liaison Work in<br />
RD&E<br />
Liaison Work in<br />
RD&E<br />
Liaison Work in RD&E<br />
12-2 PM: Local Academic<br />
meeting<br />
MDT Team meeting<br />
(monthly)<br />
MDT Team educational<br />
meeting (monthly)<br />
4-5 PM Educational<br />
Supervision<br />
9-9:30:<br />
Clinical Team<br />
Meeting/<br />
Boardround<br />
Liaison Ward<br />
Round<br />
Liaison Work in<br />
RD&E<br />
9-9:30:<br />
Clinical Team<br />
Meeting/<br />
Boardround<br />
Liaison Work in<br />
RD&E<br />
Liaison Work in<br />
RD&E<br />
Research/<br />
Special<br />
Interest<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision<br />
1 in 14, Second on call, non-resident, with Consultant Cover<br />
CONSULTANT TIMETABLE<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m. OPMH<br />
Clinical<br />
Directorate<br />
Day<br />
9-9:30:<br />
Clinical Team<br />
Meeting/Boardround<br />
9-9:30:<br />
Clinical Team<br />
Meeting/<br />
Boardround<br />
OPMH<br />
Clinical<br />
Directorate<br />
Day<br />
p.m.<br />
Liaison Work in RD&E<br />
12-2 PM: Local Academic<br />
meeting<br />
12-2 PM: Local Academic<br />
meeting<br />
MDT Team meeting<br />
(monthly)<br />
MDT Team educational<br />
meeting (monthly)<br />
4-5 PM Educational<br />
Supervision with ST<br />
Liaison Ward Round<br />
Liaison Work in<br />
RD&E<br />
9-9:30:<br />
Clinical Team<br />
Meeting/Boardround<br />
Monthly Dementia<br />
Strategy Meetings<br />
RD&E<br />
12.50-2PM<br />
RD&E Old Age<br />
Medicine Meeting<br />
Liaison Work in RD&E<br />
37
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Old Age Psychiatry<br />
Dr Steve Pearson<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION: The Catchment area is 13,000 over 65 population in <strong>West</strong> Devon and <strong>South</strong> Hams. You will<br />
gain experience of an integrated OPMH team and be part of a weekly team meeting where cases are allocated<br />
and cases discussed at feedback. A memory assessment service is part of this community team. The team<br />
includes Speciality Doctor (1 FTE), Community Nurses, Psychology and a Clinical Team Leader. The team base is<br />
in Ivybridge, Devon.<br />
We still look after our own catchment inpatients on 6 beds in NHS Plymouth, working with CRHT for functional<br />
patients.<br />
Training Opportunities<br />
Our team is actively involved in teaching 3 rd year medical students. There will be opportunities to be involved<br />
with this. There is a chance to take part with an audit that is active within the team. Dr Pearson is actively<br />
involved in Service Development and there will be opportunities to be involved in this.<br />
Special interest sessions would be decided by discussion with the trainer. Dr Pearson has wide contacts in<br />
Derriford Hospital and in NHS Plymouth which can be used to provide ample opportunities to provide specialist<br />
sessions which could include Liaison Psychiatry, Neurology, attending specialist Parkinson’s disease clinics and<br />
other specialist memory clinics.<br />
Research<br />
Dr Pearson has a funded Research Session and is active in DeNDRoN dementia research. There are 4 research<br />
nurses as part of the team based at Derriford and you will be welcome to join in this active research centre.<br />
Huntington’s disease<br />
Dr Pearson takes part in a 2 monthly specialist clinic with a neurologist and neuropsychologist at Launceston as<br />
part of his specialist interest in Huntington’s disease. There are active plans to develop research in<br />
Huntington’s disease.<br />
TIMETABLE:<br />
Monday<br />
A.M.<br />
9-12 Community Assessments<br />
12-1 Supervision with Consultant<br />
P.M.<br />
Ward Round, Dementia<br />
Tuesday Team Meeting Community Assessments<br />
Wednesday Ward Round, Functional Special interest<br />
Thursday Community Assessments Outpatient Clinic, Tavistock<br />
Friday Community Assessments Research session<br />
On-Call 1: 10 with Consultant Cover (Plymouth on-call rota)<br />
38
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Substance Misuse Psychiatry<br />
Dr Mary Rowlands<br />
Devon Partnership NHS Trust<br />
JOB DESCRIPTION: This is a training post where the candidate will be working with supervision. The cases seen<br />
are at the same level of complexity as those cases that are referred to the consultant, after a period of training.<br />
There will therefore be regular access to complex case discussion with the consultant:<br />
1. To be an active member of the multidisciplinary community and criminal justice drug teams.<br />
2. To assess new outpatients referred to the addiction service, decide upon their treatment and develop a<br />
care package with their allocated key worker.<br />
3. To liaise with the General Practitioners, primary healthcare teams and non-statutory drug agencies in<br />
the care of patients with substance misuse problems. To communicate promptly with GP’s in writing,<br />
to a given professional standard so they are fit for purpose, agreed with the Consultant.<br />
4. To maintain accurate multidisciplinary medical records, other clinical documentation of clinical activity<br />
and individual care plans where appropriate so they are updated promptly to ensure available to other<br />
professions.<br />
5. To provide regular reviews of complex cases in collaboration with key worker reviews supervised by<br />
senior non-medical clinicians with referral as professionally agreed with the Consultant.<br />
6. To provide during office hours in designated clinic sessions urgent addiction support/advice in<br />
conjunction with the Consultant, other ENDAS SAS doctors and Nurse Prescribers to staff caring for<br />
addiction team patients admitted to the Wonford House Hospital inpatient beds.<br />
7. To liaise with staff at the Royal Devon and Exeter Hospital in the care of inpatients with co-morbid<br />
physical problems associated with drug misuse.<br />
8. To participate in teaching and training of other disciplines and agencies as appropriate.<br />
9. To participate in appropriate addiction audits.<br />
10. To participate in educational sessions appropriate to Personal Development including special interest<br />
and research sessions.<br />
TIMETABLES:<br />
TRAINER A.M. P.M.<br />
Monday Admin/Consultant Meetings Multi-agency meetings<br />
Emergency clinic inc Young Persons<br />
Tuesday MDT 1130-1330 Journal Club/Case<br />
Conference<br />
Clinic/Teaching<br />
Wednesday<br />
Thursday<br />
Friday<br />
Ward Round and Medical<br />
Students/Psych SHO Teaching<br />
Clinic/Teaching if 3 med student<br />
placements<br />
0900-1000 SAS supervision<br />
1000-1200 Teaching<br />
Clinic/Teaching<br />
1700-1900 Evening clinic every 2 nd<br />
& 4 th month as required<br />
1300-1400 Vulnerable babies and<br />
pregnant drug misusers meeting<br />
every 3 rd of the month<br />
1400-1730 Protocol Development<br />
1230-1330 Nurse Prescriber<br />
supervision/development<br />
1330-1430 ST4-6 Supervision<br />
1430-1630 Emergency clinic<br />
39
TRAINEE A.M. P.M.<br />
Monday<br />
Tuesday<br />
Wednesday<br />
Thursday<br />
MDT<br />
Journal Club and Case Conferences<br />
Clinic/Ward Round<br />
Teaching<br />
Clinic/Teaching<br />
Clinic<br />
Friday Clinic/Teaching Supervision<br />
Emergency Clinic<br />
On-Call: There is on call commitment with this post, as part of the Wonford House Hospital Consultant<br />
supervised StR rota, currently 1 weekday in 7 weeks and 1 in 20 weekends, but it will vary according to service<br />
exigencies.<br />
40
POST:<br />
TRAINER:<br />
SUPERVISOR:<br />
EMPLOYING TRUST:<br />
OPMH Inpatient/Medical Management Torbay ST4-6<br />
Dr David Somerfield<br />
Dr David Somerfield, Consultant Psychiatrist and Co-Medical Director<br />
Devon Partnership NHS Trust<br />
Inpatient work<br />
Beech is a 14 bedded OPMH functional ward at Torbay Hospital, Torquay, Devon. The ward is the primary<br />
admission unit for the whole of Torbay and <strong>South</strong> and <strong>West</strong> Devon and relates to 4 OPMH CMHTs. The ward<br />
works closely with the all adult Crisis Resolution and Home Treatment team and the younger adult ward and<br />
the all adult psychiatric liaison service on the same site. The low number of beds for the local population means<br />
there is the challenge of rapid assessment and management of mental illness and working closely with the<br />
community teams and home treatment to facilitate discharges as safely and as soon as possible. The ward has<br />
support from a CT1 or GPVTS.<br />
The post holder will gain supervised experience of the assessment and management of acute and complex<br />
psychiatric illness in older people, risk management, recovery orientated practice, working across health/social<br />
care/third sector boundaries and the use of the Mental Health Act in this population.<br />
Recovery based practice<br />
The ward has a strong recovery ethos with patients contributing and taking control of planning their care with a<br />
weekly ‘Planning My Recovery’ meeting rather than attending traditional ward rounds. Patients are<br />
encouraged to attend and contribute throughout the whole meeting to review how they have been over the<br />
week and in their care planning for the forthcoming week with a small representation from the<br />
multidisciplinary team. Care plans are reviewed ‘live’ on RiO and they are given a copy of their agreed care<br />
plans and other pertinent information e.g. medicines information at the meeting.<br />
OPMH Community, liaison and/or Crisis Resolution and Home Treatment additional experience is also available<br />
if this is required as part of identified developmental need.<br />
Educational<br />
There is a monthly 3 hour post graduate educational meeting and weekly teaching sessions organised by and<br />
with the local trainees<br />
Medical Management<br />
There are opportunities to undertake supervised management projects, shadow senior managers and attend<br />
key quality and financial governance, commissioning and other meetings to help gain an understanding of<br />
medical, service and budgetary management. Torbay has a nationally renowned healthcare system and the<br />
post holder will be encouraged to spend time in different parts of the local healthcare system to understand its<br />
philosophy and key components.<br />
Project opportunities<br />
Torbay has just been awarded £255,000 from the Prime Ministers Dementia Challenge Fund for the<br />
development and implementation of an innovative dementia care home education package and the post<br />
holder will be welcome to participate and help lead the project with the guidance of the educational<br />
supervisor.<br />
We are currently planning and writing the script for the fourth carer DVD. This film is for paid carers of people<br />
with dementia in residential and hospital care and is a joint venture between several health and social care<br />
41
organisations. The post holder will be welcome to participate and help lead the project with the guidance of<br />
the educational supervisor.<br />
On call<br />
On call currently consists of a 1 in 14 rota covering all adult specialities (including learning disability and older<br />
adults but excluding forensic).<br />
Trainee Timetable<br />
Timetable is negotiable depending on educational needs. The supervisor has 6 PAs of DCC on the ward<br />
Tuesday, Wednesday and Fridays and medical management Monday and Thursdays.<br />
Monday Tuesday Wednesday Thursday Friday<br />
AM<br />
Medical<br />
Management<br />
Ward Work Ward Work<br />
Supervision<br />
Ward Work Special<br />
Interest/Research<br />
PM<br />
Medical<br />
Management<br />
Ward Work<br />
Post Graduate<br />
meeting<br />
Monthly<br />
Medical<br />
Management<br />
Ward Work<br />
Special<br />
Interest/Research<br />
About the supervisor<br />
I have been a consultant psychiatrist in OPMH in Torbay since 1999. I have helped to lead the development of<br />
the locally well regarded OPMH service and have won two Royal College of Psychiatrist Innovation Prizes for<br />
work with service delivery and carers learning resources. I have been a lecturer at the University of Bristol and<br />
Royal College of Regional Psychiatrists Representative for OPMH. I have been Medical Director and Caldicott<br />
Guardian for the Trust since 2006, was Clinical Director for Trust OPMH services 2011-2012 and more recently<br />
have become Responsible Officer. I am currently Executive Director responsible for IPP, Pharmacy and service<br />
redesign and development with budget responsibilities of £31m. I have a particular interest in educational<br />
resources for carers, use of technology to improve reliability of care and large scale change theory.<br />
42
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Community Psychiatry and Early Intervention In Psychosis<br />
Dr Antony Thekkepalakkal<br />
Devon Partnership Trust<br />
JOB DESCRIPTION: This is a new and exciting opportunity for ST4-6 trainees to work in a diverse setting in<br />
the community covering a large but predominantly rural area of outstanding natural beauty. The trainee would<br />
be a much valued member of the Early Intervention in Psychosis (STEP) Team (<strong>South</strong> and <strong>West</strong> Devon) & the<br />
Community Mental Health Teams (Mental Well being and Access/ Recovery and Independent Living/Assertive<br />
Outreach functional network teams, in the areas of Totnes and Dartmouth). The trainee would join a skilled<br />
and experienced multi-professional team which includes a Consultant Psychiatrist (Educational Supervisor) and<br />
a Specialty doctor based at Cabot House, Totnes.<br />
The trainee would have opportunity to work flexibly either across the 4 teams or focus on a specific team(s)<br />
based on their interests, clinical experience and learning needs. The trainee could also develop his/her<br />
confidence and leadership skills by providing psychiatric input to the team working in a particular geographical<br />
area with regular supervision and the support of an efficient medical secretary. Our award-winning STEP team<br />
works with young people (age range 14 to 35) with first episode psychosis, sharing the positive and forward<br />
looking EI ethos adopting an assertive but befriending model of care for up to three years often in close<br />
collaboration with other local services including CAMHS. There are ample opportunities to gain experience of<br />
working with families and to learn CBT based techniques as well as psycho-educational skills from a well<br />
motivated, enthusiastic and friendly team. By working with the functional network teams, the trainee would<br />
gain valuable experience in the clinical management of patients in the community with an emphasis on the<br />
Recovery principles. The teams comprise of experienced clinicians and the trainee could learn to develop and<br />
maintain close working links with GPs, service user/carer groups (e.g.: Be Involved Devon), voluntary sector<br />
(e.g.: Rethink), other local Trusts (e.g.: Community Care Trust) and the private sector (e.g.: Community of St.<br />
Antony and St. Elias, Totnes) which would benefit the trainee immensely in their transition process from being<br />
an StR to a Consultant psychiatrist.<br />
The Educational supervisor has done his basic and specialist psychiatric training in the <strong>South</strong> <strong>West</strong> <strong>Peninsula</strong><br />
<strong>Deanery</strong> and is keen to support the trainee to meet and/or shadow other senior clinicians, clinical/medical<br />
directors, Chief Executive and the Trust managers in order to develop their knowledge and understanding of<br />
the new Clinical Directorate as well as the role of clinicians in management within the modern NHS structure.<br />
This post also offers opportunity to teach medical students during their local SSU placements (‘Road to<br />
Recovery’) and the FT/CT doctors at Journal clubs/Case Conferences/Tutorials/ Audit meetings/ MRCPsych<br />
exam practice sessions in <strong>South</strong> Devon. The trainee would be encouraged to be innovative and take on clinical<br />
audit and service evaluation projects that might be of interest to them. Research and other special interests<br />
would be fully supported in this post. The trainee would be encouraged to do Section 12 MHA work/training<br />
and attend educational courses/events for CPD/NHS appraisal purposes. Mentorship via the <strong>Deanery</strong> will be<br />
supported. They would also receive support for their WPBA with a view to achieving a satisfactory ARCP while<br />
working towards a Certificate of Completion of training (CCT) and obtaining a Consultant job in the NHS.<br />
a.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Clinical and<br />
9.30 to 11.30 : Research<br />
Educational<br />
Clinical Team session<br />
Supervision with meeting<br />
Consultant ( 9.30 to<br />
11.00 am )<br />
Clinical<br />
work/Home visits<br />
Clinical work/Home<br />
visits<br />
11 am : Clinical<br />
12.30 to 1.30 :<br />
43
work/Outpatient<br />
clinic<br />
Tutorials/Teaching<br />
for FT/ST 1-3 at<br />
Torbay Hospital<br />
p.m.<br />
Clinical<br />
work/Outpatient<br />
clinic<br />
Clinical work/Home<br />
visits<br />
Regional Educational<br />
meeting-Case<br />
conference/Journal<br />
Club (monthly) &<br />
Clinical Audit<br />
Meeting (every 2<br />
months)<br />
Clinical work/Home<br />
visits<br />
OR<br />
StR(4 -6) Peer group<br />
meeting (monthly)<br />
Special<br />
Interest<br />
session<br />
Supporting<br />
Professional<br />
Activities<br />
(SPA)/Emergency<br />
assessments<br />
The frequency of on calls would be 1 in 14 as part of the senior trainee/consultant rota at Torbay hospital.<br />
The trainee would be expected to provide advice for (and attend if required) any emergencies and requests for<br />
Mental Health Act assessments of patients at Torbay hospital, APOS suite, Police Custody and in the<br />
community (Torbay, Teignbridge, part of <strong>South</strong> Hams area). They would also be expected to advise/support the<br />
junior doctors (FT/ST 1-3) who will be 1 st on call in psychiatry. There would be a consultant on call along with<br />
the ST4-6 trainee, for clinical supervision and support. Trainees could also attend the out of hours supervision<br />
group conducted by the new liaison psychiatry team at Torbay Hospital.<br />
44
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Psychiatry -Inpatient and Home Treatment<br />
Dr Naresh Buttan<br />
Plymouth Primary Care Trust<br />
JOB DESCRIPTION: This full time equivalent (FTE) training post provides an ample opportunity to gain<br />
experience in managing acutely unwell mental health working age clients. The post is primarily based in<br />
Glenbourne Unit and has close liaison work with Home Treatment Team as a part of gate keeping admissions to<br />
this inpatient unit. This post is under Inner City Locality of HTT/Glenbourne Unit. The inner city locality caters to<br />
people living and registered with GP practices within inner city catchment area and works in close association<br />
with 2 Community Mental Health Teams (<strong>South</strong> East-Tamarside & <strong>South</strong> <strong>West</strong>- Waterfront localities). The<br />
populace of nearly 98,000 people are covered by 14 GP practices in this catchment area. As this area is<br />
deprived, the patients present with more complex psychosocial needs in addition to mental health needs and<br />
often carry dual diagnoses (with comorbid substance use, personality disturbances, learning difficulties and<br />
forensic involvements). The Integrated Care Pathways are being developed in lines with NICE & RCPsych<br />
Guidelines to manage these complex conditions. The inpatients are managed as voluntary or detained under<br />
Mental Health Act. Mostly admissions to Glenbourne are gatekept by HTT and discharged through the same<br />
route under newly developed Nurse Led Discharge Policy & facilitated by Satellite Service of HTT.<br />
The secondary mental health services are being redefined currently under QIPP & TCS agendas and apex<br />
services like Glenbourne & HTT are at the forefront of leading some quality improvement changes. The post<br />
holder would gain a greater understanding of these reforms and would provide a substantial support to teams<br />
working here. The post holder can accompany educational supervisor in some of these administrative meetings<br />
e.g., Consultant Psychiatrists Meetings on alternate Mondays and Glenbourne Development Meetings on once<br />
a month Wednesday mornings.<br />
The clinical responsibilities include assessment of new admissions to Glenbourne (Inner City Clients), reviewing<br />
them on regular basis, liaise with GPs, carers or key workers, discharge planning and leading weekly<br />
multidisciplinary ward rounds and community clinical reviews each under direct supervision of trainer.<br />
Additional skills in preparing reports and representing RC in Mental Health Tribunal Reviews as needed. Sec. 12<br />
(2) approval or training for the same would be required.<br />
The post holder would be directly responsible to Dr. Naresh K. Buttan, Lead Consultant HTT & Glenbourne Unit.<br />
Trainee would also have opportunities to interact with Dr. Mike Cooper, Consultant Psychiatrist covering outer<br />
city division of Glenbourne & HTT. The clinical supervision during day time would be available from Dr. Buttan,<br />
Educational Supervisor (in addition to protected 1 hr weekly session on Tuesday mornings) and his team at<br />
Glenbourne & HTT.<br />
The Glenbourne Unit has Foundation Year 2 Trainees posted for 4 months in each wards (Harford & Bridford).<br />
The post holder would be expected to provide work based supervision to FY2 Dr. in Harford Ward. The other<br />
teaching avenues e.g., teaching at MRCPsych programme being run locally can be negotiated. The <strong>Peninsula</strong><br />
Medical School sends 3 rd & 4 th year medical students for 3 weeks rotation in psychiatry and this post holder<br />
would be expected to provide clinical bedside teaching to them.<br />
Post holder would also be able to co-chair (Chair- Dr. Buttan) twice monthly case conferences presented by<br />
other trainees. The Journal Club and Case Conferences are held twice/thrice in a month for 1 hrs each on<br />
Wednesday mornings at Glenbourne Unit. Monthly once CPD and Grand Rounds each provide opportunities for<br />
this post holder to demonstrate their presentation skills. The presentation slot in these academic activities can<br />
be negotiated. The post holder would be expected to participate in an ongoing or fresh audit to demonstrate<br />
their research skills.<br />
45
The trainer has special interest in Transcultural Psychiatry and would support & supervise trainee in developing<br />
special interest in that area or any area of trainee’s choice depending upon the availabilities of resources.<br />
Trainee would be encouraged to join Balint Group meetings held on Wednesday mornings as a part of<br />
reflective practice. Dr. Cooper, College Tutor provides further support to trainees and organizes reviews of<br />
ARCPs.<br />
Other information regarding pay scales, hours of working, leave arrangements will be laid out in service<br />
contract and can be obtained from Medical Staffing Department at Glenbourne Unit.<br />
TRAINEE TIMETABLE: (Subject to variations)<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Visit Glenbourne Community Academic<br />
Ward rounds with<br />
Unit for new Clinical Reviews at activities at Trainer at<br />
assessments/revi HTT & 1 hour Glenbourne Unit Glenbourne<br />
ews, support (protected) of (Balint group,<br />
Satellite service supervision with journal club, case<br />
of HTT & F2 Trainer<br />
conference)<br />
doctor in<br />
Glenbourne Unit<br />
HTT (Home visits/<br />
assessments)<br />
HTT/Glenbourne<br />
(visits /<br />
assessments)<br />
Glenbourne Unit /<br />
HTT as per the<br />
clinical needs.<br />
HTT<br />
(visits/assessment<br />
s)<br />
Special interest /<br />
research /<br />
academics<br />
Special interest /<br />
research /<br />
academic<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision<br />
Currently 1 in 10 with consultants on call. The on-call cover is to provide psychiatrist cover for Plymouth<br />
Area, A& E, HTT, Glenbourne and other peripheral units within the trust. The supervision as per the clinical<br />
need provided by on-call consultants.<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m. Visit Glenbourne Community Academic<br />
Ward rounds with Special interest/<br />
Unit for new Clinical Reviews at activities at Trainer at research/<br />
assessments/revie HTT & 1 hour Glenbourne Unit Glenbourne academics<br />
ws, support (protected) of (Balint group,<br />
Satellite service of supervision with journal club, case<br />
HTT & F2 doctor in<br />
Glenbourne Unit<br />
Trainer<br />
conference)<br />
p.m. HTT (Home visits/ HTT/Glenbourne Glenbourne Unit/ HTT (visits/ Special interest/<br />
assessments) (visits/<br />
assessments)<br />
HTT as per the<br />
clinical needs.<br />
assessments) research/<br />
academic<br />
46
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Adult Psychiatry working with North <strong>West</strong> PCLT<br />
Dr Sara Cunningham (0.65wte)<br />
Plymouth Primary Care Trust<br />
JOB DESCRIPTION: Dr Cunningham works as a Consultant Psychiatrist in the North <strong>West</strong> PCLT (Primary Care<br />
Liaison team). The team consists of 1.6 Consultants, 1 CT1, 5 CPN's (one Band 7 team leader), 1 Occupational<br />
therapist (Band 6), 1 social worker (AMHP), 2 support workers, 2 medical secretaries and 1 team secretary. The<br />
catchment area is approximately 40,000 population and covers 8 GP surgeries in the Whitleigh/St Budeaux area<br />
of Plymouth. We see a wide range of psychiatric problems from the major psychoses (depression,<br />
schizophrenia and bipolar affective disorder) to adult ADHD, personality disorders and severe anxiety<br />
disorders. The ST4-6 trainee will be expected to see patients with a variety of clinical problems of appropriate<br />
complexity.<br />
Dr Cunningham has trained in psychiatry since 1988 in Liverpool, Nottingham, Leicester and Plymouth. She has<br />
been a Consultant Psychiatrist in Plymouth since 1999 and trained a number of ST4-6 psychiatrists. She has a<br />
special interest in treating Occupational Health psychiatry problems within the <strong>South</strong> <strong>West</strong> <strong>Peninsula</strong>r. She has<br />
an interest in medical education (PGCMedEd) and regularly delivers training and feedback within the<br />
<strong>Peninsula</strong>r Medical School. The trainee will devise a programme suitable for their training needs, but focusing<br />
on adult community psychiatry.<br />
Opportunities for a Specialty Trainee:<br />
Outpatient clinics, in patient care, emergency psychiatry – both day & night (on call), experience of a well<br />
functioning multidisciplinary team, writing Court and Tribunal reports under supervision, teaching for junior<br />
medical staff and other disciplines, regular teaching programme, audit, protected research sessions and<br />
psychotherapy training.<br />
TIMETABLE<br />
Monday<br />
Tuesday<br />
Wednesday<br />
A.M.<br />
Consultant Meeting<br />
On call daytime<br />
assessments/liaison work –<br />
Derriford hosp<br />
Outpatient clinic – medical student<br />
teaching clinic<br />
Elmview<br />
Supervision - Glenbourne<br />
Case Conference / Journal Club<br />
/CPD(Glenbourne)<br />
P.M.<br />
Team referral meeting<br />
Elmview<br />
Special Interest Session<br />
Emergency Assessments clinic<br />
Thursday<br />
Outpatients<br />
Admin<br />
Elmview<br />
Friday Flexible clinical/admin Research<br />
On-Call 1: 10 with Consultant Cover<br />
47
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
General Adult Psychiatry<br />
Dr M Cooper<br />
Plymouth Primary Care Trust<br />
Glenbourne Unit & Home Treatment Team (HTT)<br />
JOB DESCRIPTION: This full time equivalent (FTE) training post provides an ample opportunity to gain<br />
experience in managing acutely unwell mental health working age clients. The post is primarily based in<br />
Glenbourne Unit and has close liaison work with Home Treatment Team as a part of gate keeping admissions to<br />
this inpatient unit. This post is under Outer City Locality of HTT/Glenbourne Unit. The outer city locality caters<br />
to people living and registered with GP practices within outer city catchment area and works in close<br />
association with 3 Community Mental Health Teams (Central North East, Plym and North <strong>West</strong> localities). The<br />
populace of nearly 77400 people are covered by 27 GP practices in this catchment area. As this area is<br />
deprived, the patients present with more complex psychosocial needs in addition to mental health needs and<br />
often carry dual diagnoses (with comorbid substance use, personality disturbances, learning difficulties and<br />
forensic involvements). The Integrated Care Pathways are being developed in lines with NICE & RCPsych<br />
Guidelines to manage these complex conditions. The inpatients are managed as voluntary or detained under<br />
Mental Health Act. Mostly admissions to Glenbourne are gate kept by HTT and discharged through the same<br />
route under newly developed Nurse Led Discharge Policy & facilitated by Satellite Service of HTT.<br />
The secondary mental health services are being redefined currently under QIPP & TCS agendas and apex<br />
services like Glenbourne & HTT are at the forefront of leading some quality improvement changes. The post<br />
holder would gain a greater understanding of these reforms and would provide a substantial support to teams<br />
working here. The post holder can accompany educational supervisor in some of these administrative meetings<br />
e.g., Consultant Psychiatrists Meetings on alternate Mondays and Glenbourne Development Meetings on once<br />
a month Wednesday mornings.<br />
The clinical responsibilities include assessment of new admissions to Glenbourne (Outer City Clients), reviewing<br />
them on regular basis, liaise with GPs, carers or key workers, discharge planning and leading weekly<br />
multidisciplinary ward rounds and community clinical reviews each under direct supervision of trainer.<br />
Additional skills in preparing reports and representing RC in Mental Health Tribunal Reviews as needed. Sec. 12<br />
(2) approval or training for the same would be required.<br />
The post holder would be directly responsible to Dr. Michael Cooper, Consultant HTT & Glenbourne Unit.<br />
Trainee would also have opportunities to interact with Dr. Naresh Buttan, Consultant Psychiatrist covering<br />
inner city division of Glenbourne & HTT. The clinical supervision during day time would be available from Dr.<br />
Cooper, Educational Supervisor (in addition to protected 1 hr weekly session on Monday afternoon) and his<br />
team at Glenbourne & HTT.<br />
The Glenbourne Unit has Foundation Year 2 Trainees posted for 4 months in each wards (Harford & Bridford).<br />
The post holder would be expected to provide work based supervision to the F2 Doctors in Bridford Ward.<br />
There are other teaching avenues. Local MRCPsych teaching can be negotiated. The <strong>Peninsula</strong> Medical School<br />
sends 3 rd & 4 th year medical students for 3 weeks rotation in psychiatry and this post holder would be expected<br />
to provide clinical bedside teaching to them.<br />
The post holder would also be able to co-chair (Chair- Dr. Buttan) twice/thrice monthly case conferences<br />
presented by other trainees. The Journal Club and Case Conferences are held twice/thrice in a month for 1 hrs<br />
48
each on Wednesday mornings at Glenbourne Unit. Monthly once CPD and Grand Rounds each provide<br />
opportunities for this post holder to demonstrate their presentation skills as well. The presentation slot in<br />
these academic activities can be negotiated. The post holder would be expected to participate in an ongoing or<br />
fresh audit to demonstrate their research skills.<br />
The trainer has a special interest in Psychotherapies having trained in Cognitive Analytic Therapy and<br />
Psychodynamic therapy and has links with the psychotherapy department which offers opportunities for<br />
formal psychotherapy training across several modalities. There would be support and supervision for the<br />
trainee in developing a special interest in that area or any area of trainee’s choice depending upon the<br />
availabilities of resources.<br />
Other information regarding pay scales, hours of working, leave arrangements will be laid out in service<br />
contract and can be obtained from Medical Staffing Department at Glenbourne Unit.<br />
Weekly Timetables<br />
TRAINEE TIMETABLE: (Subject to variations)<br />
am<br />
pm<br />
Monday Tuesday Wednesday Thursday Friday<br />
Ward rounds with<br />
Glenbourne Unit/<br />
Trainer at<br />
HTT as per the<br />
Glenbourne<br />
clinical needs<br />
Visit Glenbourne Unit for<br />
new assessments/<br />
reviews support Satellite<br />
service of HTT & F2<br />
doctor in Glenbourne<br />
Unit<br />
Option to attend<br />
Consultant Planning<br />
Meeting<br />
HTT (Home visits/<br />
assessments)<br />
1 hour (protected) of<br />
supervision with Trainer<br />
Special interest/<br />
research/<br />
academics<br />
Academic activities<br />
at Glenbourne Unit<br />
(Balint Group,<br />
journal club, case<br />
conference)<br />
Community Clinical<br />
Reviews at HTT<br />
HTT (visits/<br />
assessments)<br />
HTT/ Glenbourne<br />
(visits/<br />
assessments)<br />
Special interest/<br />
research/ academic<br />
The Home Treatment Team Consultant Psychiatrist is the first point of call for Mental Health Act assessments<br />
which the trainee will be encouraged to undertake as per their educational needs.<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision<br />
Currently 1 in 10 with consultants on call. The on-call cover is to provide psychiatrist cover for Plymouth Area,<br />
A&E, HTT, Glenbourne and other peripheral units within the trust. The supervision as per the clinical need<br />
provided by on-call consultants.<br />
TRAINER TIMETABLE:<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m. Consultant<br />
Meetings<br />
Glenbourne<br />
Ward Rounds<br />
Academics/CPDs/<br />
Peer reviews<br />
Psychotherapy<br />
supervision<br />
HTT<br />
p.m.<br />
Glenbourne/ Home<br />
Treatment Team<br />
1 hour (protected)<br />
of supervision with<br />
Trainer<br />
Glenbourne<br />
Ward Rounds<br />
Psychotherapy<br />
HTT Clinical reviews HTT(visits/assessments) HTT<br />
49
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Inpatient and Home Treatment<br />
Dr Stephen<br />
Plymouth Primary Care Trust<br />
JOB DESCRIPTION: This post will allow the trainee to experience working with a high fidelity, large, well<br />
established home treatment team covering Plymouth city. They will take a senior medical role, under the<br />
supervision of the consultant, in the care of patients referred to and taken on by the team. They will perform<br />
assessments (including mental health act assessments) and reviews of people in severe mental health crises<br />
under the care of the team at the patient’s home. They will work with the multidisciplinary team including<br />
nurses, OT, psychology, social workers and five other doctors to provide care at home as an alternative to<br />
admission. The team are based at Mt Gould Hospital with inpatient services based at the Glenbourne Unit.<br />
There is also an opportunity to develop a role within the inpatient unit, as patients admitted remain under the<br />
care of the home treatment consultant including report writing and tribunal experience.<br />
The trainer has a particular interest in medical education and is the locality lead for the <strong>Peninsula</strong> Medical<br />
School and Lead Consultant for the <strong>Peninsula</strong> MRCPsych Course, providing opportunity for a trainee to gain<br />
experience in these areas. He also is involved with local service development projects and would expect<br />
trainees to become involved in this role. Research opportunities, particularly focused on service development<br />
and evaluation, are also embedded in the team and trainees are involved in these processes, developing<br />
projects towards poster presentations and publications. The trainer is also able to provide supervision for other<br />
external research projects.<br />
TIMETABLE:<br />
Monday<br />
Tuesday<br />
A.M.<br />
Consultant Committee, Teaching,<br />
Audit and Psychotherapy<br />
Inpatient Ward round or HT<br />
reviews<br />
P.M.<br />
HTT review and assessments/<br />
MHAs<br />
HT reviews and assessments/<br />
MHAs<br />
Wednesday<br />
Supervision/ HT reviews/ Case Community Reviews (HTT Ward<br />
Conference and Journal Club/ CPD Round with Consultant)<br />
Thursday TBA Special Interest<br />
Friday TBA Research<br />
On-Call 1: 10 with Consultant Cover<br />
50
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Core Old Age Psychiatry<br />
Dr Rodney Ford<br />
Plymouth Primary Care Trust<br />
JOB DESCRIPTION: The Specialty Trainee will be expected to carry out assessments of patients referred to the<br />
service and to manage their care under the supervision of the Consultant Psychiatrist. An open referral system<br />
is in operation. Most patients are assessed either as outpatients or at home in the first instance. There is a<br />
liaison service for elderly psychiatric patients at Derriford and Mount Gould Hospitals run by experienced<br />
nursing staff. Inpatients are based at Plympton Hospital, where there are beds for functional illness and organic<br />
assessment. Outpatients are seen at Plympton Hospital.<br />
Outpatients with dementia are managed through our memory service at Mount Gould Hospital. The catchment<br />
area covered is that of the outer city, and there is a population of about 13,000 people of age 65 years or older.<br />
At present the medical establishment consists of three Consultant Psychiatrists, one staff-grade and two SHO’s.<br />
There is a well-staffed multi-disciplinary team with a full-time psychologist, CPNs and occupational therapists.<br />
There are opportunities for teaching undergraduate medical students from the <strong>Peninsula</strong> Medical School. The<br />
Specialty Trainee will also be expected to provide teaching to other members of the multi-disciplinary team<br />
and to trainees on the local psychiatric rotation and to participate in the locally organised academic<br />
programme. There are opportunities for up to two special interest sessions and two sessions for supervised<br />
research.<br />
The Specialty Trainee will take on increasing responsibilities for the management of patients under the<br />
supervision of the Consultant in preparation for a Consultant post. There will also be opportunities to attend<br />
meetings with the Consultant and to obtain management experience.<br />
There is a full-time secretary as well as the usual IT facilities.<br />
TIMETABLE<br />
Monday<br />
Tuesday<br />
A.M.<br />
Consultants’ meeting/<br />
Community visits<br />
09-00 to 10-00 Team meeting.<br />
10-00 to 12-00 Oakdale ward<br />
round.<br />
P.M.<br />
Administration.<br />
14-00 to 15-30 Pinewood Ward<br />
Round.<br />
16-00 to 17-00<br />
Supervision with consultant.<br />
Wednesday<br />
Academic Programme<br />
11-30 to 13-30<br />
Community visits/liaison psychiatry<br />
(Derriford Hospital).<br />
Thursday Memory-service 09-30 to 12-00. Outpatients (Plympton Hospital)<br />
(Mount Gould Hospital).<br />
Friday Study day Study day<br />
On-Call 1: 14 with Consultant Cover<br />
51
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Primary Care Liaison General Adult Psychiatry<br />
Dr Fiona Murphy<br />
Plymouth Primary Care Trust (currently – shortly to become a social<br />
enterprise, under new management)<br />
JOB DESCRIPTION: This is a post in general adult (community) psychiatry, working at Elmview, Plympton<br />
Hospital, as part of the Plymouth Community Mental Health Team, covering the Plympton and Plymstock areas<br />
of Plymouth. The catchment area is approximately 40,000, the majority of which is relatively affluent, and<br />
predominantly suburban, though there are some small rural patches; it is served by seven GP practices. The<br />
post is purely community based as care for all inpatients is provided by the specialist inpatient/home treatment<br />
consultant.<br />
There is only one consultant working in the Plymouth CMHT. There are four other consultants (3.6 WTE)<br />
working at Elmview, in the two other CMHTS’s based there (Central North East, and North <strong>West</strong>). The five<br />
consultants have a daytime duty rota to cover emergencies across the whole locality, and also to provide a<br />
consultation service to Derriford hospital (red top referrals). The trainee will have the option of participating in<br />
this rota.<br />
The Plymouth team consists of one band 7 CPN team leader, one band 6 deputy team leader (post currently<br />
held by an OT), four band 5 CPN’s, one OT, two support workers, and two AMHP’s (social workers). There is<br />
also a full time team secretary, in addition to a medical secretary. There are three psychologists based at<br />
Elmview who work collectively to provide a service to all three teams at Elmview. We have access to other<br />
psychological therapies, including CBT and family therapy, through the psychotherapy department. There is a<br />
full time specialty doctor working with the Plymouth CMHT. Sometimes there is also a core psychiatric trainee<br />
in post, but this cannot be guaranteed.<br />
The trainee will work closely with other members of the team and provide assessments to new referrals which<br />
require medical input, either at base, or at the patient’s home. He/she will also be expected to carry a small<br />
caseload of patients requiring follow up/ continuing care. We do not currently have the facilities to provide<br />
clinics at GP surgeries but it is hoped that this will change in the near future. However the trainee will be<br />
encouraged to link in with a small group of primary care practitioners. The trainee will also be expected to<br />
attend the multidisciplinary team referral meetings, provide advice and support to staff in accordance with<br />
degree of experience and participate in Care Planning meetings with other members of the team. In order to<br />
help with transition arrangements with the home treatment team, the trainee will have the option of attending<br />
the weekly discussion meetings held by the home treatment team, and may also attend the weekly ward round<br />
for Plym patients, by agreement with the ward consultant.<br />
There is an active teaching programme for junior medical staff with weekly case conference and journal clubs.<br />
The trainee will be expected to take an active part in this and to help with its organisation. There will also be<br />
opportunity to provide teaching to other professional groups.<br />
Dr Murphy is a trained group therapist and runs a number of staff and patient groups. The trainee will<br />
therefore be given the opportunity to co-facilitate one or more groups, according to his/her interest.<br />
52
TIMETABLE<br />
Monday<br />
Tuesday<br />
A.M.<br />
Consultants committee meetings,<br />
Building one boardroom<br />
New patient clinic, Elmview<br />
12 – 1 Supervision with Consultant<br />
P.M.<br />
Follow up outpatient clinic,<br />
Elmview<br />
Multidisciplinary team meeting<br />
Elmview<br />
Wednesday<br />
Academic Teaching programme Special Interest<br />
Glenbourne<br />
Thursday Home visits with team members Outpatient clinic, Elmview<br />
Friday Admin Research<br />
On-Call 1: 10 with Consultant Cover<br />
53
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Assertive Outreach Service/Rehabilitation, and Early Intervention Psychiatry,<br />
Plymouth<br />
Dr Simon Payne<br />
Plymouth Primary Care Trust<br />
JOB DESCRIPTION: This post provides core adult experience with the opportunity to manage patients on both<br />
the acute inpatient unit at Glenbourne, and in the community. The inpatient (Bridford) ward is fully accredited<br />
by the Royal College of Psychiatrists under the AIMS project. The Assertive Outreach Service supports<br />
approximately 100 clients. There are typically 10-15 patients either on the ward or on leave from the ward at<br />
any one time. The Trainee would also have the opportunity of gaining experience in managing patients at<br />
Syrena House – a community-based rehabilitation unit for younger people, and/or patients at our 12-bedded<br />
low-secure unit at Lee Mill. There is a junior doctor on Bridford ward, and Staff Grade cover for Lee Mill,<br />
Syrena House, and the Assertive Outreach Service.<br />
Dr Payne has been a Consultant since 1993 and moved from Nottingham to Plymouth in 2002. He is currently<br />
Medical Director and Lead Consultant Psychiatrist for Plymouth Primary Care Trust. Subject to the Interest of<br />
the Trainee, there would be the opportunity to be involved in the development of psychiatric services locally<br />
and the wider work of the Plymouth Primary Care Trust. Full Secretarial support is available for the post with<br />
office accommodation, both at Glenbourne and the Assertive Outreach Team base at Mount Gould Hospital.<br />
Trainees may welcome the opportunity to work with Dr Dawe in the Early Intervention Service – either as a<br />
Special Interest, or in place of work at either Syrena House or Lee Mill. The Plymouth Early Intervention Service<br />
was one of the first in the country. It is based in the City centre along with other youth services and has an<br />
excellent reputation.<br />
*TIMETABLE:<br />
A.M.<br />
P.M.<br />
Monday Consultant Meetings AOS Ward Round at Glenbourne<br />
Tuesday Flexible – to be confirmed AOS m.d.t.<br />
Wednesday<br />
AOS/Rehabilitation Medical<br />
Meetings/Journal Club/Case<br />
Conference<br />
Flexible – to be confirmed<br />
Thursday Early Intervention Service m.d.t. Flexible – to be confirmed<br />
Friday Lee Mill m.d.t. Flexible – to be confirmed<br />
On-Call : To be confirmed<br />
* Subject to the particular Interest of the Trainee.<br />
54
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
Old Age Psychiatry<br />
Dr Sadir Altaan<br />
Cornwall Partnership NHS Foundation Trust<br />
Banham House, Bodmin Hospital, Cornwall/ Elfordleigh Community Resource<br />
Centre, Launceston, Cornwall<br />
JOB DESCRIPTION:<br />
This post will provide training opportunities in both organic and functional disorders for the older adult<br />
population of Northeast Cornwall (Launceston, Bude, Boscastle, Tintagel, Camelford and Callington). The<br />
population of this catchment area is about 13,000 spreading out through historical coastal and rural towns and<br />
villages.<br />
Community Services<br />
This service involves memory assessment (Memory Clinics), the assessment and management of dementia with<br />
behavioural and psychological symptoms in different settings (patients’ homes, care homes and occasionally in<br />
Launceston Community Hospital), and the assessment and management of functional psychiatric disorders<br />
complicated by complex physical health problems and the effects of aging.<br />
Inpatient Services<br />
There is one 25 bedded organic ward for the whole of Cornwall and about six functional bed on Fletcher ward<br />
for the east part of Cornwall. This service involves the assessment and management of severe mental disorder<br />
(organic and functional) when the risk to the patient is too high for their management in the community or<br />
when community support is felt to be inappropriate. Inpatients will be supported by the Multi-Disciplinary<br />
Team and a Junior Doctor, usually a GP trainee. Admission rate is generally low.<br />
The Community Team<br />
This includes the Team manager, four CPN’s, two HCA’s, an OT and a Dementia Liaison Nurse. Primary Care<br />
Practitioners have also been appointed and will be working closely with the local General Practitioners and the<br />
different members of the community team. All referrals are team referrals, which will triage and discuss them<br />
in the weekly MDT meeting.<br />
Training Opportunities<br />
The trainee will have the opportunity to work alongside the Multi-Disciplinary Team in providing memory<br />
assessments, and diagnoses as well as managing complex cases of dementia with behavioural and<br />
psychological symptoms. The trainee will also have the opportunity to assess and manage patients with<br />
functional and complex psychiatric disorders. The trainee will gain experience in the application of the Mental<br />
Capacity Act and the Mental Health Act in clinical practice. There are monthly old age psychiatrists meetings to<br />
discuss difficult to manage patients few of them will include meetings with consultant radiologist to review<br />
neuroimaging. Formal Royal College CPD peers meetings take place four times per year.<br />
Audit and Research<br />
The trainee will have the opportunity to develop his/her own audit or to participate in or lead one of the<br />
regional or national audits such as POMH UK audits. Dr Altaan is a member of the Mental Health Research<br />
Team at Cornwall Foundation Trust and recently took over the role of research lead in Old Age Psychiatry.<br />
Currently he is taking part in a pharmaceutical research trial in dementia. Trainees will have the opportunity to<br />
have supervised experience in research and would be welcome to attend the periodic Mental Health Research<br />
Team meetings.<br />
55
Teaching<br />
There is a weekly teaching programme for GP trainees and core psychiatric trainees. There is a monthly Grand<br />
round for all the trainees and consultants and there are regular MRCPsych exam training classes during which<br />
the senior trainee could develop his/her teaching and educational skills. There are also opportunities in<br />
providing teaching and training to the Multi-Disciplinary Team and to the local General Practitioners.<br />
ECT<br />
There is a well-established ECT team based at Bodmin Hospital which is led by an Old Age Psychiatrist<br />
colleague, this could provide opportunities for a senior trainee to develop his/her ECT experience further.<br />
CBT<br />
Dr Altaan is a fully qualified CBT therapist and accredited member of BABCP and has a once weekly CBT clinic.<br />
The trainee would have the opportunity to develop his/her experience in psychological therapies should<br />
he/she wish to do so.<br />
Leadership and Management<br />
There is a senior medical and consultants business meeting which takes place once a month as well as regular<br />
business meetings for the Old Age Psychiatrists which the senior trainee is welcome to attend.<br />
Weekly Timetables (see point 4 in Notes for Guidance)<br />
TRAINEE TIMETABLE: (This can be adapted and tailored to trainees needs)<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m. Community Work Community MDT Meeting<br />
Clinical Supervision (1<br />
Hour)<br />
Teaching/ CPD<br />
Training<br />
Research/ Special<br />
interest<br />
Inpatient<br />
work<br />
p.m.<br />
ON CALL:<br />
Community Work<br />
/Admin<br />
In patients MDT meeting<br />
Community<br />
Work<br />
1:10 includes S12 work- on call work will be supervised by consultants<br />
Research/ Special<br />
interest<br />
Admin<br />
TRAINER TIMETABLE:<br />
Monday Tuesday Wednesday Thursday Friday<br />
a.m.<br />
Community Work Community MDT<br />
Meeting<br />
Clinical<br />
Supervision (1<br />
Hour)<br />
SPA Community work Community work<br />
p.m.<br />
Community<br />
Work/Admin<br />
In patients MDT<br />
meeting<br />
SPA CBT Clinic Community<br />
Work/Admin<br />
56
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Learning Disability Psychiatry<br />
Dr Jane Bernal<br />
Cornwall Partnership Trust<br />
57
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Adult Psychiatry<br />
Dr Rick Bowers<br />
Cornwall Partnership NHS Foundation Trust<br />
The Specialist Registrar will provide supervised medical input to a comprehensive mental health service for<br />
patients registered with the Carrick Community Mental Health Team. The whole zone comprises seven general<br />
practices totalling 44 GP’s.<br />
Facilities / In-patients:<br />
The acute in-patient beds are at Longreach House, Redruth where there are 32 beds shared between six<br />
consultant psychiatrists. The Ward is divided into male and female bays. Continuing treatment beds are<br />
available at Fettle House, Bodmin Hospital. Psychiatric intensive care is provided at Harvest Ward, Bodmin<br />
Hospital by a consultant-led team. One full time CT1 trainee works with the Carrick in-patients.<br />
Out-patients:<br />
Clinics will be held at 57 Pydar Street, Truro at the community mental health team base providing<br />
comprehensive psychiatric assessments of existing CFT patients or new referrals following screening<br />
assessment. Some joint screening assessments with other healthcare professionals when early medical need<br />
identified.<br />
Ongoing development:<br />
CFT provides weekly academic programme for trainees involving Grand Round (case conferences), critical<br />
appraisals and lectures. There is monthly CPD sessions which trainees are encouraged to attend. Specialist<br />
Registrars can attend local consultant peer group meetings and is also invited to consultant business meetings.<br />
Consultants:<br />
The Consultant Psychiatrist for the Carrick area is Dr Richard K Bowers. He will provide personal supervision<br />
regularly for one hour per week as well as additional clinical supervision when appropriate. The trainee will be<br />
given a wide range of clinical experience in General Adult Psychiatry and work with sub-specialist teams, eg<br />
Assertive Outreach Team and Home Treatment Team. The supervising consultant also provides support for the<br />
Homeless GP Service in Carrick. The other consultant for adult psychiatry in Carrick is currently a locum.<br />
There are consultants working in Child and Adolescent Psychiatry, Old Age Psychiatry, Learning Disability and<br />
Drug Misuse covering west Cornwall. In addition, there are consultants working in Liaison Psychiatry, Recovery<br />
and in the Early Intervention in Psychosis Teams.<br />
Team Base:<br />
The CMHT is based at 57 Pydar Street, Truro, comprising of:<br />
Consultant Psychiatrist<br />
Clinical Trainee (1)<br />
CMHT Manager (1)<br />
Community Psychiatric Nurses (4)<br />
Healthcare Practitioner (to be appointed)<br />
58
Occupational Therapist (1 shared with <strong>South</strong> Carrick)<br />
Clinical Psychologist (1 shared with <strong>South</strong> Carrick)<br />
Approved Mental Health Professional (1)<br />
Social Work Assistant (1 wte shared with <strong>South</strong> Carrick)<br />
TRAINEE TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Community<br />
Meeting Team<br />
Supervision<br />
11-12noon<br />
Supervision<br />
Outpatient Clinic<br />
Admin<br />
Ward Round with<br />
Consultant<br />
Postgraduate<br />
teaching at<br />
<strong>West</strong>heath House<br />
or Consultants<br />
meetings<br />
Outpatient clinic Research /<br />
Special Interest<br />
Admin Admin Research /<br />
Special Interest<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision<br />
1:18 on-call with supervising Consultant. Available to provide psychiatric assessments, mainly under MHA 2007<br />
for 24-hour period. Also, advice to supporting medical staff and in-patient facilities. Day-time cover for<br />
Consultant On-call the previous day.<br />
59
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
ST4-6 Old Age Psychiatry<br />
Dr Henry Cameron<br />
Cornwall Partnership NHS Foundation Trust<br />
Roles and responsibilities of the trainee<br />
To contribute to medical community and inpatient care of older people with mental illness in the <strong>West</strong> Penwith<br />
and Isles of Scilly region of Cornwall. Specific responsibilities can be agreed early in the post but the general<br />
aims for the trainee are<br />
to gain experience in assessment and management of older people with organic and functional mental<br />
illness<br />
to develop ability to work independently in conjunction with a community mental health team and<br />
inpatient unit<br />
to manage a portion of the consultant catchment area under supervision<br />
Core clinical work<br />
Assessment of early memory problems in a ‘memory clinic’ setting<br />
Assessment of new or complex cases referred by CMHT members<br />
Regular input to local dementia nursing and residential homes<br />
Inpatient care to a functional ward and dementia assessment ward based at Longreach House, Redruth<br />
(weekly ward round)<br />
Weekly CMHT meeting<br />
Location of post<br />
Primary work base is Penzance<br />
Areas covered include Penzance, St Ives, Marazion and St Just<br />
Inpatient work at Redruth<br />
<strong>Peninsula</strong>r Medical School facilities at Royal Cornwall Hospital, Truro<br />
Other Opportunities<br />
Unique opportunity to work with a remote island community on the Scilly Isles and contribute to the<br />
development of services for this population<br />
Regular peer clinical meetings including quarterly sessions with a radiologist with special interest in<br />
dementia<br />
Academic activities<br />
Contribution to the weekly academic programme for junior trainees in Cornwall<br />
Participation in undergraduate training where possible<br />
Study leave and opportunities for research and audit sessions will be strongly supported<br />
Monthly county-wide grand round presentations<br />
Old Age Psychiatry management and clinical meetings<br />
Supervision<br />
Weekly consultant supervision is timetabled and made a priority.<br />
Intended learning Outcomes<br />
These will be agreed at the outset and achieved through a variety of clinical experience, formal and informal<br />
supervision and use of study leave, research and special interest sessions.<br />
60
About the Trainer<br />
I have been a consultant for 4 years, having completed higher training locally and part of junior training in<br />
London. My undergraduate training was at St Georges in London. I have an interest in clinical education and am<br />
enthusiastic about contributing to training in Old Age Psychiatry. I am an academic tutor for <strong>Peninsula</strong>r Medical<br />
School Undergraduates and have a Postgraduate Diploma in Clinical Education. I work full time over 4 days with<br />
extended working hours.<br />
Weekly Timetables<br />
TRAINEE TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Home Visits /<br />
admin<br />
Home Visits /<br />
admin<br />
0900 Ward<br />
Round (Cove<br />
Ward)<br />
Research /<br />
Special Interest<br />
Peer meetings /<br />
Academic<br />
programme<br />
Research / Special<br />
Interest<br />
0900 Team<br />
Meeting<br />
1130 Clinical<br />
Supervision with<br />
consultant<br />
1330 Memory<br />
clinic (Penzance)<br />
Admin / home visits<br />
/emergency<br />
assessments<br />
Admin / home visits<br />
/ emergency<br />
assessments<br />
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision<br />
Cornwall Rota, 1 in 14 days with Consultant supervision<br />
TRAINER TIMETABLE:<br />
a.m.<br />
p.m.<br />
Day off<br />
Day off<br />
Monday Tuesday Wednesday Thursday Friday<br />
0900 Ward<br />
Round (Cove<br />
Ward)<br />
Memory clinic (St<br />
Ives) / Home<br />
visits<br />
Meetings / CPD /<br />
Peer support<br />
Audit / research /<br />
CPD<br />
0900 Team<br />
Meeting<br />
1130 Clinical<br />
supervision with<br />
trainee<br />
1330 Memory<br />
clinic (Penzance)<br />
Home visits / clinic<br />
appointments<br />
Admin /<br />
emergencies<br />
61
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
Liaison Psychiatry<br />
Dr Adrian Flynn<br />
Cornwall Partnership NHS Foundation Trust<br />
Department of Liaison Psychiatry, Well-Being Centre, Royal Cornwall Hospital<br />
Trust, Treliske Hospital, Truro, TR1 2LJ<br />
JOB DESCRIPTION: The trainee will be based at Treliske Hospital, which is a 750 bedded hospital, within the<br />
Liaison Psychiatry Department and will also have access to office space at the Carrick Community Mental<br />
Health Team base where Dr Flynn’s medical secretary works. This is at 57 Pydar Street, Truro, TR1 2SS.<br />
The trainee will be part of a medical and nursing team providing psychiatric services to the Royal Cornwall<br />
Hospital, Treliske. The team comprises a full-time Consultant Psychiatric time, there is an ST2 trainee and an F1<br />
doctor. There is a Team Manager, two Psychiatric Liaison Nurses, and Alcohol Liaison Nurse and a half time<br />
Team Administrator.<br />
The team accepts referrals for the full range of psychiatric presentations in the general hospital. The majority<br />
of referrals are for self-harm and alcohol and substance misuse. The trainee will have an opportunity to see<br />
these patients, particularly more complex presentations and to supervise more junior medical staff in their<br />
assessments. They will be expected to provide advice and support to the senior nursing staff within the team<br />
and joint assessments are encouraged where possible. The assessment of more complex referrals is where the<br />
trainee will have their predominant role. These referrals include neuropsychiatric presentations, perinatal<br />
psychiatric presentations, complex somatoform disorders and co morbid common mental health disorders that<br />
are influencing the presentation of long term medical conditions. An outpatient clinic is available for the follow<br />
up of these patients. The trainee will be directly supervised by the Consultant for one hour each week. The<br />
Liaison Service is establishing links with many other hospital departments. There will be an opportunity to<br />
establish a special interest in one of these areas and an excellent opportunity for service development and<br />
research.<br />
The timetable is flexible and can be adjusted according to commitments. It provides an opportunity to<br />
supervise the F1 doctor.<br />
TIMETABLE:<br />
A.M.<br />
P.M.<br />
Monday Liaison Ward work Administration / F1 supervision<br />
Tuesday Liaison Ward Work Liaison MDT<br />
Supervision (1 hour)<br />
Wednesday Teaching/CPD Research or Special Interest<br />
Thursday Research or Special Interest Liaison OPD clinic<br />
Friday Liaison ward work Liaison ward work<br />
On-Call 1: 15 approx with Consultant Cover<br />
62
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Adult Psychiatry, Bolitho House, Penzance<br />
Dr Colin Hunter<br />
Cornwall Partnership NHS Foundation Trust<br />
JOB DESCRIPTION: The Specialty Trainee will provide supervised medical input to a comprehensive mental<br />
health service for patients registered with GPs in the <strong>South</strong> Penwith Community Mental Health Team<br />
catchment area.<br />
The acute inpatient beds at Longreach House, Redruth where there are 30 acute beds shared between nine<br />
consultant psychiatrists. The Bay Unit is divided into two wards; Perran and Carbis Wards generally gender<br />
specific. Psychiatric intensive care is provided at Harvest Ward, Bodmin Hospital by a consultant led team. An<br />
inpatient based junior doctor is shared with Dr Stefano Kustermann.<br />
Clinics will be held at Bolitho House, Penzance at the Community Mental Health Team Base.<br />
The total population of the catchment are is 36,539.<br />
The Consultant Psychiatrist for the <strong>South</strong> Penwith area is Dr Colin Hunter. The supervising consultant also<br />
provides medical cover to the Home Treatment Team, Assertive Outreach Team and some community forensic<br />
patients.<br />
TIMETABLE<br />
Monday<br />
Tuesday<br />
A.M.<br />
Community Meeting<br />
11.00-12.00 Supervision with<br />
Consultant<br />
Admin<br />
P.M.<br />
Ward Round with Consultant<br />
Outpatient Clinic<br />
Team Supervision<br />
Wednesday<br />
Post-grad Teaching at Bodmin Special Interest<br />
Hospital<br />
Thursday Emergency clinic / home visits Special Interest<br />
Friday Research Research<br />
On-Call 1: 21 with Consultant Cover<br />
63
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Adult Psychiatry<br />
Dr Stefano Kustermann<br />
Cornwall Partnership NHS Foundation Trust<br />
The Specialist Registrar will provide supervised medical input to a comprehensive mental health service for<br />
patients registered with Marazion Surgery in Marazion within the North Penwith Community Mental Health<br />
Team. The whole zone comprises five general practices. In addition to Marazion Surgery, it includes Cape<br />
Cornwall (St. Just), Stennack (St. Ives), Bodriggy (Hayle) and Phoenix Surgery (Camborne). The trainee will<br />
cover a surgery with five general practitioners.<br />
Facilities / In-patients:<br />
The acute in-patient beds are at Longreach House, Redruth where there are 32 acute beds shared between<br />
nine consultant psychiatrists. The Ward is divided into male and female bays. Psychiatric intensive care is<br />
provided at Harvest Ward, Bodmin Hospital by a consultant-led team. A Foundation Trust 2 junior doctor works<br />
with <strong>South</strong> Penwith in-patients as well as 2 part-time staff-grade doctors in the Community.<br />
Out-patients:<br />
Clinics will be held at Bolitho House, Penzance at the community mental health team base providing<br />
comprehensive psychiatric assessments of existing CFT patients or new referrals following screening<br />
assessment. Some joint screening assessments with other healthcare professionals when early medical need<br />
identified.<br />
Population:<br />
The total population of the catchment area is approximately 40,000.<br />
Ongoing development:<br />
CFT provides weekly academic programme for trainees involving Grand Round (case conferences), critical<br />
appraisals and lectures. There is a monthly CPD sessions which trainees are encouraged to attend. Specialist<br />
Registrars can attend local consultant peer group meetings and is also invited to consultant business meetings.<br />
Consultants:<br />
The Consultant Psychiatrist for the <strong>South</strong> Penwith area is Dr S. Kustermann. He will provide personal<br />
supervision regularly for one hour per week as well as additional clinical supervision when appropriate. The<br />
trainee will be given a wide range of clinical experience in General Adult Psychiatry and work with subspecialist<br />
teams, eg Assertive Outreach Team and Home Treatment Team. The other consultants for adult<br />
psychiatry in the west of Cornwall are:<br />
Dr Colin Hunter (<strong>South</strong> Penwith and Isles of Scilly)<br />
Dr Darren Mackintosh (<strong>South</strong> Kerrier)<br />
64
There are consultants working in Child and Adolescent Psychiatry, Old Age Psychiatry, Learning Disability and<br />
Drug Misuse covering west Cornwall. In addition, there are consultants working in Liaison Psychiatry, Recovery<br />
and in the Early Intervention in Psychosis Teams.<br />
TRAINEE TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Community<br />
Meeting Team<br />
Supervision<br />
Out-patient clinic<br />
Ward Round with<br />
Consultant<br />
Out-patient clinic<br />
or<br />
Admin (once a<br />
month)<br />
Post-graduate<br />
teaching at<br />
<strong>West</strong>heath House,<br />
Bodmin<br />
Admin<br />
Supervision (4pm-<br />
5pm)<br />
Admin<br />
Admin<br />
Research/Special<br />
Interest<br />
In-patients review<br />
Research/Special<br />
Interest<br />
ON CALL:<br />
1:20 on-call with supervising consultant. Available to provide psychiatric assessments, mainly under MHA 2007<br />
for 24-hour period. Also, advice to supporting medical staff and in-patient facilities. Day-time cover for<br />
Consultant On-call the previous day.<br />
TRAINER TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Community<br />
Meeting Team<br />
Supervision<br />
Out-patient clinic<br />
Ward Round with<br />
SpR Trainee<br />
Supervision of<br />
Staff Grade<br />
Psychiatrist<br />
Out-patient clinic<br />
or<br />
Admin (once a<br />
month)<br />
CPD<br />
Consultant Meetings<br />
MHRT/Managers<br />
Reviews<br />
Admin<br />
MHRT/Managers<br />
Reviews<br />
Supervision (4pm-<br />
5pm)<br />
Admin<br />
Admin<br />
(off on alternate<br />
weeks)<br />
Emergency outpatient<br />
clinic<br />
In-patients review<br />
65
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
General Adult Psychiatry (Continuity Model- outpatients and inpatients)<br />
Dr Richard Laugharne<br />
Cornwall Partnership NHS Foundation Trust<br />
JOB DESCRIPTION: This placement provides experience in working with a multi-disciplinary team in a Rural<br />
Locality. The Trainer has a particular interest in service organisation and this post will provide a good<br />
experience in Core General Adult Psychiatry with a Consultant who is a member of the Academic Department<br />
of Mental Health at Exeter University Medical School. Trainees will have an opportunity to develop their<br />
research skills, teach others and acquire the necessary knowledge and skills to work as a General Adult<br />
Psychiatrist in both inpatient and community rural settings. Dr Laugharne has been past Head of School of<br />
Psychiatry and is currently Lead for Research and Innovation for the Trust. His current research interests<br />
include public education through a radio phone in, trust in psychiatrists and mental health teaching in Ghana.<br />
He has published over 30 peer reviewed papers, and co-authored papers with at least six trainees who have<br />
worked with him.<br />
DAY AM PM<br />
MONDAY 9 – 10 Bed Management Meeting<br />
10.30 – 12 Ward round Fletcher ward<br />
12 – 1 Supervision F2 doctor<br />
TUESDAY<br />
WEDNESDAY<br />
10 – 11.30 Weekly CMHT meeting/referral meeting<br />
11.30 – 12.30 Weekly supervision of SpR<br />
Attend monthly CPD sessions 4 th Wednesday in<br />
month<br />
Attend monthly SMSC<br />
Peer Group<br />
2 – 5 Admin/Home visits<br />
Trevillis House<br />
OPD clinic alternating between<br />
Liskeard/ Looe/St<br />
Blazey/Fowey/Lostwithiel<br />
Community Clinical director work<br />
Occasional work on BBC Cornwall<br />
Radio phone in programme<br />
THURSDAY <strong>Peninsula</strong> Medical School - Mental Health Research Lead for Research and Innovation<br />
Group, Exeter: Research<br />
FRIDAY Ward Round – Fletcher Ward, Bodmin Hospital *** Meetings/Visits<br />
Ad hoc OPD clinics/home visits<br />
Admin at Trevillis House<br />
On-Call 1 : 18 with Consultant Cover<br />
Supported activities fitted into timetable as opportunity arises.<br />
*** Meetings/Visits<br />
Quarterly Research Governance Committee meetings<br />
Quarterly Regional Division meetings<br />
Quarterly Research and Innovation Committee meetings (Lead)<br />
EMDR sessions with patients<br />
Roles<br />
Community Clinical Director, CFT<br />
Lead for Research and Innovation, CFT<br />
Honorary Senior Lecturer, <strong>Peninsula</strong> Medical School<br />
66
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
General Adult Psychiatry<br />
Dr Darren Mackintosh<br />
Cornwall Partnership NHS Foundation Trust<br />
Trengweath, Penryn Street, Redruth, Cornwall TR15 2SP<br />
JOB DESCRIPTION: The Specialty Trainee would undertake an apprenticeship role, learning psychiatry through<br />
joining both an inpatient and community team and taking a responsible clinical role. They will provide<br />
supervised medical input to a comprehensive mental health service for adults of working age registered with<br />
GP Surgeries in Camborne, North Kerrier, and in the <strong>South</strong> Kerrier region. The trainee will be expected to<br />
conduct ward rounds, complete new assessments and joint visits with community colleagues.<br />
The acute inpatient beds are based on Bay Unit at Longreach House, Redruth where there are 32 acute beds<br />
shared between eight consultant psychiatrists. Bay Unit is divided into two wards; Perran and Carbis Wards,<br />
generally gender specific. The wards are served by an FY2 trainee attached to the team, who also assesses<br />
community patients in the outpatient clinic.<br />
The CMHT is spilt between Trengweath, serving the Camborne population, and Helston, serving <strong>South</strong> Kerrier;<br />
though joint meetings are held weekly in Helston for referral allocation and discussion of clinical issues.<br />
Outpatient Clinics are held at both Trengweath, in Redruth, and at the Community Mental Health Team base in<br />
Helston.<br />
The supervising consultant also provides medical cover to the Home Treatment Team, Assertive Outreach<br />
Team, the Eating Disorders Team, and some community forensic patients. Intensive care, rehabilitation and<br />
low secure beds for the whole of the county are located at Bodmin with separate medical cover; though the<br />
supervising consultant is called on to provide cover when colleagues are away. Close liaison with the Early<br />
intervention team is required, as the catchment area consultant provides inpatient care for that team’s<br />
patients when required.<br />
Teaching opportunities are available in the form of medical students attached to the inpatient unit. Teaching<br />
at the academic meetings for junior doctors will also be encouraged. The Audit department is located close to<br />
the trainee’s office, facilitating audit projects if desired.<br />
The trainee will be provided with at least one hour direct supervision per week. The trainee’s office is located<br />
immediately adjacent to the trainer so regular informal discussions should also be possible.<br />
Weekly Timetables<br />
TRAINEE TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
Research Training 0930-1300<br />
Outpatient Clinic<br />
0915-1000 bed<br />
management<br />
1200-1300 CT4-6<br />
Supervision<br />
1400-1700 Ward<br />
Round<br />
Special Interest<br />
Flexible session-<br />
DVs/MHRTs<br />
1400-1600 CMHT<br />
Allocation<br />
0930-1200<br />
HTT/Emergency<br />
Clinic<br />
1400-1500 Ward<br />
Review<br />
67
ON CALL –<br />
The trainee will participate in a rolling rota which incorporates general adult, old age and learning disability<br />
psychiatry county wide, on a 1:9 basis. An accredited trainer will second you for on call purposes. When you<br />
are absent on leave and scheduled for duty the seconding consultant will pick up your duty as a matter of<br />
course.<br />
TRAINER TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
0930-1300<br />
Outpatient Clinic<br />
0915-1000 bed<br />
management<br />
1200-1300 CT4-6<br />
Supervision<br />
1400-1700 Ward<br />
Round<br />
1400-1500 F2<br />
Supervision<br />
Peer<br />
Group/CPD/Senior<br />
Medical Staffing<br />
Committee/Working<br />
Practices Meeting<br />
0930-1300<br />
Outpatient<br />
Clinic<br />
1400-1600<br />
CMHT<br />
Allocation<br />
0930-1200<br />
HTT/Emergency<br />
Clinic<br />
1100-1300 Med<br />
Student Teaching<br />
(alternate weeks in<br />
term time)<br />
1400-1500 Ward<br />
Review<br />
68
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
General Adult Psychiatry<br />
Dr Mather<br />
Cornwall Partnership NHS Foundation Trust<br />
Bodmin Hospital, Bodmin, Cornwall<br />
JOB DESCRIPTION: The specialist Trainee will provide supervised psychiatric care and input to working age<br />
adults from 16 years upwards in an area of North Cornwall which includes a mix of deprived, affluent, urban<br />
and rural areas. The patch covers Padstow, St Columb, Wadebridge, Bodmin and the Launceston area. This<br />
busy post serves a population of approximately 31,000 adults. The CMHT enjoys good relationships with<br />
primary care and has been a key contributor to the now completed and successful integrated care pilot project<br />
currently being rolled out to the rest of Cornwall. Monthly ‘hub’ meetings occur between CMHT staff, the<br />
Consultant Psychiatrist and GPs at GP surgeries.<br />
Inpatients reside at Fletcher Ward on the same site as our administrative and out patient clinics in Bodmin<br />
Hospital. Other teams such as AOT, EIP, HTT, Forensic, Complex Care/Dementia and HCAs/supported housing<br />
workers also have staff based at this site which makes maintaining high quality and efficient relationships with<br />
other teams easier.<br />
Outpatient clinics are held at primarily at Bodmin Hospital and also in GP surgeries in Launceston and<br />
Wadebridge. There is also ample scope for joint community working with other members of the wider team.<br />
The Consultant for the post is Dr Greg Mather. The supervising Consultant also provides medical cover to the<br />
Home Treatment Team and Assertive Outreach Team. The post enjoys the valuable support of a full time ST2<br />
trainee. The ST4-6 post links well with the supervising consultant post providing good opportunities for readily<br />
accessible support and supervision. The higher trainee will also have ample opportunity to develop their<br />
interests and skills of independent working or of linking with other members of the wider team.<br />
Weekly Timetables<br />
TRAINEE TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
OPD<br />
OPD Bodmin/<br />
Bodmin<br />
Community Visits<br />
Administration<br />
Clinical supervision<br />
HTT<br />
Inpatient review<br />
round Bodmin<br />
Team Meeting<br />
(monthly)<br />
MDT meeting<br />
CPD Sessions<br />
(monthly)<br />
SMSC (monthly)<br />
Contribution to<br />
Junior Doctor<br />
training available<br />
Special Interest or<br />
Research<br />
Research or<br />
Special Interest<br />
Inpatient review<br />
round<br />
Bodmin<br />
Educational<br />
Supervision<br />
ON CALL – 1:18 with Consultant Cover<br />
69
TRAINER TIMETABLE:<br />
a.m.<br />
p.m.<br />
Monday Tuesday Wednesday Thursday Friday<br />
OPD<br />
OPD<br />
Bodmin<br />
Launceston/Wadebridge<br />
Administration<br />
Clinical<br />
supervision<br />
(ST4-6)<br />
HTT<br />
Inpatient review<br />
round Bodmin<br />
Team Meeting<br />
(monthly)<br />
MDT meeting<br />
Educational<br />
Supervision<br />
(ST2)<br />
CPD Sessions<br />
(monthly)<br />
SMSC (monthly)<br />
Peer Gp (twice<br />
monthly)<br />
Administration<br />
Management:<br />
MHA Section<br />
12(2) panel work<br />
OPD<br />
Launceston/Wadebridge<br />
Inpatient<br />
review round<br />
Bodmin<br />
Educational<br />
Supervision<br />
(ST4-6)<br />
70
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Early Intervention in Psychosis<br />
Dr Michael Metcalfe<br />
Cornwall Partnership NHS Foundation Trust<br />
The Cornwall Early Intervention in Psychosis Service has approximately 200 clients and is divided into two<br />
teams, one based at Bodmin Hospital and the other based at Trengweath Unit in Redruth. In addition to<br />
nursing staff, the service includes Occupational Therapists and Psychologists. There is a full time Consultant<br />
Psychiatrist (Dr Mike Metcalfe) and Associate Specialist (Dr Cathy English). The team receives referrals of<br />
individuals with a suspected first episode of psychosis between the ages for 14 and 35 years. Consultant<br />
responsibility for those under16 years of age remains with the Child and Adolescent Consultants.<br />
The full-time medical secretary and Associate Specialist are based at the Trengweath Mental Health Unit in<br />
Redruth with office space also available at Bodmin Hospital. The trainee will have dedicated office space and a<br />
networked computer and will be co-located with one of the Early Intervention Teams. The Consultant<br />
Psychiatrist works across the whole county, the Associate Specialist mainly in the west. Clinical work may have<br />
a focus in the west or east of the county, and this will be negotiated individually with trainees.<br />
The trainee will be expected to take part in initial assessments for individuals referred to the service as well as<br />
working with those individuals taken on by the service during their three year period of contact with Early<br />
Intervention. This work will involve significant multi-disciplinary and multi-agency liaison and the majority of<br />
clinical consultations will be carried out in conjunction with another member of the team. The trainee’s work<br />
will be fully and comprehensively supervised by the Consultant Psychiatrist.<br />
There is no direct inpatient commitment involved in this post. The majority of clinical contacts will take place<br />
in outpatient clinics, general practice settings and at individuals’ homes. The experience gained and skills<br />
learned will primarily be focused on identification and treatment of psychosis. The range of referrals will<br />
enable the trainee to fine-tune their ability to distinguish early psychosis from other problems and disorders.<br />
The work with those already on the caseload will enable the trainee to develop their skills and knowledge in<br />
the treatment of psychosis, both in terms of medication and non-medical approaches.<br />
There are particular opportunities to have clinical experience and training in Cognitive Behavioural Therapy for<br />
psychosis and to train in use of the Positive and Negative Symptoms Scale (PANSS) under the supervision of<br />
one of the clinical psychologists.<br />
The Early Intervention service has monthly CPD sessions which the trainee will be encouraged to attend and<br />
contribute to. There is also a monthly Trust CPD morning offering high quality educational presentations.<br />
The team works in line with the principles of Recovery and the Whole Life Approach. Support workers and a<br />
group worker focus on non-clinical activities, including a wide range of activity groups and an allotment. The<br />
trainee will have the opportunity to work alongside these individuals and to develop their skills in using social<br />
approaches in addition to the psychological and biological approaches already described.<br />
71
SAMPLE TIMETABLE:<br />
Monday<br />
A.M.<br />
10.00 – 11.00 Supervision<br />
Audit<br />
P.M.<br />
Clinical<br />
Tuesday Special Interest Clinical/Admin<br />
Wednesday<br />
CPD, teaching sessions,<br />
Research<br />
meetings<br />
Thursday 9.30 – 1.30 Team Meeting, WEST Clinical<br />
Friday Clinical Clinical/Admin<br />
On-Call: Senior on-call rota, with Consultant Cover<br />
72
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
TRAINING BASE:<br />
Old Age Psychiatry<br />
Dr Steven Naylor<br />
Cornwall Partnership NHS Foundation Trust<br />
Trengweath, Redruth<br />
SW PENINSULA <strong>DEANERY</strong> SCHOOL OF PSYCHIATRY<br />
Rotational SpR/ST4-6 Training Scheme (GA & OA Psychiatry)<br />
The older person's psychiatric service for Redruth and the Lizard provide care for the over 65 year olds with<br />
functional or organic disorders and under 65s with dementia.<br />
There is a memory clinic and liaison psychiatric services provided to Helston Community Hospital (GP run<br />
hospital) and Camborne/Redruth Community Hospital (eldercare medicine). There are two inpatient wards.<br />
Cove Ward in Redruth is an organic assessment unit with 20 beds. Functional patients are admitted to the<br />
functional adult psychiatric ward (Bay Ward) in Redruth. For functional psychiatric outpatients there is an acute<br />
Home Treatment Team who will work with patients intensively for short periods of time.<br />
The specialist trainee will be a member of the community mental health team and be given a role matching<br />
his/her seniority and experience. When trainees have appropriate competency they may medically manage a<br />
proportion of the catchment area (under supervision) to enable them to experience a full range of the day to<br />
day issues arising for senior psychiatrists.<br />
Specialist interest experience can be arranged with the old age psychiatric liaison service at Treliske, ECT at<br />
Bodmin, and Parkinson's Disease Clinics in Redruth. There are opportunities to teach junior doctors, nursing<br />
staff and medical students. There are grand rounds/journal clubs held at the weekly Wednesday morning<br />
teaching.<br />
TIMETABLES:<br />
Trainer A.M. P.M.<br />
Monday Clinic Clinic/Visits<br />
Tuesday Ward Round Ward/or Community Work<br />
Trainee Supervision<br />
Wednesday Meetings/Training Administration<br />
Thursday Team Meeting Visits<br />
Friday<br />
Emergency cover by pairing<br />
consultant<br />
Emergency cover by pairing<br />
consultant<br />
Trainer A.M. P.M.<br />
Monday Clinic Clinic/Visits<br />
Tuesday Ward Round Ward Work and Supervision<br />
Wednesday Teaching or meetings Administration<br />
Thursday Team Meeting Visits<br />
Friday Specialist Interest/Research Specialist Interest/Research<br />
On-Call1: 10 with Consultant Cover<br />
73
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Old Age Psychiatry<br />
Dr Giles Richards<br />
Cornwall Partnership NHS Foundation Trust<br />
JOB DESCRIPTION: The placement in Old Age Psychiatry would be an excellent training opportunity. Dr<br />
Richards has a great interest in teaching and experience at undergraduate and postgraduate training (Current<br />
Training Programme Director for ST Training in Adult and Old Age Psychiatry). His clinical work is<br />
comprehensive and varied and offers excellent preparation to be a Consultant. Dr Richards is involved in<br />
current research (linked to DeNDRon research org) and audit. Any research undertaken by the SpR can be<br />
supervised by himself or alternatively research-active members of the Mental Health Research Group at the<br />
<strong>Peninsula</strong> Medical School.<br />
Role of the Trainee: To assist in the provision of medical care to the inpatient and community service for<br />
patients with a mental illness who have Complex Care needs or are suffering from dementia in the Caradon<br />
area of Cornwall.<br />
Facilities: There is a 20 bedded dementia assessment unit at Bodmin Hospital for patients from the East of the<br />
county. Our functionally ill patients are admitted to Fletcher Ward, Bodmin Hospital, where we have a limited<br />
number of beds on an adult inpatient ward. We average a total of 2-8 inpatients. The community team based<br />
at Trevillis House comprises of 4.5 Community Psychiatric Nurses, 1 Occupational Therapist and 3 Health Care<br />
Assistants. There is one CMHT meeting per week for review of referrals, allocation and discussion of clinical<br />
issues and any business matters that affect the team. We also provide a Memory Clinic for the patients of<br />
Caradon comprising a Staff Nurse, an Occupational Therapist, Health Care Assistant and psychology input. The<br />
Memory Clinic recently achieved ‘Excellence’ in the MSNAP Accreditation process. The medical team is a<br />
Consultant Psychiatrist and a shared SHO.<br />
Population Served: We cover the population of ten GP practices in Caradon with an elderly population of<br />
15,500. This is a rural farming area with a low income and poor transport facilities. The consultant carries out<br />
the vast majority of assessments and follow up appointments in the patient’s home with the exception of the<br />
weekly review of the Memory Clinic patients.<br />
Number of Consultants for the Service: There is an overall elderly population of just of 120,000 which is<br />
served by 10 Consultant Old Age Psychiatrists that are based throughout the county. We meet monthly as a<br />
group to discuss clinical, education and business matters.<br />
Opportunity for Teaching: Medical students from the <strong>Peninsula</strong> Medical School have clinical placements with<br />
our team and feedback sessions. There are also regular internal team training days, teaching staff in the local<br />
community hospitals and the SpR would be encouraged to be involved in the academic meetings for the junior<br />
doctors, both in house and on the MRCPsych course in Exeter.<br />
Opportunity for Research: Specialist Registrars will have the opportunity to develop their own research<br />
project under supervision from an appropriate supervisor or joining an established research project. There is a<br />
<strong>South</strong> <strong>West</strong> older person’s research group that meets regularly and currently the inpatient team are gaining<br />
great experience in the use of alternative approaches in managing dementia, including aromatherapy, art and<br />
drama.<br />
74
TIMETABLE:<br />
A.M.<br />
P.M.<br />
Monday Clinical work/Admin (community) Clinical work/Admin (community)<br />
Tuesday Clinical work/Admin (community) Inpatient Ward Round<br />
Wednesday Management CPD Clinical work/Admin (community)<br />
Thursday<br />
Team Meeting<br />
Clinical work/Admin (community)<br />
11.30 – 12.30 Supervision<br />
Friday Research and Special Interest Research<br />
On-Call 1: 10 with Consultant Cover<br />
75
POST:<br />
TRAINER:<br />
EMPLOYING TRUST:<br />
Substance Misuse Psychiatry<br />
Dr Rupert White<br />
Cornwall Partnership NHS Foundation Trust<br />
JOB DESCRIPTION: Cornwall Drugs and Alcohol Team (CDAT) provides treatment and support to problem drugusers<br />
across Cornwall, a relatively poor rural county with a total population just under 500,000. CDAT medical<br />
staff comprises 1 SHO wte, 1.8 Staff Grade wtes, 1 Clinical Assistant wtes, 3 Consultant wtes. The Specialty<br />
Trainee would be attached to the team in the mid-zone PCT, with a catchment area population of around<br />
150,000. It is one of three Consultant-led teams for the county as a whole, and has an office based in Redruth,<br />
with clinics in Truro, St Austell, Newquay and Falmouth. There is also a smaller cohort of amphetamine users<br />
on dexamphetamine. The Specialty Trainee would be expected to gain experience in prescribing methadone,<br />
buprenorphine and dexamphetamine and would be encouraged to take a small caseload as key worker in order<br />
to do this.<br />
Alcohol and other specialist teams: There are a number of specialist services also provided by CDAT. As well as<br />
successful youth and criminal justice teams, there is a small but rapidly-evolving alcohol team co-located with<br />
the larger core drug team. This alcohol team works closely with the CMHT’s in co-managing clients with<br />
complex needs. Although it is a prescribing service there is more emphasis on psychosocial interventions,<br />
especially motivational enhancement. The alcohol team also has a detoxification bed in the local DGH.<br />
Links with other agencies: There would be opportunities to link to local CMHTs, and provide some training and<br />
support to them. In general, supporting recently developed dual diagnosis initiatives would be encouraged, and<br />
it is imagined that a Specialty Trainee could contribute a lot in this area. CDAT has close links with local GPs,<br />
and indeed some have clinical sessions with the team. Shared care initiatives are being taken up by GPs all over<br />
the county, and there would be opportunities for the trainee to have experience of supporting and advising<br />
local doctors re the management of their clients.<br />
Research: CDAT is an authority on substitution treatments for amphetamine users. It has also pioneered the<br />
use of buprenorphine substitution therapy in the UK. There have been a number of peer-reviewed research<br />
publications relating to these areas, and more evaluations are planned. Research and audit is a particular<br />
strength of this team, and this will therefore be encouraged. The Specialty Trainees timetable would be<br />
adapted to suit their training requirements. Assuming that the Specialty Trainee had had little experience in the<br />
field they would be encouraged to take a small case-load of both drug and alcohol clients, and act as their keyworker.<br />
As well as formal time-tabled supervision, adequate informal supervision would be assured as all the<br />
sessions on the attached timetable are also attended by the supervising Consultant.<br />
A.M.<br />
P.M.<br />
Monday<br />
Home Detoxification Assessment and<br />
Alcohol Team Meeting (Redruth)<br />
prescribing (Redruth)<br />
Tuesday Drug Outpatient Clinic (St Austell/Truro) Special Interest (?psychotherapy-<br />
Redruth)<br />
Wednesday CPD Programme Research<br />
Thursday Alcohol Clinic (Truro/St Austell alternating) Special Interest (?psychotherapy)<br />
Friday<br />
Drug Team Meeting<br />
11.00 - 12.00 Supervision with Consultant<br />
On-Call 1: 18 with Consultant Cover<br />
Research<br />
76