Specialty Training - South West Peninsula Deanery

Specialty Training (ST4-ST8)
DUAL TRAINING IN MEDICAL PSYCHOTHERAPY AND
GENERAL ADULT PSYCHIATRY
Role Profile
February 2013
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Contents
PAGE
Schedule of Posts 3
Introduction 5
Research 12
Special Interest Sessions 13
Training Centres 14
Specific Posts 17
NOTE:
The information contained in this document may be subject to change long term. Any
applicant successfully appointed to a Specialty trainee post is advised to see up to date
information of this kind from the Trust to which they are appointed and from the Trusts to
which they subsequently rotate.
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SCHEDULE OF POSTS
Speciality
Page
No
Centre Trainers Old Age Adult (Core) Adult
Specialty
Devon Partnership NHS Trust
9-10 Dr Aitken ✓ (Liaison)
11 Dr Dickinson (U&I)
12 Dr Dorkins (Forensic)
14 Dr Dunn
15 Dr Feller (Learning Dis)
16 Dr Freer
17 Dr Gupta
18 Dr Laszlo (Eating Dis)
19-20 Dr Lovett (U&I)
21-22 Dr Lynch
23 Dr McLaren (Subst Misuse)
24 Dr Mizen
(Psychotherapy)
25 Dr Montgomery
26 Dr Nelson
27 Dr Pearson
28-29 Dr Rowlands (Subst Misuse)
29 Dr Saluja
30 Dr Somerfield
31 Dr Dixon (U&I)
32 Dr Noble (U&I)
33 Dr Moore
34-35 Dr Thekkepalakkal
36-37 Dr Warren-Penny
38-39 Dr Owens (Liaison)
Plymouth Teaching Primary Care Trust
40 Dr Battersby (Subst Misuse)
41-42 Dr Buttan (U&I)
43 Dr Cunningham
44-45 Dr Cooper
46 Dr Dinniss
47 Dr Ford
48 Dr Murphy
49 Dr Payne
(Rehabilitation)
Cornwall Foundation Partnership Trust
50-51 Dr Altaan
51 Dr Bernal (LD)
52-53 Dr Bowers ✓
54 Dr Flynn (Liaison)
55 Dr Hunter
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56-57 Dr Kusterman ✓
58 Dr Laugharne
59 Dr Mather
61 Dr Menon
62 Dr Metcalfe (E.I.S)
63 Dr Naylor
64 Dr Richards
65 Dr White (Subst
Misuse)
66 Dr Scobie
67-68 Dr Mackintosh
68 Dr Shankar (neuropsych)
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INTRODUCTION
DUAL TRAINING
The South West Peninsula Deanery General Psychiatry and training scheme is introducing a new Dual training
in Medical Psychotherapy and General Adult Psychiatry. The five year advanced training integrates training
provision in both sub-specialties to enable qualification on the Royal College of Psychiatrists’ specialist register
with two Certificates of Completion of Specialist Training (CCT) recognised by the General Medical Council as a
Medical Psychotherapist and as a General Psychiatrist. The General Medical Council ratified this dual training
award in 2012.
The training programme outlined in this document describes a combined structure for training in medical
psychotherapy and general psychiatry with the aim of integrating these specialist trainings to equip the doctor
to practice as a Consultant Psychiatrist in Medical Psychotherapy, and/or a Consultant General Adult
Psychiatrist.
The training programme is guided by an awareness of the need for the future Consultant Psychiatrist in
Medical Psychotherapy/General Adult Psychiatry to deliver expert psychotherapy, to apply expert
psychotherapeutic thinking to inform patient care through consultation and reflective practice in a range of
psychiatric settings but also to deliver and manage specialist psychotherapeutic services in inpatient, day
patient and outpatient settings for highly complex patients.
This dual training offers a psychotherapeutic approach to the understanding of the development of the
personality, which forms a bridge between both the general psychiatric and the general psychotherapeutic
patient populations. The dual training will also equip the trainee to understand and respond to the emotional
demands of working in general psychiatric settings therapeutically. It is recognised that it is likely in future that
the role of medical psychotherapists will be in the psychotherapeutic treatment and therapeutically informed
management of people with combinations of eating disorder, personality disorder, substance misuse and
autistic spectrum disorder. The training therefore has particular opportunities in these areas for trainees. The
training offers breadth of experience of working with a high range of complexity including medically
unexplained symptoms, gender dysphoria, family and parenting assessments and Primary Care liaison.
For psychoanalytic trainees personal therapy will be a central required part of their professional development
throughout the five year training programme. For trainees who major in other models of therapy such as
cognitive behavioural therapy, self-reflective personal development experience, which would be considered
congruent with the adopted main therapeutic modality training orientation would be required. The chosen
path of self-reflective development would not preclude personal therapy. The importance of an awareness of a
range of models of psychotherapy will be incorporated in the dual training programme in line with the Royal
College of Psychiatrists’ curriculum requirements for medical psychotherapy training. In addition, the role of
pharmacotherapy in combination with psychotherapy will be a feature of both the psychiatric and the medical
psychotherapeutic training of the dual trainee, who will be using psychotherapeutic approaches (alongside
psychotropic medication and bio-psycho-social approaches).
THE TRAINING SCHEME
The Scheme offers posts in all Trusts providing psychiatric care in Devon and Cornwall, with experience ranging
from cities to suburban and dispersed rural areas. There is a range of models of service provision on inpatient,
outpatient and community based care. The general adult rotational scheme affords placement in several
branches of psychiatry; liaison psychiatry; substance misuse, general psychiatry, psychiatry of old age; Forensic
Psychiatry, Home Treatment and Early Intervention in Psychosis. Training occurs in a number of different
settings; psychiatry hospitals, community units and academic departments. As there are more approved
training opportunities than funded posts Specialty Trainees have considerable choice and flexibility in planning
an individually tailored training programme. The Medical Psychotherapy Training scheme offers placements in
a Generic Psychotherapy outpatient service offering a range of evidence based models, a Therapeutic Day
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Programme and inpatient setting for people with Personality Disorder in Exeter as well as experience of
psychological therapies as provided by the psychology service, mental health teams and IAPT services. The
training in each of the training posts have been planned to give each Specialty Trainee a broad experience as
well as providing scope to develop research and pursue a special clinical interest.
ORGANISATION OF TRAINING
The dual training is five years in length and on satisfactory completion will lead to the award of two Certificates
of Completion of Training (CCT) in Medical Psychotherapy and General Psychiatry, recognised by the General
Medical Council if the trainee is appointed to the two dual training sub-specialties in an appointment
committee simultaneously. The Training Programme Director in the South West Peninsula Deanery for the
Medical Psychotherapy Scheme is Dr Susan Mizen and the Training Programme Director for the General
Psychiatry Scheme is Dr Giles Richards. The two Training Programme Directors take joint responsibility for the
running of the dual training scheme as a whole. The dual trainee will at all times be allocated an educational
supervisor (trainer) who is a trained Consultant Medical Psychotherapist and an educational supervisor
(trainer) who is a Consultant General Psychiatrist. There are three strands to the training programme over the
five
years. One strand is a full higher training in General Psychiatry, the second strand is a full higher training in
Medical Psychotherapy and the third strand is in integrating these two sub-specialty trainings in the
applications of psychotherapy in different psychiatric settings. The following model of dual training developed
in The Peninsula Deanery outlines each year of the five year programme in which gaining a wide range of
experience of placements across the geographical area of the scheme is balanced with the importance of
allowing sufficient time to take on long term psychotherapeutic work. The underlying principle of exposing the
trainee to both General Psychiatry and Medical Psychotherapy from the outset of training concurrently is to
foster a ‘training dialogue’ for both trainee and trainers between the two sub-specialties and their different
paradigms of mind.
In the first year the trainee will be offered General Psychiatry training and preparation for starting their
psychotherapy training which will include starting Personal Analysis where the trainee has chosen to specialise
in Psychoanalytic Psychotherapy. In the second year three days per week will be spent in general adult
psychiatry and two days in psychotherapy. In the third year the trainee will spend two days in adult psychiatry
and three in psychotherapy. During the second and third year trainees will be offered opportunities to develop
their thinking and skills in applying psychotherapeutic ideas to psychiatric practice. In the fourth year a full time
placement in psychotherapy and the Personality Disorder service will be offered and in the fifth year a
specialist psychotherapeutically oriented placement will be offered in keeping with the trainee’s career plans.
The basic plan of each one year training post is:
Eight clinical sessions with the principal Consultant Trainer, except in the second and third years where the
training is integrated.
One special interest session, which may be with the Consultant Trainer or with another Consultant. The
special interest sessions will be arranged after discussion with the Programme Director.
One research session supervised by a member of the Academic Department or a supervisor approved by
the Programme Director.
The training scheme is based around main centres in Bodmin, Redruth, Exeter, Plymouth, Barnstaple and
Torbay. Each centre has its own on-call arrangements. Specialty trainees on the scheme are employed by one
of three NHS Trusts: Cornwall Partnership Foundation NHS Trust, Devon Partnership Trust and Plymouth
Healthcare Community Interest Company (A Social Enterprise). The Regional Postgraduate Dean is Professor
Martin Beaman, Peninsula Medical School, John Bull Building, Research Way, Tamar Science Park, Derriford,
Plymouth.
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Allocation of posts is made by the Programme Director in the light of discussions with individual Specialty
Trainees, initially directly after appointment and then a few months prior to each rotation point in July of each
year. Specialty Trainees are strongly encouraged to meet with the Consultant trainers for their preferred
placements prior to the final allocation. Placements will be made tailored to particular trainees interests where
possible. However is also the case that placements may change in the course of training and not all of those
currently available will continue to be so at the time the trainee is approaching that stage of training.
There are 16 posts on the rotation. Four NTN’s exist in Old Age Psychiatry, eleven in Adult Psychiatry and one
in Medical Psychotherapy. Of the sixteen posts, four are allocated to Cornwall Partnership Trust, four to
Plymouth Primary Care Trust and eight to Devon Partnership Trust.
Throughout his/her tenure, each Specialty Registrar is entitled to one session per week for research as part of
the core training programme in psychiatry and this does not constitute study leave. Specialty Trainees are
entitled to additional study leave and one half day for special interest to be planned between trainee and
trainer. The Specialty Trainees are also encouraged to meet monthly for informal support and specific
educational activities.
The Programme Director runs a regular training surgery in each locality and trainees are encouraged to make
use of this facility. The scheme has a well-established ARCP (Annual Review Competency Progression) process
which is highly regarded by trainees.
OUTLINE STRUCTURE FOR THE FIVE YEAR TRAINING PERIOD
The principle of proposing and ratifying each year of the Advanced Medical Psychotherapy Training Plan (see
appendix A) year on year between the Trainee, the Training Programme Directors and the two Educational
Supervisors will apply throughout the period of dual training, depending on the developing training needs of
the trainee. The detail of where particular General Psychiatry placements take place is therefore omitted in the
following outline with the principles underlying the training objectives for each year described. There are two
Consultant Psychiatrists in Psychotherapy on South West Peninsula Deanery Psychotherapy training scheme, Dr
Mizen Consultant Psychotherapist and Dr Darnley who is a Consultant Psychiatrist in Forensic Psychotherapy. It
is anticipated that Dr Darnley will be able to offer placements to interested Trainees in the Medium Secure Unit
at Langdon Hospital. General Psychiatry placements will be identified which do not necessarily include
Educational supervisors with a special interest in psychotherapy but do include the Educational Supervisor
actively in planning the placement and articulating the aims of the dual training before the trainee begins in
their General Psychiatry placement.
YEAR 1 Specialty Training Year ST4
General Adult Psychiatry: Five days per week
The first year of training will be spent in General Adult Psychiatry. This post is more likely to be in a location
outside Devon Partnership NHS Trust in order that the trainee can gain the broadest Adult Psychiatry
experience before the commitments of their psychotherapy training begin. During this year the trainee will
meet with the Psychotherapy training programme director to discuss their psychotherapeutic interests and
career plans. If their Psychotherapy training at CT 1-3 has substantial gaps they may attend the training
programme in the Psychotherapy Department at Wonford House. If the trainee’s interest is in psychoanalytic
psychotherapy as their primary modality they will be expected to start in Personal therapy during the course of
this year.
The General Adult Psychiatry Educational Supervisor is the Consultant in this placement.
YEAR 2 Specialty Training Year ST5
General Adult Psychiatry: three days per week
Three days per week will continue to be spent in a General Adult Psychiatry setting which will be congruent
with the trainee’s needs and developing interests. For example, this could be in an early intervention service, a
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crisis team, an in-patient team, liaison psychiatry, rehabilitation and recovery or a community team with a
specialist area, such as assertive outreach.
Medical Psychotherapy: two days per week
Two days per week will be spent in the Generic Psychotherapy Service and outpatient Personality Disorder
Service where the trainee will have an opportunity to see patients individually or in groups for three years.
Clinical supervision of psychotherapy cases seen once weekly in more than one modality, including group
analysis will begin in the second year and continue throughout training. Trainees will be expected to attend an
appropriate training course in their primary therapy modality. The trainee will undertake assessments for
psychotherapy.
YEAR 3 Specialty Training Year ST6
General Adult Psychiatry: two days per week
The General Adult Psychiatry will now begin to be orientated towards developing applied skills in different
psychiatric settings. For example, the trainee could co-facilitate a reflective practice group in a community
mental health team. The trainee would also join Medical Psychotherapy Consultations on behalf of other
specialists seeking a medical psychotherapeutic opinion for complex psychiatric patients.
Medical Psychotherapy: three days per week
In the third year it will be anticipated that one of the two subsidiary models of therapy will be introduced
alongside the adopted major modality of medical psychotherapy. The trainee will work within the generic
psychotherapy service and the outpatient Personality Disorder Service.
YEAR 4 Specialty Training Year ST7
Medical Psychotherapy: five days per week
The trainee will undertake more intensive/challenging clinical cases under supervision and pursue appropriate
experience in all three therapy modalities, e.g. psychoanalytic/systemic/cognitive behavioural or an agreed
derivative therapy model of these three therapies such as Mentalisation Based Therapy or integrative models
such as Cognitive Analytic Therapy. These cases will continue to be seen in the outpatient generic and
Personality Disorder Services. In addition the trainee will be offered a placement in the Specialist Day
Therapeutic Programme for people with Personality Disorder currently based at the Iris Centre in Exeter where
they will have an opportunity to gain experience in the functioning and leadership of a therapeutic team as
well as direct clinical experience of individual and group psychodynamic therapy and systemic work within this
setting.
YEAR 5 Specialty Training Year ST8
Medical Psychotherapy in Psychiatry: five days
This final year of dual training is devoted to honing competence in psychotherapy and its applications in various
settings of psychiatry. The aim in this final year of dual training is for the trainee to begin to consolidate the
integration of their psychiatric and psychotherapeutic experience that has been developing over the previous
four years and to consolidate their emerging as a psychotherapeutic psychiatrist in mental health services. This
experience may for example be gained in one of a number of inpatient therapeutic settings such as the
proposed Tier 4 Inpatient Personality Disorder service, the Medium Secure Unit led by Dr Darnley at Langdon
hospital or the Haldon Unit specialising in eating disorders.
The trainee’s placements and Advanced Training Plan (see Appendix A) will, in the latter part of the training,
have come to reflect particular areas of special interest and career aspiration as far as possible with placements
agreed in collaboration with Educational Supervisors and the Medical Psychotherapy and General Psychiatry
Training Programme Directors.
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PERSONAL THERAPY
Trainees undertaking psychoanalytic training undergo their own personal analytic experience. This is for their
personal and emotional development and the development of an understanding of the impact of the work with
severe psychiatric disturbance, and in particular the emotional challenges of working across different settings
with potentially very different ways of thinking about patients.
Psychoanalytic psychotherapy is required throughout the training period with a psychoanalyst or a
psychoanalytic psychotherapist registered with the British Psychoanalytic Council and agreed with the Medical
Psychotherapy Training Programme Director. The trainee may begin in a once weekly therapy and increase the
frequency as they develop through the training but also in keeping with the requirements of the formal
psychotherapy training they undertake. This may include three four or five times weekly therapy depending on
the training. Some account will be taken of the time required to attend therapy during the working week, some
will be in the trainee’s own time. It is expected that personal therapy would continue throughout the duration
of training.
For trainees who choose to major in other models of therapy such as cognitive behavioural therapy, selfreflective
personal development experience which would be considered congruent with the adopted main
therapeutic modality training orientation would be required. The chosen path of self-reflective development
would not preclude personal therapy.
Trainees in cognitive behavioural therapy or systemic therapy as their major modality who wish to undergo
personal therapy would be supported subject to approval of the Training Therapist by the Training Programme
Director.
A contribution towards the cost of personal therapy and training can be applied for from the study leave
budget. Additional funds can be applied for from the Deanery and will be allocated at the discretion of the
Head of the School of Psychiatry. If agreed this is not likely to amount to more than the cost of one session of
personal psychotherapy or psychoanalysis or their model congruent equivalent in self-reflective development
per week.
ACADEMIC TRAINING
The aim of the dual training programme is to help the trainee to become a medical psychotherapist and
psychiatrist, who embraces and integrates their medical and psychiatric identity as a specialist
psychotherapeutic psychiatrist. The general goals of professional attributes, risk, audit, teaching and
supervision, clinical and service management, organisational change and clinical governance will form the
backbone of this training programme as they do other advanced psychiatric training programmes.
The distinct theoretical and experiential aim of dual training is to integrate the knowledge and skills of two CCT
trainings in both General Adult Psychiatry and Medical Psychotherapy in such a way that the future Consultant
Psychiatrist in Psychotherapy is helped to inform their professional orientation to their Medical Psychotherapy
role according to these two different sub-specialities and different paradigms of mind.
Trainees majoring in systemic psychotherapy will be expected to attend the Intermediate Course in systemic
psychotherapy in Plymouth and the Masters course in systemic psychotherapy at Exeter University.
Trainees majoring in CBT will be expected to attend a high quality training Course in CBT such as the Oxford
Course. This will need to include the application of CBT to a number of different psychological disorders as well
as training in supervision.
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Psychoanalytic trainees will be required to learn about the theoretical foundations of Psychoanalytic
Psychotherapy as well as undertaking a clinical training which will lead to a qualification and a registered
Psychotherapist. Courses available in the South West include the two year MSc Course at Exeter University, the
subsequent two year BPC qualifying course. There are also opportunities to develop this training into a Clinical
Doctorate or a PhD through Exeter University with which the psychotherapy department and PD service have
training and research links.
Alternatively the Trainee may choose to train with the Severnside Institute in Bristol or with Group Analysis
South West.
The Training Programme Director in Medical Psychotherapy recommends that all psychoanalytic trainees
consider and discuss the possibility of an external psychodynamic training with a training recognised by the
British Psychoanalytic Council during their training in developmental discussion with their Medical
Psychotherapy Educational Supervisor. The Dual Medical Psychotherapy and General Psychiatry Training
Programme will aim to help the trainee to integrate any external psychoanalytic training with their
development as an NHS Consultant if they are accepted and commence training within the CCT training period.
CLINICAL EXPERIENCE
The trainee will be expected to carry out a minimum of 700 clinical hours in their adopted major model of
psychotherapy and 100 clinical hours in two supplementary models of therapy. The three models in the South
West Peninsula Deanery are chosen from psychoanalytic psychotherapy, cognitive behavioural therapy and
systemic therapy. 100 hours of clinical practice in the chosen supplementary model of therapy and 100 hours
of a third model is required which can include supervision. The Training Programme Director will decide with
the trainee and Medical Psychotherapy Educational Supervisors what clinical experience and models of
psychotherapy can contribute to the hours of experience required.
Work place based assessment of all psychotherapies will be undertaken, including the formative Structured
Assessment of Psychotherapy Expertise (SAPE) during clinical supervision of therapy, Structured Assessment of
Psychotherapy Assessment (SAPA) and a summative Psychotherapy Assessment of Clinical Expertise at the end
of each therapy (PACE or Psychotherapy ACE). All these WPBAs are on line in the Royal College of Psychiatrists’
portfolio on line training website.
Trainees will observe assessments and be observed undertaking assessments in psychotherapy using the
Structured Assessment of Psychotherapy Assessment (SAPA) to assess.
All trainees will be required to maintain reflective practice reports discussed in Educational Supervision of their
psychotherapies and general psychiatry assessment feedback as part of self-reflective practice development in
the Advanced Medical Psychotherapy Curriculum (2013).
CLINICAL SUPERVISION
The dual trainee will receive clinical supervision from practitioners both within the scheme in psychotherapy
and also outside of the scheme as part of their external training. In the early stages of training (ST4, ST5) clinical
supervision is from the Consultant Psychiatrist in Psychotherapy but will also be provided by adult
psychotherapists and psychologists.
The clinical supervisors who supervise the clinical work within the scheme are invited to attend and contribute
to the Deanery Medical Psychotherapy Training Committee to facilitate the development of the Medical
Psychotherapy Training Scheme.
Clinical supervisor’s reports will be requested on a once yearly basis around six months before the Annual
Review of Competence Progression (ARCP).
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These Clinical Supervision Reports will be used to inform the annual assessment of the trainee’s progress and
development for the Annual Psychotherapy Appraisal between the Trainee, Medical Psychotherapy
Educational Supervisor and Training Programme Director prior to and in preparation for the Annual Review of
Competence Progression (ARCP).
ASSESSMENTS
The trainee will have experience of assessments of patients for psychotherapy and other psychological
interventions, as well as seeing patients for assessment as part of the consultation process.
The trainee is required to have a minimum of 60 hours of assessments.
Joint assessments will be undertaken with Medical and other Psychotherapists with experience of different
modalities, and mental health colleagues and medical and psychiatric colleagues as appropriate.
Trainees will observe assessments and be observed undertaking assessments in psychotherapy using the
Structured Assessment of Psychotherapy Assessment (SAPA) to assess.
Trainees will be expected to develop skills in psychodynamic risk assessment both in forensic and non-forensic
placements.
MEDICAL PSYCHOTHERAPY CONSULTATION
In the first and second years of dual training (ST4 and ST5) the trainee will be offered psychoanalytic
consultation on some of the psychiatric cases they see in their training placement psychiatric settings or on call
within Educational and Clinical Supervision with a Consultant Psychiatrist in Medical Psychotherapy. This will
take the form of a Balint group facilitated by a Consultant Psychiatrist in Psychotherapy with Advanced
Psychiatry training peers in psychiatry and forensic psychotherapy who are on placement in the psychotherapy
department.
From their third year onwards (ST6) the trainee will begin to participate in Medical Psychotherapy Consultation
accompanying a Consultant Psychiatrist in Psychotherapy offering consultation on complex patients to other
specialist colleagues working in psychiatry and to GPs and other professionals in primary care. In the fourth and
fifth years (ST7 and ST8) the dual trainee will undertake their own supervised consultations.
Since clinical consultation is one of the most challenging aspects of the interface between the Medical
Psychotherapist and their psychiatric colleagues, careful consideration will be given to the selection of cases
and the supervision of this work.
The Medical Psychotherapy clinical consultation interface with other specialists represents the ‘coalface’ for
the development of the trainee’s emergent psychotherapeutic and psychiatric identity. Medical Psychotherapy
Consultation is therefore a crucial and central component of the dual training to become a Consultant
Psychiatrist in Psychotherapy.
Work place based assessment (WPBA) of consultation will include cased based discussion (CBD) Structured
Assessment of Psychotherapy Expertise (SAPE) and Assessment of Clinical Expertise (ACE). The work place
based assessment (WPBA) Direct Observation of Non-Clinical Skills (DONCS) can be used for chairing
professionals meetings or participating in a Care Programme Approach meeting.
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REFLECTIVE PRACTICE
Medical Psychotherapy Consultation in observing and seeing colleagues and their cases for consultation will
offer a foundation for the development of observing reflective practice competence in others. One important
role for the application of medical psychotherapy skills lies in developing reflective practice competence
amongst colleagues.
Consultation and reflective practice supervision provided by a Consultant Psychiatrist in Psychotherapy will
provide a foundation for dual trainees from ST6 onwards to bring consultations observed and seen and for
some dual trainees to plan and establish running a reflective practice group in an acute psychiatric setting such
as an in-patient ward or a crisis team. The dual trainee would not be expected to consult with colleagues within
their General Psychiatry placement as this would place them in the dynamic of an internal consultancy position
making this untenable.
The dual trainee will also maintain reflective practice reports discussed in Consultation and Reflective Practice
Supervision of their consultation and reflective practice activity experience as part of self-reflective practice
development in the Advanced Medical Psychotherapy Curriculum (2013).
TEACHING AND SUPERVISION OFFERED BY THE DUAL TRAINEE
Throughout training the dual trainee will be actively involved in teaching, training and supervision. In the later
part of training this will include the provision of clinical case supervision to Core Trainee Psychiatrists (CT1-CT3)
and lectures to medical students at the Peninsula Medical School, and mental health professionals as well as
teaching on the MRCPsych course. The trainee will develop and evaluate teaching materials and will be
encouraged to undertake a Certificate in Medical Education.
The dual trainee will also have an opportunity to observe a Consultant Psychiatrist in Psychotherapy conduct a
Balint group for Core Trainee Psychiatrists and will later in training (ST6 onwards) facilitate their own Balint
group, for Core Trainees. The dual trainee is required to conduct work place based assessment of their Balint
groups using the Balint group assessment (BGA) and formative assessment of their clinical supervisees using
the Structured Assessment of Psychotherapy Expertise (SAPE).
NON-CLINICAL RESPONSIBILITIES
MANAGEMENT
The dual trainee will attend the PD and psychotherapy service clinical governance, business, management or
other committee meetings during their placements. A clinical governance perspective on psychotherapy
service delivery including the economic aspects of care systems will be incorporated throughout the
programme.
The trainee will be expected to attend Deanery and national management courses at points in their training
which are relevant to their needs.
RESEARCH
The trainee will be expected to familiarise themselves with the literature in relation to the evidence base and
research in their respective sub-specialties. The methodological strengths and weaknesses of the relevant
literature should be familiar.
The issues surrounding the evidence base and comparison between different models of psychotherapy should
be familiar. The trainee should be aware of current psychotherapy outcome measures and their strengths and
limitations and should be able to appraise the literature critically.
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Exeter University
Exeter University has an active and progressive School of Psychology which has attracted large research grants
in developing Cognitive Behavioural Treatments for Mood Disorders and Dialectical Behaviour Therapy for
Emotionally Constricted Personality Disorder. The School of Psychology runs undergraduate courses in
Psychology but also postgraduate courses in psychological therapies including MSc courses in Psychodynamic,
Family Systemic and Cognitive Behavioural Therapies. There are also Clinical Doctorate and PhD courses. In
addition the School of psychology has developed research links with the Trust, for example the Eating Disorders
service has developed links with the School of Psychology to run a trial of DBT for patients with Eating
Disorders. The School of Psychology has expressed a keen interest in developing links with the Specialist
Personality Disorder Service to undertake similar studies. Links with the University are therefore through the
clinical placements of MSc students in the psychotherapy service and developing Personality Disorder Service,
through the provision of professional development opportunities in furthering psychotherapy training for Trust
employees including the post holder if required and through research.
Specialty Trainees are encouraged to conduct research. Each Trust has modern library facilities and access to
internet facilities.
AUDIT
The trainee will be expected to have an understanding of the audit cycle and carry out at three to four audit
projects during their training in Medical Psychotherapy and General Psychiatry.
SPECIAL INTEREST SESSIONS
Specialty Trainees are encouraged to make full use of their special interest sessions which may be used to
pursue a higher qualification that is relevant to their training.
TRAINING PROGRAMME APPRAISAL AND ASSESSMENT
The trainee will have usually weekly contact with both their Educational Supervisors in Medical Psychotherapy
and General Psychiatry to consider their developmental progress.
The Educational Supervisor role is to support the trainee as a mentor and to challenge as a colleague, enabling
the trainee to reflect openly and robustly about their capacities and development. This process will be largely
informal.
The more formal element of appraisal and assessment takes place in formative assessment throughout training
in the work place based assessments (minimum of one a month) and in the annual summative assessment the
ARCP panel (Annual Review of Competence Progression). The ARCP panel for dual trainees will include both
Training Programme Directors from General Psychiatry and Medical Psychotherapy.
The ARCP will be undertaken by the South West Peninsula Postgraduate School of Psychiatry informed by the
reports of the Training Programme Directors, who are in turn informed by both Educational Supervisors in the
preceding year’s General Psychiatry and Medical Psychotherapy placements. A six monthly Medical
Psychotherapy review of the Training Plan (see Appendix A) is undertaken with the dual trainee informed by
the Clinical Supervisors’ reports and the Educational Supervisor’s Annual Report with the Medical
Psychotherapy Training Programme Director. The review provides an opportunity for the dual trainee to raise
concerns or highlight good practice relating to placements or the programme generally and for the Educational
Supervisor to highlight good progress or areas of concern and plan appropriate support/teaching or remedial
action. The review also helps the trainee to prepare their portfolio for the ARCP. The Work Place Based
Assessment Guide for Advanced Medical Psychotherapy training is attached as Appendix B.
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The Medical Psychotherapy component of the ARCP will be supplemented by the annual Clinical Supervisors’
reports and an Annual Psychotherapy Appraisal. This will be conducted prior to the ARCP (usually around April-
May before the June ARCP).
TRAINING CENTRES
Cornwall
Cornwall has a population of approximately 486,000. It represents the second largest county in the area but
has the lowest population density.
The county has the longest coastline of any English county, some 570 km; the river Tamar forms a physical and
cultural divide with the rest of Great Britain for all but 18km of its length. The Isles of Scilly lie 45km off Lands’
End. The distance between the north and south coast varies from 72km in the east of the county to as little as
8km at the western end.
Much of the county’s identity has been maintained in traditions and culture and it possesses distinctive
physical features in its peninsular form with stunning coastlines, moorlands and a temperate climate. A past
history of mining has been subsumed by the growth as a holiday area together with some recent
manufacturing industry. The area remains however largely rural in character and farming and fishing in the
west is still the mainstay of economy.
There is a wide scatter of small towns and villages. Only 31% of the population live in towns of over 10,000
inhabitants (Penzance, Camborne, Redruth, Falmouth, Truro, Newquay, St Austell, Bodmin and Saltash).
Cornwall’s renowned temperate climate allows for such activities as sailing, wind surfing, swimming, and
walking. There are also several Golf Courses in the county. Leisure Centres are provided throughout the
county. The attractive cathedral city of Truro is the sub-regional centre and offers extensive shopping and
leisure facilities. Performing arts are catered for at the Hall for Cornwall, Truro and a range of other venues
including the spectacular Minack theatre in Carrick. There is a thriving artistic community and the centre for
modern and contemporary art is at the St Ives Tate Gallery in the west of the County. There are also a number
of impressive restaurants throughout the county providing a wide choice of cuisine. The County offers excellent
primary and secondary education through state and public schools, coupled with a comprehensive choice of
adult education classes.
Major national and international tourist attractions such as Heligan Gardens and the Eden Project attract
visitors throughout the year.
A choice of properties including waterfront, smallholdings, traditional and new build are all available within
county.
Plymouth
Plymouth is a major centre of population with large industrial, residential and leisure sectors and as such its
population has a wide range of health care needs. Plymouth Healthcare Community Interest Company is
responsible for providing secondary mental health, rehabilitation medicine and geriatric services plus a range
of primary community services including community nursing, reablement teams, dental services and remedial
therapies. In addition the Trust manages two community hospitals, located at Tavistock and Kingsbridge. The
social enterprise provides services to acute general adult psychiatry, rehabilitation and old age psychiatry for
the catchment area. There is a specialist Community Drugs Service and a developing Community Alcohol
Service. Child and Adolescent Psychiatry care is now also provided by the organisation. Glenbourne also
houses an ECT suite, administrative offices and meeting and conference rooms.
14

Almost 60% of the population served live in the city itself and services must therefore cater for a large inner
city population. Unlike some other areas of the SW Region, Plymouth does not have an unusually high number
of elderly people in its population. The age structure is similar to the national pattern with 19% under 15 years
and 17% over 64 years. Projections show that although the population will grow by only 3% during the next 10
years, there will be a 36% increase in those over 75 years of age. There are good road and rail links to central
southern England and flights from Plymouth Airport at Derriford to London and other major cities. To the
north-east is the rugged and virtually unpopulated Dartmoor national park. The South Hams area to the east of
Plymouth boasts many charming villages and fishing ports. The area has a full range of educational and leisure
facilities.
A large part of Wednesday mornings is devoted to the academic programme for the training of junior doctors.
Under the supervision of the Clinical Tutor, the Specialty Trainees are involved in organising and participating in
this training. There is a weekly case presentation and Journal Club, where Specialty Trainees are expected to
be active participants in organising, delivering and teaching. In addition, Dr Montgomery runs a regular
research clinic to support trainees undertaking research projects. From September 2009, the Peninsula
MRCPsych course will be coordinated and delivered from Plymouth run by Drs Cooper, Dinniss and Bickerton.
Higher trainees are actively encouraged and supported to involve themselves in delivering the teaching.
Devon Partnership Trust
The Devon Partnership NHS Trust was created on 1 April 2001. From July 2002 the Trust provided Mental
Health, Learning Disability and Social Services to the majority of the Devon population apart from those living
in Plymouth, who continue to receive those services from Plymouth Primary Care Trust and Plymouth Social
Services.
The Devon Partnership Trust offers a comprehensive range of mental health and social care provision with
services to adults, older people, people with learning disability, children and adolescents, adults with
physical/sensory disability and people with drug and alcohol problems. Across the Trust there are specialist
services for Forensic Psychiatry and Psychotherapy. There are strong academic links with our main research
partner, the Peninsula Medical School, through the Mental Health Research Group based in Exeter.
Exeter
Exeter is a Cathedral city and is the regional centre and county town of Devon. The Devon Partnership Trust
headquarters are at Wonford House Hospital, Dryden Road, Exeter. Wonford House Hospital is adjacent to the
Royal Devon and Exeter Hospital on the same site. The Wonford site is within its own grounds, a mile from the
city centre. Devon Partnership Trust provides services to Exeter and the surrounding area through the Exeter
and East Devon locality. The Exeter and East Devon locality serves a population of 243,000 in total; 21% of that
population are aged 65 plus; 57% lie between 20 and 64; and 22% between 0 and 19.
Wonford House Hospital houses the Specialist Eating Disorders Unit, Older Persons Psychology facilities for
Exeter City, and district Psychiatric Rehabilitation Services. The Cedars, a purpose-built unit, adjacent to
Wonford House, provides acute admission facilities for Exeter, East Devon and Exmouth localities, Delderfield
Ward; and the Tiverton/Okehampton localities, Coombehaven Ward. The Liaison Psychiatry service to the
Royal Devon & Exeter Hospital, and the Mental Health Group of the Institute of Health and Social Care
Research, Peninsula Medical School, (www.ex.ac.uk/dmh/) are co-located in Wonford House Hospital. The
Psychotherapy Department and Department of Clinical Psychology is also on the Wonford site, adjacent to
other medical academic departments of the Peninsula Medical School. The Iris Centre a psychotherapeutic day
programme for people with severe and complex personality disorder is based at Franklyn Hospital in Exeter.
The library situated in Wonford House is specialist and stocks a wide range of books covering all aspects of
mental health. It is part of the University of Exeter library service and the catalogue can be accessed on
www.ex.ac.uk/library/eml/whh/html. There is a range of periodicals and journals for reference. The library is
15

staffed during weekdays except Wednesdays. The librarian can arrange inter-library loans. There is access to
online databases and literature searches. Additional specialist journals are held in the department of clinical
psychology.
Within Wonford House there are regular, well organised, activities supporting training and continuing
professional development:
Case conferences are held over Tuesday lunchtime from 12.30 in the Bucknill Conference Room. Journal
club runs on Wednesday lunchtime in the junior doctor’s common room from 12.30.
Audit meetings are held monthly on Mondays from 12–1pm. There is support from the audit department
for trainee projects.
Wonford House Hospital hosts the Exeter Part 1 and Part 2 MRC Psych course on Thursdays and Fridays,
attended by trainees from across the Peninsula.
Torbay
Torbay incorporates the areas of Torquay, Paignton and Brixham and extends from Dartmouth in the south to
Dawlish and Moretonhampstead in the north.
The district is mainly rural in nature, with small towns and a major urban conurbation on the bay. It provides
extensive holiday facilities which produce a large increase in population in the summer months and holiday
periods of the year. The main industries are tourism, leisure and residential care. The area has an extensive
range of leisure facilities from water sports to moorland walking. There are good schools in the area including
both boys and girls grammar schools. Torbay is an attractive centre with a favourably mild climate and easy
access to Dartmoor National Park and the coast. The county’s two major cities, Exeter and Plymouth, are both
less than an hour away by road. There are good rail links with Bristol and London (less than four hours away).
The teaching programme is organised by the Clinical Tutor (psychiatry). There is a weekly session for
postgraduate education with a tutorial held by the Clinical Tutor and a weekly tutorial held by the Specialty
Trainee and/or Consultants in the Department of Psychiatry. The postholder would be expected to contribute
to the educational session, tutorials and examination practice sessions.
Clinical audit is co-ordinated by the Consultant responsible for audit, who is supported by a secretary. The
postholder will be expected to present at audit at least once in the academic year. The postholder will be
expected to contribute to audit and training sessions with the non-medical clinical staff.
Peninsula College of Medicine and Dentistry
The Peninsula Medical School is the first new medical school for 30 years. Within the College Institute of
Health and Social Care, the Mental Health Research Group conducts health services research and has a strong
track record of publication and grant income generation. Details of research activity is available at
www.ex.ac.uk/dmh. Specialty Trainees are encouraged to become involved. Many recent Specialty Trainees
have been involved in research through the department and have published successfully in the peer-reviewed
literature. There are opportunities for training in research methodology and statistics through the Peninsula
Medical School. There are a number of research-based courses available from workshops through taught
masters degrees to MD or PhD. Full details are available at www.pms.ac.uk. Peninsula Medical students began
their training in 2002 in both Exeter. Plymouth and Truro. The Peninsula MRCPsych course is hosted in
Plymouth. Specialty Trainees are actively encouraged to become involved in postgraduate teaching on the
course.
16

SPECIFIC POSTS
These timetables and descriptions are indicative only and subject to change with service development and
will be tailored to meet individual trainees learning needs after discussion and agreement from individual
educational supervisors.
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Liaison Psychiatry
Dr Peter Aitken
Devon Partnership NHS Trust
Wonford House Hospital, Dryden Road, Exeter, EX2 5AF
JOB DESCRIPTION This integrated mental health and wellbeing service will maintain and improve current
mental health care provision to RD&E hospital. All service user presentations to the RD&E that are referred to
the service will be seen and assessed by an integrated clinical team, who can deliver sophisticated assessments
and interventions shaped to the needs of patients of the RD&E, draw on all three functions in any of the
Mental Health Networks or arrange care out of county. The team uses bio-psycho-social assessment,
signposting, brief intervention, or brokerage depending on identified level of need. The team conducts
environmental risk assessment & management, mediation, group and team work, anxiety management, care
planning, contingency planning, education, training, mentoring and medico-legal advice. The team uses a brief
intervention tool kit based on motivational interviewing toward engagement with the care plan, problem
solving or CBT based sessions at the bedside or in outpatient follow up.
The team was commissioned three years ago to provide to adults of working age 0900 – 1700 Monday to
Friday. (The same model of service is offered from the Exeter Crisis Team as the ‘Hospital At Night Team’
between 0000 – 0900.The SHO on call service provides from 5pm - midnight) The liaison team provides a
service within one hour to the Emergency Department of the RD&E and a same day service to the 650 inpatient
beds on the Wonford and Heavitree sites. Its performance is measured against 650 assessed annually,
admissions avoided, action against delay to discharge, actions to avoid repeated admission, compliance with
the 4 hour wait, suicide reduction.
Health and Neuropsychology
The service has been developed over many years to meet the psychological needs of inpatients in the RD&E,
and to provide a neuropsychology service to adults with acquired neuro-disability.
The health psychology team uses psychological assessment, brief interventions, short term psychotherapy
(CBT, CAT) and multidisciplinary multimodal group work in outpatients. The team conduct care planning,
education, training, supervision for psychological interventions and leadership of bio-psychosocial group
interventions. The health psychology service is currently provided to specialist services- pain management,
respiratory medicine; cancer care, kidney unit; otolaryngology. The service also provides rapid response to
referrals from any department, where psychological distress impedes medical or surgical treatment.
The neuropsychology service offers psychological assessment; neuropsychological assessments; brief
interventions; neuro-rehabilitation; short term psychotherapy (CBT, CAT) and couple therapy with adjustment
issues in outpatients. The team conduct care planning; coordination of bio-psychosocial intervention and
support packages; education & training; support, coaching and supervision with enablers. The median number
of individual therapy sessions delivered is 6. Integrated multi-professional group sessions up to a maximum of
6. The service is currently provided to neuro-reablement inpatient and community units, including Mardon.
17

The health and neuropsychology services are available 0900-1700 Monday to Friday.
Research Innovation and Improvement.
The department of psychological medicine is co-located with the Directorate of Research & Development
where there is an MRC NIHR funded program of research into suicide prevention and harm minimisation from
self-harm, a research support service, an innovation group developing novel uses of information management
for the prevention of suicide and harm minimisation, and an improvement (Patient safety) group driving
toward safer mental health services.
Training and Development
The department hosts students from all disciplines at all stages of training including Foundation doctors at level
1 and 2 on rotation to the Royal Devon and Exeter Hospital.
TIMETABLE
Monday
Tuesday
Wednesday
a.m.
Liaison Psychiatry
RD&E Wards
Team Meeting
Academic Programme
Liaison Psychiatry
RD&E Wards
p.m.
Liaison Psychiatry
RD&E
OPD
1.30 – 2.30 Supervision with
Consultant
Liaison Psychiatry
RD&E Wards
Thursday TBA Research
Friday TBA Special Interest
On-call
POST
TRAINER
1 in 14, Consultant Rota with Consultant Cover
CRS/Home Treatment/Acute Inpatient Psychiatry
Dr Tim Dickinson
EMPLOYING TRUST
TRAINING BASE
Devon Partnership NHS Trust
Haytor Unit, Torbay Hospital
JOB DESCRIPTION The ST4-6 will provide medical input to both the Crisis Resolution/Home Treatment Team
and the Acute Inpatient Service. Elements of these teams have integrated to provide a seamless service for
people in mental health crisis in the community, through admission (if required) and back to community care
providers (Primary Care/CMHT).
The weekly timetable is flexible with little adherence to fixed clinical sessions, the Consultant and ST4-6
providing input to the teams activities when and where needed. Each morning a one hour Acute Services
meeting plans the activities for the day which ensures medical time is used most efficiently. There are nominal
18

fixed sessions to allow multidisciplinary team meetings with community colleagues and these will usually be
chaired either by the Consultant or ST4-6, depending on clinical need.
Time will be provided for the ST4-6 to undertake supporting professional activities as well as protected time for
a special interest or research. There is a rotational (4 monthly) F2 junior doctor attached to the team and we
also provide Peninsula Medical School Year 5 placements (Specialities Block).
The ST4-6 will be encouraged to participate in the teaching and assessment of these junior colleagues.
The service locally is undergoing a substantial redesign and there will be opportunity for the ST4-6 to gain
experience in the management of this process.
Office space will be provided in the Crisis Resolution/Home Treatment Team office with administrative support
from the Consultant’s secretary.
TIMETABLE
Monday
Tuesday
Wednesday
TRAINER a.m. p.m.
9am-10am Acute Services Meeting
10-12pm Flexible
Clinical/Supporting
12-1pm Supervise ST4-6
9-10am Acute Services Meeting
10-12am Flexible
Clinical/Supporting
12-1pm Supervise F2
9am-10am Acute Services Meeting
10-1pm Flexible Clinical/Supporting
1-5pm Multidisciplinary Team
Meetings
1-2pm Flexible Clinical/Supporting
2-5pm Local Academic Programme
1-5pm Multidisciplinary Team
Meetings
Thursday
Friday
9am-10am Acute Services Meeting
10-1pm Flexible Clinical/Supporting
9am-10am Acute Services Meeting
10-1pm Multidisciplinary Team
Meetings
10-1pm Flexible Clinical/Supporting
1-5pm Flexible Clinical/Supporting
TIMETABLE
Monday
TRAINEE a.m. p.m. a.m.
9-10am Acute Services Meeting 1-5pm Multidisciplinary Team
10-1pm Flexible Clinical/Supporting Meetings
Tuesday
Wednesday
9-10am Acute Services Meeting
10-1pm Flexible Clinical/Supporting
9-10am Acute Services Meeting
10-1pm Flexible Clinical/Supporting
1-2pm Flexible Clinical/Supporting
2-5pm Local Academic Programme
1-5pm Multidisciplinary Team
Meetings
Thursday Research/Special Interest Research/Special Interest
Friday
9-10am Acute Services Meeting
10-1pm Multidisciplinary Team
Meetings
1-5pm Flexible Clinical/Supporting
POST
Forensic
19

TRAINER
EMPLOYING TRUST
Dr Eluned Dorkins
Devon Partnership Trust
ONE YEAR FORENSIC PLACEMENT (RUNNING FROM AUGUST TO JULY)
This post is designed for specialist trainees who wish to gain a broad experience of what forensic mental health
services can offer. In particular, it aims to help trainees develop their risk assessment and management skills
through a structured approach and by exposure to a variety of different clinical environments, (where the
elements of structural, relational and procedural security all vary). The aim is to develop skills which will have a
broad applicability in whatever context trainees will work in the future.
Langdon Hospital has an established track record in providing forensic training and is the base of the Peninsula
Deanery Forensic Training Scheme for ST4 to ST6. There are already three forensic trainees on the site so that
trainees from the general scheme will automatically have a peer group based at Langdon during the year’s
attachment.
The year is divided into three x four month placements, starting in the medium secure environment,
Raleigh/Drake Ward, followed by two placements in open/low secure settings which serve different a different
population. The first of these placements is on the Leander Unit (mild/borderline learning disability), followed
by placement at Avon House (longer term rehabilitation) and Chichester House (predischarge rehabilitation).
There is a separate document available from the General Adult and Old Age Training Programme Director
which describes each of these placements in detail. This includes induction, a brief description of the units, a
timetable for the trainee, the competencies which can be achieved, particular training opportunities and the
kind of objectives that can be set. A variety of special interest sessions are also described, although it is
anticipated that the general psychiatric trainee may have other interests they wish to pursue, granted that they
may not be heading for a career in forensic psychiatry. The documentation also includes a map of general and
specific knowledge and skills which can be obtained during the placement, mapping out how these could be
achieved through a variety of different mechanisms.
There is also an academic programme that runs throughout the year, which takes place on a Thursday
afternoon, which includes a lunchtime multidisciplinary case conference, followed by a medical academic
programme. The trainees will take part in this; this includes journal club, medico legal presentations, and
challenging cases. There is also clinical governance programme, and Equip that run through the hospital site
and again trainees will be anticipated to take part in this in whatever setting they find themselves.
There are sessions in psychodynamic psychotherapy related to forensic patients which general adult trainees
are also welcome to attend.
The trainee will have one supervisor for each placement who will provide both clinical and educational
supervision. However, to ensure continuity, the trainee will meet with the training programme director shortly
after starting the year, at six months and then at the ARCP. Trainees can also meet with the training
programme director informally throughout the year. Trainees who are considering undertaking this placement
can contact the training programme, Dr Eluned Dorkins, at any point during the year and can make an
appointment to discuss their specific training needs. Contact details:
Jenny Peterson – 01626 884423 – jenny.peterson@nhs.net or eluned.dorkins@nhs.net
First placement August-November Butler Clinic (Raleigh/Drake Dr Jason Fee
wards)
Second placement December-March Leander Unit Dr Eluned Dorkins
Third placement April-July {Avon House Dr Adrian James
20

{Chichester House
Dr Helen Smith
FIRST PLACEMENT AUGUST-NOVEMBER
Raleigh/Drake Ward (rehabilitation and recovery wards in medium security), Butler Clinic, Langdon Hospital –
Supervisor : Dr Jason Fee
Monday
Tuesday
a.m. Lunch p.m.
9am admin, ward work and
assessments
9am – 10 am Supervision with
consultant
1:30pm – 5pm CPA’s on alternate
Mondays
otherwise assessments
1:30pm Case Reflection
2:00pm – 5pm Care Review
Meetings
MHRT’s, manager hearings, ward
work, assessments
1pm - 4 pm Academic programme
Wednesday MHRT’s, manager hearings,
ward work, assessments
Thursday 9am Referrals meeting
10am
Governance/Management
meetings
11:45am MDT meetings
Friday Research/special interest Research/special interest
SECOND PLACEMENT : DECEMBER-MARCH
Leander Unit, Langdon Hospital - Supervisor : Dr Eluned Dorkins
Monday
a.m. Lunch p.m.
Care Review Meeting (Half of
the caseload alternate weeks)
Tuesday CPA Meeting and HCR20
reviews
Wednesday Assessments Ward work
Thursday 9 a.m. Referral meeting 11.45 multidisciplinary
10 a.m.
Administration/HCR20/Case site wide Case
summary preparation, etc. Conference.
(scope to attend site wide
governance meeting third
Thursday of the month)
Friday
Supervision
Ward work/mental health review
tribunals/governance project work
Assessments/report writing
1 – 5 p.m.
Doctors meeting including Journal
Club, Medico-legal presentations.,
management meetings, etc.
Special Interest/ Research sessions as agreed in advance with measurable goals
THIRD PLACEMENT : APRIL-JULY
Avon House, Langdon Hospital - Supervisor : Dr Adrian James
a.m. Lunch p.m.
Monday Ward work Ward work/Mental Health Review
Tribunals/Governance project work.
Tuesday Care Review Meetings and
Assessments report
Care Programme
Approach meeting
Wednesday Supervision Ward work
21

Thursday
9 a.m. Referral meeting
10 a.m. Admin/Mental Health
Review Tribunal Reports/HCR-
20 /Case Summary
11.45 multidisciplinary
site wide Case
Conference.
1 – 5 p.m.
Doctors meeting including
Management meeting, Journal Club,
Medico-legal presentations.
Friday
Special Interest and Research
THIRD PLACEMENT WITH AVON HOUSE) : APRIL-JULY
Chichester House, Langdon Hospital – Supervisor : Dr Helen Smith
a.m. Lunch p.m.
Monday Prison session CRM/CPA
Chichester House
Tuesday Special Interest Research
Wednesday Assessment for admission
Thursday Supervision Lunchtime
MDT
Academic afternoon
Friday
Ward work
Clinical audit
Ward work
Clinical audit
Details of this third placement will be discussed with Drs James and Smith at the start of the year.
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Old Age Psychiatry,
Dr John Dunn
Devon Partnership Trust
Estuary House, Collett Way, Brunel Industrial Estate, Newton Abbot
JOB DESCRIPTION This post offers the opportunity for a Specialty Trainee to gain experience in a mainly
community based Old Age Psychiatry service but fitting the job to their stage of development on the scheme.
The core service is a multi-disciplinary community team. The area whilst primarily described as rural has a
good road network and a population concentration in a few small towns and large villages. Thus apart from
the memory clinic, assessment and treatment is by home visits. However opportunities to work in inpatient
settings, day hospital memory clinic and prescription of cholinesterase inhibitors are available. The post could
also offer the opportunity to act in the capacity of ‘Consultant’ in part of the patch enabling the Specialty
Trainee at the end of their rotation to experience the demands of the future in a supervised way. Considerable
flexibility is envisaged in the timetable to allow specific educational needs to be met. Experience with the
Consultant being responsible for ECT is also possible. The Specialty Trainees have a major part in the
educational sessions and audit in the locality.
With recent reconfiguration, the NSF for Older Adults and growing interagency working there are a number of
avenues to gain experiences in service development, committee work and guideline development.
TIMETABLE (flexible)
22

Monday
a.m.
9-11am ECT clinic (Torbay Gen
Hospital)
11-12pm Administration
12-2pm Memory Clinic Feedback
Meeting
p.m.
2-3pm Supervision with Consultant
3-5pm Community visits
Tuesday
9-11am Community Team Meeting
11-1pm Liaison and supervision
with team
1-5pm Supporting activities –
educational meeting monthly,
audit bimonthly, management
meetings monthly. CPD,
educational supervision
Wednesday Special Interest Session Special Interest Session
Thursday
9-11pm ECT clinic (Torbay Gen
Hospital)
11-1pm Community visits
1-5pm Flexible time for CPD,
management, training
Friday
9-1pm Outpatients or community
visits/work
1-5pm admin/community work
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Learning Disabilities
Dr Rolf Feller
Devon Partnership Trust
JOB DESCRIPTION The StR post for higher training in adult Psychiatry of Learning Disabilities is a unique
opportunity to gain experience in the assessment and treatment of individuals who suffer from a whole range
of psychiatric disorders in the context of impaired and arrested development of their intellectual and cognitive
function. Communication difficulties are one of the main problems for individuals with LD in particular in the
context of Autistic Spectrum Disorders, specific syndromes and severe and profound LD. All this can lead to
extreme distress and maladaptive behaviour and is often complicated by underlying physical illness, epilepsy,
pre-senile dementia. These issues are addressed by multidisciplinary teams in the community and in the two
regional in-patient units located in Exeter. Special interest sessions in Genetics and Neuropsychiatry are
available locally and there are excellent research facilities and opportunities within this speciality.
TIMETABLE
This timetable is flexible to a degree and can be negotiated according to the needs of the StR trainee.
a.m.
p.m.
23

Monday
ASU and Knightshayes inpatient
unit
Outpatient clinic, Franklyn House
Tuesday
Allocation meeting, Franklyn House Ward round, Knightshayes
Admin/Supervision
Wednesday
Home visits
Special Interest Session
Admin/New Referrals
Thursday Outpatient clinic, Franklyn House Ward round at ASU
Friday Admin and Emergencies Research Session
ASU – Additional Support Unit, Whipton Hospital, Whipton, Exeter
Knightshayes – Inpatient unit, Whipton Hospital, Whipton, Exeter
Frankly House – Learning Disabilities Community Team Base, StR base, Franklyn Drive, St. Thomas, Exeter,
EX2 9HS. Secretary: Tracy Austin 01392 208741.
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry
Dr Tegwedd Freer
Devon Partnership Trust
JOB DESCRIPTION The Specialty trainee will be a valued member of Exmouth CMHT, having a clinical role both
within the Wellbeing and Access team and the Recovery and Independent Living team, both based at Danby
Terrace CMHT. In the absence of the Consultant, the teams will look to the trainee for a medical viewpoint and
guidance. The trainee is expected to attend and contribute to the weekly team meetings and regular team
educational meetings and case discussions. There will be opportunities to take on a managerial role within the
teams if so wished.
Trainees will be on call approx 1 in 14 on the consultants On Call rota. This includes section 12 work. On Call
responsibility is from 5pm to 9am weekdays and 9am Saturday to 9am Monday on weekends. Part timers will
be pro rata.
Academic activities include attendance at the weekly Journal Club and Case Conference at Wonford House.
There are also ample opportunities for research projects within the Research and Development Department in
the Trust.
Learning outcomes will be identified at the beginning of your placement and the clinical content of the weekly
timetable adjusted to ensure these can be met.
TIMETABLE
a.m.
p.m.
Monday MAC Meeting Consultants Meeting Supervision with Consultant
Tuesday Team meeting W & A client medical assessments
24

Case Conference
Wednesday Clinical administration
RIL client CPA Reviews
Journal Club
Thursday TBA Special Interest
Friday TBA Research
On Call: 1:14 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry
Dr Subhash Gupta
Devon Partnership Trust
JOB DESCRIPTION We have a multi-disciplinary team consisting of the manager, nurses, social workers,
approved social workers, ST and R workers, psychologist, myself and a staff grade psychiatrist along with a SHO
psychiatry trainee. We serve a population of about 60,000 (35000 adults of working age). This is a Community
Mental Health Team, which is one of the 2 CMHTs in the Teignbridge area of Devon partnership NHS trust
(DPT). We have got a separate Acute Services Team (Ward with 11 beds and CRS) headed by another
consultant psychiatrist. We have got a full time medical secretary and a full time team secretary.
As mentioned above, we are well supported by a full time service grade doctor and a 0.5 WTE CT2 trainee and
the clinical work taken on by the ST trainee will be geared more towards their training needs rather than
sharing the workload. The trainee will be assessing and treating patients in outpatient settings in collaboration
with other members of the multi-disciplinary settings, as well as make home visits. These appointments can be
pre-arranged or urgent referrals. He will also be involved in assessing patients under the mental Health Act. He
will be discussing the assessments and treatment plans with the GPs and the patient’s carers and get involved
in bio psychosocial management of the cases that would include prescribing medications. He will give medical
consultation regarding clients to other members of the team (such as nurses and social workers) and also
provide supervision (along with the consultant) to the SHO trainee. The trainee will also attend multidisciplinary
team meetings where all members of the team discuss cases for advice and management.
The trainee will also participate in the On Call rota.
As is evident from my CV, I am the psychiatry lead for Peninsula Medical School for DPT and we conduct 2-3
short study units (3 weeks each) per year for medical students and there is a variety of other options to teach
medical students available and the trainee will be expected to take an active role in the same. We get funded
for this teaching which can be used by trainee for educational activities/training/conferences.
I have also been teaching and designing modules for the Psychiatry trainees (SHOs) with the South west
Deanery and the SpR trainee will have ample opportunities to teach psychiatry trainees ST1 to ST3.
As we are in close collaboration with GPs and our trust is planning to start a series of mental health seminars
for the GPs (I have submitted one of them), the trainee will also have a chance to engage in this.
We have regular educational meetings where various teams present cases/journal clubs and then discuss the
same. The trainee will be able to present and attend these meetings.
We are a research active team and the various projects and presentations in various conferences that we are
involved with are detailed in my CV. The trainee will have a chance to participate in these and future projects
as well as future audits.
25

I have been the Associate Clinical Director for 4 years now and there will be an opportunity for the trainee to
engage in management meetings and hands on training in relation my Associate Clinical Director role and
quality management of teaching for medical students
TIMETABLE
a.m.
p.m.
Monday Outpatients/Home Visits Urgent referrals/assessments
Tuesday Home visits/administration Academic Meeting
Wednesday CMHT Meeting Special Interest
Thursday
Outpatients
Special Interest
12 noon -supervision from
Consultant
Friday Research Research
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Eating Disorders
Dr Mary Rowlands
Devon Partnership Trust
JOB DESCRIPTION This SpR 4-6 post, based within the South West Peninsula Eating Disorders Service, is an
exciting new development. This service is expanding with the start of a Day Service in 2009 and a Network In-
Reach Consultation Service across Devon, and possibly further afield to Plymouth and Cornwall.
The service has adopted the principles of Dialectic Behavioural Therapy (DBT) as a therapeutic stance. This
informs across all therapeutic interventions and the day to day management of the Service. Innovative
research of DBT in this approach is partnered with the Mood Disorders Centre and the Psychology Department
at Exeter University. This community based post is flexible and clinical responsibilities will be in community
work and the day programme at Wonford House Hospital, as well as some cross cover on the Inpatient Unit, as
part of a seamless service. The Service base will be at Wonford House Hospital with secretarial and electronic
support.
Day to day work will be either in the community as part of the In reach Service for the Resident and non-
Resident Service, working as part of a team with Consultant supervision. It is a full time post with the
expectation that you are available for at least four days per week, excluding the Research day. Research is
encouraged and a dedicated part time ED Researcher is available for assistance or to do collaborative work.
On-call is expected with Consultant back up.
There is an Educational Programme at Wonford House Hospital and participation in this is expected.
To assist with the Network In-Reach work, there is a dedicated Dietician and Psychologist as part of this team,
besides the Day patient complement of professionals. During this rotation you should be able to get a
thorough understanding of Eating Disorders, the dynamics that are created within teams, how to manage this
and how to draw up and follow through management plans to help these challenging clinical presentations
within community settings.
TIMETABLE
TRAINER a.m. p.m.
Monday Community Outreach Community Outreach
26

Tuesday Inpatient Reviews Supervision
Wednesday CPD Clinical Admin
Thursday MDT Reviews MDT Reviews
Friday Community Outreach Community Outreach
TRAINEE a.m. p.m.
Monday Community Outreach Community Outreach
Tuesday Clinical Admin Supervision
Wednesday Research or Special Interest Research or Special Interest
Thursday MDT Reviews MDT Reviews
Friday Community Outreach Community Outreach
On-Call 1: 10 with Consultant Cover
TRAINING POST IN
TRAINER
EMPLOYING TRUST
TRAINING BASE
Community Psychiatry
Dr Kate Lovett
Devon Partnership NHS Trust
Estuary House, Newton Abbot
JOB DESCRIPTION This post provides excellent training in community psychiatry through an integrated
experience of working with an assertive outreach team, assessment and short intervention team and
longerterm recovery team. Trainees will have the opportunity to gain experience in modern community
psychiatry with significant opportunities for involvement in service development . The overall psychiatric
service focuses on effective gate-keeping of inpatient beds and facilitation of early discharge. The post gives
the opportunity to gain competencies in acute psychiatric care in the community by gaining experience in
looking at alternatives to hospital admission and effective home treatment. The focus throughout is on
providing effective treatment and care that makes it safe for patients to recover.
The service covers the Teignbridge area of South Devon which serves a population of approx. 130,00 centred
around the towns of Teignmouth, Newton Abbot, Totnes and Dartmouth and surrounding rural villages. This
post serves 6 GP practices in the Newton Abbot area providing good opportunities for primary care liaison.
In addition to support from the consultant the service is supported by a part time staff grade and CT1-3 trainee.
Torbay hospital has a well-established academic and audit programme and it is expected that the ST4-6 trainee
would take an active role within this. There is access to appropriate IT and library facilities within the hospital
site.
27

Dr Lovett has been a consultant for 12 years. She trained in Manchester, obtaining a Distinction in Psychiatry at
finals. Her MSc thesis was on the role of ovarian steroids in the development of postnatal depression. She has
worked for the last 6 years in Urgent and Inpatient Psychiatry having worked as a sector psychiatrist prior to
reconfiguration. Her involvement in training has been longstanding. She was formerly Lead for Undergraduate
Psychiatry in the Plymouth locality for the Peninsula College of Medicine and Dentistry. She obtained a
Postgraduate Certificate in Clinical Education with Distinction in 2008, the same year in which she became a
Fellow of the Royal College of Psychiatrists. She has now trained 5 SpRs and has been Training Programme
Director for General and Old Age Psychiatry in the Peninsula Deanery since 2009. She is elected to the Central
Education, Training and Standards Committee of the Royal College of Psychiatrists and is an examiner for the
CASC exams. In January 2012 she was appointed as Head of School of Psychiatry for the Peninsula Deanery.
WEEKLY TIMETABLES
TRAINEE TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. AOS meeting
ST supervision
Clinic
Recovery Team
Meeting
Research/Special
Interest
Clinic
p.m. Clinic Academic
Teaching
Emergency
Assessments
Research/Special
Interest
Admin
On Call is currently 1;14. Involves Section 12 assessments at Torbay police station, Alternative Place of Safety
Unit based in inpatient unit and community assessments as necessary. Involves advice to first on call CT1-3
doctor and is supported by on-call consultant who is available for advice.
TRAINER TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. AOS Meeting Clinic Recovery Team
Meeting
Referral Meeting
Referral Meeting SPA
p.m.
Clinic
ST supervision
Academic
Teaching/
Consultant
Meeting
Admin Clinic SPA
POST
TRAINER
Adult and Community Psychiatry, Exeter
Dr Sean Lynch
RESEARCH INTERESTS Chronic Fatigue Syndrome and Somatoform Disorders
EMPLOYING TRUST
Devon Partnership NHS Trust
28

JOB DESCRIPTION This post offers experience in assertive outreach approaches (including outreach with the
homeless mentally ill) or community psychiatry.
The community psychiatry component (general adult psychiatry) is based in Exeter and involves the Recovery
and Independent Living Team (formerly CMHT) with opportunities for new patient reviews, community and
hospital reviews (with the team). The service operates within a “New Ways of Working” model, with reviews
being largely planned jointly with care co-ordinators and other staff on the team. The team also receives new
patient referrals (triaged by the Wellbeing and Access team). About 45-50,000 adults of working age in Exeter
are covered by this part of the Recovery and Independent Living Team. The team is multidisciplinary with
nursing, social work, occupational therapy and recovery/support workers. Dr. Saluja (consultant psychiatrist)
and Dr. Pieczora (Associate Specialist) and a core trainee at CT2 level, work alongside the trainer, covering the
remaining areas of the Recovery and Independent Living Team. Cross-cover arrangements are well-established
between medical staff (it is anticipated that an additional core training post will be allocated to the service in
February 2010).
The Wellbeing and Access service, a new service with a primary care liaison function and which co-ordinates
and triages referrals and assessments, has been developed. This is multidisciplinary and based in Exeter. It has
close relationships with primary care services and can offer brief working and also assessment of referrals. This
might also offer training opportunities of interest to specialty trainees.
The Assertive Outreach component is based in Mid-Devon with the AOT base being in Crediton. This is a rural
area and offers experience of this model of assertive outreach. The team consists of nursing and occupational
therapy disciplines. This is a wide geographical area with two major clinical bases at Hillbank in Crediton and
Silverlea at Tiverton. It has a caseload of about 39 patients, three care co-ordinators and a support worker.
Care is delivered by a team-based approach. Regular clinical review meetings are held as well as planning and
feedback meetings as per the Policy Implementation Guidelines for AOT services.
The Outreach service for the homeless mentally ill of Exeter is based at the Clocktower Surgery in Exeter. The
mental health workers in the service consist of two CPN’s and a social worker. The service links closely and
seamlessly with the primary care team for the homeless and SHOT team (housing and accommodation
outreach and support). About 70 patients are on the caseload of the mental health workers who have complex
needs and co-morbidities in addition to severe mental illness. Due to their complex needs liaison with the
Exeter AOT and ENDAS/EDP (alcohol and substance use services) frequently occurs. The service offers
experience of outreach approaches for this patient group within in an inner urban area and of multi-agency
working. There are regular Clinical Team / Review meetings and the team is moving towards a team-based
model of working for more complex clients.
Additional training opportunities include the special interest of the trainer in chronic fatigue syndrome and
related disorders. The trainer has a wide range of interests and experience in medical education and research
and can offer supervision opportunities in these areas.
TIMETABLES
TRAINER a.m. p.m.
Monday
Patient reviews with Recovery and
Independent Living Team (CMHT),
Exeter
Patient reviews with Recovery and
Independent Living Team (CMHT),
Exeter
Tuesday
Team Meeting Recovery and
Independent Living Team (CMHT),
4pm Clinical Supervision
Clocktower Surgery, Exeter
(Outreach Service for Homeless
29

Wednesday
Thursday
Friday
Exeter
CFS / ME Clinic, Whipton Hospital,
Exeter
Mid Devon Assertive Outreach
Team Clinical Meeting. Crediton
Patient reviews with Recovery and
Independent Living Team (CMHT),
Exeter
Mentally Ill)
4 pm Educational Supervision
Patient reviews with Mid, Devon
AOT, Tiverton
Patient reviews with Recovery and
Independent Living Team (CMHT)
or Wellbeing and Access Team
(primary care liaison)
4pm Educational Supervision
Patient reviews with Recovery and
Independent Living Team (CMHT)
or Mid Devon AOT
TRAINEE a.m. p.m.
Monday
Patient reviews with Recovery and
Independent Living Team (CMHT),
Exeter
Patient reviews with Recovery and
Independent Living Team (CMHT),
Exeter
Tuesday
Wednesday
Thursday
0915-1115 Team Meeting Recovery
and Independent Living Team
(CMHT), Exeter
1130-1345 Clinical Education
Programme (Case Conference and
Journal Club)
Special Interest Session or Patient
reviews with Recovery and
Independent Living Team (CMHT)
Mid Devon Assertive Outreach
Team Clinical Meeting. Crediton
4pm Clinical Supervision
Clocktower Surgery, Exeter
(Outreach Service for Homeless
Mentally Ill)
4 pm Educational Supervision
Special Interest Session or Patient
reviews with Mid-Devon AOT
Patient reviews with Mid-Devon
AOT
4pm Educational Supervision
Friday Research Research
On-Call 1: 14 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Substance Misuse
Dr Stuart McLaren
Devon Partnership Trust
JOB DESCRIPTION The trainee will be involved in the assessment and treatment of patients with both drug and
alcohol related problems within the context of a well-developed district, multi-disciplinary drug and alcohol
service. They will gain experience in liaising with other services, with opportunities for joint working with the
Probation Service. They will be encouraged to integrate clinical practice with research findings in the field by
30

attendance at medical audit meetings, case conference and journal clubs held in the psychiatric department.
They will be encouraged to participate in a research or audit project within the addiction field.
TIMETABLE
TRAINER a.m. p.m.
Monday Administration/Other Associate Medical Director
Tuesday Outpatient clinic – The Willows Academic meeting/audit
Wednesday
Multidisciplinary team meeting,
The Willows
Consultant supervision slot
Thursday Multidisciplinary team meeting –
Shrublands House
Outpatient Clinic, Shrublands
House/GP surgeries
Friday Outpatient Clinic Ward round - Haytor
TRAINEE a.m. p.m.
Monday Research or Special Interest Research or Special Interest
Tuesday Outpatient clinic – The Willows Academic meeting/audit/teaching
Wednesday
Multidisciplinary team meeting,
The Willows
Consultant supervision slot
Thursday Multidisciplinary team meeting –
Shrublands House
Outpatient Clinic, Shrublands
House/GP surgeries
Friday Administration/other Ward round - Haytor
On-Call 1:12 non-resident second on-call to psychiatric SHO. South and West Devon catchment area of Devon
Partnership NHS Trust. A consultant psychiatrist is always available to supervise and attend if necessary.
POST
TRAINER
EMPLOYING TRUST
Psychotherapy
Dr C Susan Mizen
Devon Partnership Trust
JOB DESCRIPTION The Psychotherapy department at Wonford House is a busy outpatient service offering a
range of therapies and with an emphasis on the treatment of patients with severe and enduring mental illness.
31

The population served by the service is 243,000 and it is available to adults between the ages of 18 and 65. The
service receives around 160 referrals per year from Exeter, East Devon and Mid Devon. There is a Consultant
Psychiatrist in Psychotherapy in post, Dr C S Mizen. The service offers long term psychodynamic psychotherapy
and gestalt therapy once weekly, Cognitive Analytic Therapy, Mentalisation Based Therapy and EMDR group
analytic psychotherapy and systemic family and couple therapy. The Exeter, East and Mid Devon Intensive
outpatient therapy programme (The Combined Therapy Programme) for people with Personality Disorder also
runs from this department. There is in addition the therapeutic community day service at the Iris Centre. The
service operates as part of a co-ordinated psychological therapies service with psychology and creative
therapies services locally. These services provide the clinical experience for the medical psychotherapy part of
the Dual training as well as offering placements to Forensic Psychotherapy Higher Trainees and General
Psychiatric trainees undertaking a one year endorsement in psychotherapy or who have special interest
sessions in Psychotherapy.
The Specialty Trainee would be offered an opportunity to run a group for patients with Borderline Personality
Disorder with Dr Mizen and to participate in the liaison with psychiatric teams which takes place alongside this
service. This would include offering consultation under supervision to psychiatric wards about management of
PD patients who are frequently admitted to hospital. In addition the trainee would have the opportunity to see
patients under supervision for long term or brief individual psychodynamic therapy, cognitive analytic therapy
or cognitive behaviour therapy. There would also be opportunities to become involved in family therapy and
to gain experience in assessing patients for psychotherapy under supervision. There are regular opportunities
for teaching in the department to SHOs and medical students as well as to trainee therapists. There are
opportunities to participate in the MSc and qualifying course in Psychotherapy being run in conjunction with
Exeter University. This can lead to BPC accreditation in dynamic therapy or UKCP registration in systemic, or
cognitive therapies, for interested trainees.
The Psychotherapy department occupies spacious facilities, recently refurbished within the main hospital
building at Wonford House with a number of rooms available for individual and group therapy as well as family
therapy suite with video equipment. The Specialty Trainee would have access to office space throughout the
week. The service has a full time secretary.
TIMETABLE
a.m.
p.m.
Monday
9.30 Individual Patient
10.30 Psychotherapy Assessment
Audit, Teaching, Supervision,
Clinical Work
12.00 - 1.00 Supervision with
Consultant
Tuesday Academic programme Special Interest
Wednesday
Thursday
9.30 - 11.00 Group for borderlines
with Robert Plant
11.00 - 1.00 Patient/Admin
9.30 Patient
11.00 - 1.00 Supervision of PD
Projects, Academic Programme,
Departmental Meeting
Friday TBA Research
On-Call 1: 14 with Consultant Cover
Monthly Specialty Trainee Meeting
2 nd Monday of month
Psychotherapy Academic
Afternoon
POST
Early Intervention in Psychosis Exeter
32

TRAINER
EMPLOYING TRUST
Dr Charles Montgomery
Devon Partnership NHS Trust
This post is based at Wonford House Hospital in Exeter. STEP is a relatively new specialty service within the
access and well-being network providing tailored psychosocial and pharmacological interventions for first
episode clients. We work with young people aged 14-35 in an assertive befriending model of care for up to
three years. The trainee would gain experience in to how to engage troubled young people who are often
ambivalent about seeking help. The trainee would become adept at distinguishing symptoms of psychosis from
adolescent angst and would learn to work with diagnostic uncertainty often in the context of recreational drug
use. There is ample opportunity to gain experience of working with families and to input into our carers
support group. CBT and psycho-education are the bread and butter of EI work and the trainee would learn lots
from the skilled clinical team employing these skills. Positive risk management is a regular feature of the work
which the trainee would learn about. There are regular teaching and training opportunities at the PMS, in GP
outreach seminars and in a number of youth settings.
The team welcomes Specialty trainees and takes pride in sharing the positive and forward looking EI ethos that
has been fostered over recent years. We are highly motivated to making a real difference to client’s lives and
this makes for a fun and enthusiastic working atmosphere. The team comprises two administrators, one Clinical
team lead, one psychologist, one occupational therapist, and seven nurse practitioners.
TIMETABLE
Monday
Tuesday
A.M.
Consultant Meeting
MAC Meeting
Home visits
Specialist trainee supervision
P.M.
Home visits
Case Conference WHH
Home visits
Wednesday
STEP clinical meeting.
STEP Supervision
Journal Club (Consultants and
trainees)
.
Thursday Research Session Special Interest
Friday Home visits Clinic at YES, Exeter.
On-call
POST
TRAINER
1 in 17, Consultant Rota with Consultant Cover
Crisis Intervention
Dr Tanya Nelson
EMPLOYING TRUST
Devon Partnership Trust
JOB DESCRIPTION Catchment Area: The post of SpR, ST4-6, based with the crisis resolution service (CRS) for
Exeter. Population 130,000.This service has been established since 2003 and is about to include working with
older adults with functional mental health difficulties. The administrative base is at The Cedars, Wonford House
Hospital in the city.
33

Description: The primary clinical responsibilities of the SpR, ST4-6, will be to provide expert medical psychiatric
assessment, treatment and care to patients presenting in crisis with severe mental illness. This will allow the
post holder to develop expertise in assessing and positively managing risk. The CRS is a community service with
highly skilled membership and remit to ensure community treatment options where this is deemed
appropriate and in the patient’s best interests. It is a 24hour service and has a gate keeping role with regard to
hospital admission and carries a caseload of up to 20 patients. The post holder would be a member of the team
and would be encouraged to support the team in all aspects of their work. The post is in an ideal situation to
completely understand the care pathways of patients throughout Primary, Secondary and even Tertiary mental
health care.
Training Opportunities: Dr Tanya Nelson has been a specialist trainer for four years and has an MSc in
Psychiatric Research Methodology. She is involved in many non-clinical activities including audit, Trust
management and research. Her interests include staff satisfaction and burnout in community teams and early
discharge facilitation from inpatient stays by crisis teams. She would be happy to support and encourage the
post holder in their research.
The Special Interest subject would be decided by discussions with the trainer. The final timetable and the
nature of the work undertaken would be determined by the educational objectives and training needs of the
Specialty Trainee.
TIMETABLE
Monday
Tuesday
Wednesday
Thursday
Friday
On-Call 1: 10 with Consultant Cover
a.m.
9-10 Handover with team.
10-11 Supervision with Consultant
11-1 Clinical Session with CRS
12.30-2 Self Harm supervision
9-10 Handover with team.
10-11.45 Clinical Session with CRS
11.45-1.30 Journal Club and Case
Conference
9-10 Handover with team.
10-1 Clinical Session with CRS
9-10 Handover with team.
10-1 Clinical Session with CRS
9-10 Handover with team.
10-1 Clinical Session with CRS
p.m.
2-5 Clinical session with CRS
1.30-5 Clinical session with CRS
Research Session
Special Interest Session
1.30-5 Clinical session with CRS
POST
TRAINER
EMPLOYING TRUST
Old Age Psychiatry
Dr Steve Pearson
Devon Partnership Trust
JOB DESCRIPTION The Catchment area is 13,000 over 65 population in West Devon and South Hams. You will
gain experience of an integrated OPMH team and be part of a weekly team meeting where cases are allocated
and cases discussed at feedback. A memory assessment service is part of this community team. The team
includes Speciality Doctor (1 FTE), Community Nurses, Psychology and a Clinical Team Leader. The team base is
in Ivybridge, Devon.
34

We still look after our own catchment inpatients on 6 beds in NHS Plymouth, working with CRHT for functional
patients.
Training Opportunities
Our team is actively involved in teaching 3 rd year medical students. There will be opportunities to be involved
with this. There is a chance to take part with an audit that is active within the team. Dr Pearson is actively
involved in Service Development and there will be opportunities to be involved in this.
Special interest sessions would be decided by discussion with the trainer. Dr Pearson has wide contacts in
Derriford Hospital and in NHS Plymouth which can be used to provide ample opportunities to provide specialist
sessions which could include Liaison Psychiatry, Neurology, attending specialist Parkinson’s disease clinics and
other specialist memory clinics.
Research
Dr Pearson has a funded Research Session and is active in DeNDRoN dementia research. There are 4 research
nurses as part of the team based at Derriford and you will be welcome to join in this active research centre.
Huntington’s disease
Dr Pearson takes part in a 2 monthly specialist clinic with a neurologist and neuropsychologist at Launceston as
part of his specialist interest in Huntington’s disease. There are active plans to develop research in
Huntington’s disease.
TIMETABLE
Monday
a.m.
9-12 Community Assessments
12-1 Supervision with Consultant
p.m.
Ward Round, Dementia
Tuesday Team Meeting Community Assessments
Wednesday Ward Round, Functional Special interest
Thursday Community Assessments Outpatient Clinic, Tavistock
Friday Community Assessments Research session
On-Call 1: 10 with Consultant Cover (Plymouth on-call rota)
POST
TRAINER
EMPLOYING TRUST
Substance Misuse Psychiatry
Dr Mary Rowlands
Devon Partnership Trust
JOB DESCRIPTION This is a training post where the candidate will be working with supervision. The cases seen
are at the same level of complexity as those cases that are referred to the consultant, after a period of training.
There will therefore be regular access to complex case discussion with the consultant:
1. To be an active member of the multidisciplinary community and criminal justice drug teams.
2. To assess new outpatients referred to the addiction service, decide upon their treatment and develop a
care package with their allocated key worker.
35

3. To liaise with the General Practitioners, primary healthcare teams and non-statutory drug agencies in the
care of patients with substance misuse problems. To communicate promptly with GP’s in writing, to a
given professional standard so they are fit for purpose, agreed with the Consultant.
4. To maintain accurate multidisciplinary medical records, other clinical documentation of clinical activity and
individual care plans where appropriate so they are updated promptly to ensure available to other
professions.
5. To provide regular reviews of complex cases in collaboration with key worker reviews supervised by senior
non-medical clinicians with referral as professionally agreed with the Consultant.
6. To provide during office hours in designated clinic sessions urgent addiction support/advice in conjunction
with the Consultant, other ENDAS SAS doctors and Nurse Prescribers to staff caring for addiction team
patients admitted to the Wonford House Hospital inpatient beds.
7. To liaise with staff at the Royal Devon and Exeter Hospital in the care of inpatients with co-morbid physical
problems associated with drug misuse.
8. To participate in teaching and training of other disciplines and agencies as appropriate.
9. To participate in appropriate addiction audits.
10. To participate in educational sessions appropriate to Personal Development including special interest and
research sessions.
TIMETABLES
TRAINER a.m. p.m.
Monday Admin/Consultant Meetings Multi-agency meetings
Emergency clinic inc Young Persons
Tuesday MDT 1130-1330 Journal Club/Case
Conference
Clinic/Teaching
Wednesday
Thursday
Friday
Ward Round and Medical
Students/Psych SHO Teaching
Clinic/Teaching if 3 med student
placements
0900-1000 SAS supervision
1000-1200 Teaching
TRAINEE a.m. p.m.
Monday
Clinic/Teaching
1700-1900 Evening clinic every 2 nd
& 4 th month as required
1300-1400 Vulnerable babies and
pregnant drug misusers meeting
every 3 rd of the month
1400-1730 Protocol Development
1230-1330 Nurse Prescriber
supervision/development
1330-1430 ST4-6 Supervision
1430-1630 Emergency clinic
Tuesday
Wednesday
Thursday
MDT
Journal Club and Case Conferences
Clinic/Ward Round
Teaching
Clinic/Teaching
Clinic
Friday Clinic/Teaching Supervision
Emergency Clinic
36

On-Call : There is on call commitment with this post, as part of the Wonford House Hospital Consultant
supervised StR rota, currently 1 weekday in 7 weeks and 1 in 20 weekends, but it will vary according to service
exigencies
POST
TRAINER
EMPLOYING TRUST
TIMETABLE
Monday
Tuesday
Wednesday
Thursday
Friday
General Adult Psychiatry
Dr Bharat Saluja
Devon Partnership Trust
a.m.
p.m.
On-Call 1: 10 with Consultant Cover
POST
TRAINER
RESEARCH INTERESTS
EMPLOYING TRUST
Old Age Psychiatry, Chadwell Centre, Torquay Road, Paignton
Dr David Somerfield
Old Age Psychiatry
Devon Partnership Trust
JOB DESCRIPTION The Torquay Sector Specialty Trainee in Old Age Psychiatry is based at the Chadwell Centre,
Paignton and gain experience working with the inpatient and community multi-disciplinary teams, Memory and
Family Therapy Clinics and Day Hospital. They will have supervised responsibility for both outpatient and
inpatient assessment and treatment of a range of functional and organic disorders. The supervisor offers
Cognitive Analytic Therapy experience and supervision.
The Chadwell Team serve a population of 18,000 people over the age of sixty-five within Torquay and Paignton.
The Community Team is well developed and includes four full time G Grade CPNs, a full time Clinical
Psychologist, Occupational Therapist and Staff Grade. There are close links with Social Services and there are
plans to amalgamate the Chadwell Team with the Social Services EMI Team. Most assessment and follow up is
carried out in the patient’s own home but there is ready access to Day Hospital treatment, day care, respite
care and inpatient services. The Community Team is based in the same building as the Day Hospital, Memory
Clinic and Family Therapy Clinic, facilitating communication and treatment. The Chadwell Centre has Internet
access.
The Mental Health Directorate has a weekly audit and clinical teaching session which runs on a three term basis
and the Specialty Trainee in Old Age Psychiatry will be expected to attend and participate in teaching. There is
opportunity to attend and teach at the weekly geriatric meetings at Torbay Hospital. The Chadwell Team has a
guest speaker every month from local organisations providing care to elderly patients with mental illness in the
locality. The Specialty Trainee is encouraged to participate in teaching the multi-disciplinary inpatient and
37

outpatient teams. The supervisor organises an annual regional meeting of old age psychiatrist and the
Specialty Trainee would be welcome to participate in both organisation and management of the event.
TIMETABLES
TRAINER a.m. p.m.
Monday Medical Director, Wonford Community visits/monthly PGME
meeting
Tuesday
CMHT clinical meeting
Supervision
Community visits/monthly PGME
meeting
Wednesday Community visits Community visits
Thursday Medical Director, Wonford Medical Director, Wonford
Friday
Peer supervision, PDP, Community
visits
Community visits
TRAINEE a.m. p.m.
Monday Memory Clinic Community visits/admin
Tuesday
CMHT clinical meeting
Supervision
Community visits/monthly PGME
meeting
Wednesday Community visits/admin Community visits/admin
Thursday
Memory prescribing clinic/medical
management
Community visits/medical
management
Friday Clinical research/special interest Clinical research/special interest
On-Call: 1:14 General adult/OPMH/S12
POST
TRAINER
EMPLOYING TRUST
Urgent & Inpatient Consultant Psychiatrist
Dr Charles Dixon
Devon Partnership NHS Trust
JOB DESCRIPTION The Urgent and Inpatient Care network look after the most acutely mentally ill people for a
short time during their crisis. This can occur at home with support from the Crisis Resolution Team or may
require a stay on the inpatient unit. This post involves working across these two areas with clients who live in
East Devon. The post is based in Exeter with the Crisis Resolution Team located within the inpatient unit at the
Cedars in the grounds of Wonford House Hospital. The trainee would have the opportunity to work with the
inpatient team and the Crisis Team and follow the patient’s journey across services.
Dr Dixon is a young Consultant who trained as an SpR in the Peninsula and understands the training needs of
ST4-6’s and can help them on their path to a CCT and Consultant job. He is heavily involved in undergraduate
38

teaching with the Peninsula College of Medicine and Dentistry and leads psychosis week and a fifth year
psychiatry pathway among other things, any trainee would have the opportunity to be involved with this
teaching.
The post comes with full secretarial support, a spacious office and a GP trainee covering the ward. There is a
well-attended journal club and education meeting with lively discussion every week.
TIMETABLE
Monday
Tuesday
a.m.
Planning Meeting
Review new admissions
Planning Meeting
Medical Students welcome
Education Meeting
p.m.
Crisis Team Assessments
Ward Round
Wednesday Crisis Team Assessments Crisis Team Assessments
Thursday Special Interest Research
Friday
On-Call 1: 20 with Consultant Cover
Planning Meeting
Inpatient Reviews / CRS as needed
Medical Students teaching
ST4-6 Supervision
POST
TRAINER
EMPLOYING TRUST
INTERESTS
General Adult Psychiatry (Urgent and Inpatient Care)
Mid Devon Crisis Team and Inpatients at The Cedars
Dr Peter Noble
Devon Partnership NHS Trust
Service development, Electronic patient records, Philosophy of Psychiatry
JOB DESCRIPTION This post is based at Wonford House and The Cedars in Exeter. The Cedars contains two
wards for inpatients from Exeter, East and Mid Devon. Dr Noble is Consultant for Mid Devon inpatients and the
crisis team There is an unified crisis team covering all three areas working with Dr Tanya Nelson (Exeter) and
Dr Charles Dixon (East Devon) as well as Dr Noble. The details of the focus of the post and the day (or days) of
protected time can be adapted according to the preferences of the trainee for crisis or inpatient work, or a
combination of the two. One possibility would be to mainly be based in the crisis team and to work with the
team for patients in East and Mid Devon (working also with Dr Charles Dixon). Full secretarial support is
provided. The post holder has timetabled regular consultant supervision and access to an SpR office. The post
is supported by a CT1-3 trainee. Please feel free to contact Dr Peter Noble at any time to discuss the post
further. The trainee will take part in the Exeter consultant on call rota with supervision by a named consultant.
The rota is currently approximately 1 in 16.
39

TIMETABLE
Monday
Tuesday
a.m.
9-10 am Ward meeting or CRS
handover
CRS assessments
9-10 am Ward meeting or CRS
handover
Teaching students/ward work
p.m.
1.30 CRS handover
3.30-5.00 pm Governance meeting
1.30 CRS handover
CRS assessments
Wednesday Special interest and SpR meetings Special interest and SpR meetings
Thursday
9-10 am Ward meeting or CRS
handover
CRS assessments
1.30 CRS handover
2.00-3.00 pm Educational
supervision
3.00-5.00 pm Clinical admin
Friday Research Research
On-Call 1: 16 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
General Adult Community Psychiatry
Dr Andrew Moore
Devon Partnership NHS Trust
North Devon District Hospital (NDDH), Raleigh Park, Barnstaple, EX31 4JB and
The Gables, 1 Belmont Rd, Ilfracombe, EX31 8DR
JOB DESCRIPTION This post offers both a broad-based general adult psychiatry experience, and experience in
management and leadership, in a beautiful part of Devon. The post involves training and working with
Wellbeing & Access, and Recovery & Independent Living community teams based at Riverside (Barnstaple) and
The Gables (Ilfracombe) covering a population of c52,000. We also provide medical input to the STEP (Specialist
Team for Early Psychosis) and Assertive Outreach Teams, as well as liaising with the CRHTT and Acute IP wards.
There is a new Liaison service starting in NDDH with opportunities for training/experience if desired. Dr Moore
is the Clinical Director for the Adult Directorate (covering the whole Trust), so there is ample opportunity to
gain experience in management and clinical leadership. Thus the post is an excellent one for trainees wishing to
develop their overall "generic" clinical skills whilst being able to still focus on specialist areas too, and gain
wider management/leadership skills. Inpatient/CRHTT work is led by Dr Nicholson and his team, and there are
3 other community based Consultants (one of whom, Dr Kerry Jonsson, is p/t in Dr Moore’s team) making up a
small but friendly locality.
Dr Moore has interests in Medical Management, Teaching/Medical Education and Spirituality in Mental
Health, but trainees will be equally supported to pursue their own interests. There are good relationships with
local GPs so trainees will be encouraged to build on this, e.g. with practice visits. There is also an active
Postgraduate Training programme with weekly meetings and a Journal Club which trainees of all grades are
expected to contribute to.
40

On call experience can be arranged to suit the individual trainee. Section 12 training/approval is encouraged,
and plentiful experience can be gained in Community Mental Health Act Assessments, CTO’s (including CTO
Tribunals) and S136 work.
TIMETABLE
Monday
Tuesday
Wednesday
a.m.
9-1 pm OPC Riverside(Dr Jonsson)
Or management work with Dr Moore
9.30-11am Consultant & SpR meeting,
NDDH
11-1pm Postgraduate seminar, NDDH
9-11am CMHT meetings, R’side, adhoc
appts/CPA’s
11.30-12.00 (once monthly) STEP,
R’vale
p.m.
Admin/SPA time
Or management work with Dr
Moore
1-2pm Journal club NDDH
2-5pm Flexible: Adhoc
appointments, CTO managers
hearings, clinical admin, DVs
12-1.30pm CMHT
educational/business meet
(alternate fortnightly)
2.30-5pm OPC Gables, Ilfracombe
Thursday Special Interest Special Interest
Friday 9.30-1.00 OPClinic, Gables 1-2 PM Supervision
2-5PM Admin/audit
On-Call approx 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Community Psychiatry and Early Intervention in Psychosis
Dr Antony Thekkepalakkal
Devon Partnership Trust
JOB DESCRIPTION This is a new and exciting opportunity for ST4-6 trainees to work in a diverse setting in the
community covering a large but predominantly rural area of outstanding natural beauty. The trainee would be
a much valued member of the Early Intervention in Psychosis (STEP) Team (South and West Devon) & the
Community Mental Health Teams (Mental Wellbeing and Access/Recovery and Independent Living/Assertive
Outreach functional network teams, in the areas of Totnes and Dartmouth). The trainee would join a skilled
and experienced multi-professional team which includes a Consultant Psychiatrist (Educational Supervisor) and
a Specialty doctor based at Cabot House, Totnes.
The trainee would have opportunity to work flexibly either across the 4 teams or focus on a specific team (s)
based on their interests, clinical experience and learning needs. The trainee could also develop his/her
confidence and leadership skills by providing psychiatric input to the team working in a particular geographical
area with regular supervision and the support of an efficient medical secretary. Our award-winning STEP team
works with young people (age range 14 to 35) with first episode psychosis, sharing the positive and forward
looking EI ethos adopting an assertive but befriending model of care for up to three years often in close
collaboration with other local services including CAMHS. There are ample opportunities to gain experience of
working with families and to learn CBT based techniques as well as psycho-educational skills from a wellmotivated,
enthusiastic and friendly team. By working with the functional network teams, the trainee would
gain valuable experience in the clinical management of patients in the community with an emphasis on the
Recovery principles. The teams comprise of experienced clinicians and the trainee could learn to develop and
maintain close working links with GPs, service user/carer groups (eg: Be Involved Devon), voluntary sector ( eg:
Rethink), other local Trusts ( eg: Community Care Trust) and the private sector ( eg: Community of St. Antony
and St. Elias, Totnes) which would benefit the trainee immensely in their transition process from being an StR
to a Consultant psychiatrist.
41

The Educational supervisor has done his basic and specialist psychiatric training in the South West Peninsula
Deanery and is keen to support the trainee to meet and/or shadow other senior clinicians, clinical/medical
directors, Chief Executive and the Trust managers in order to develop their knowledge and understanding of
the new Clinical Directorate as well as the role of clinicians in management within the modern NHS structure.
This post also offers opportunity to teach medical students during their local SSU placements (‘Road to
Recovery’) and the FT/CT doctors at Journal clubs/Case Conferences/Tutorials/ Audit meetings/ MRCPsych
exam practice sessions in South Devon. The trainee would be encouraged to be innovative and take on clinical
audit and service evaluation projects that might be of interest to them. Research and other special interests
would be fully supported in this post. The trainee would be encouraged to do Section 12 MHA work/training
and attend educational courses/events for CPD/NHS appraisal purposes. Mentorship via the Deanery will be
supported. They would also receive support for their WPBA with a view to achieving a satisfactory ARCP while
working towards a Certificate of Completion of training (CCT) and obtaining a Consultant job in the NHS.
a.m.
Monday Tuesday Wednesday Thursday Friday
Clinical and
9.30 to 11.30 : Research
Educational
Clinical Team session
Supervision with meeting
Consultant ( 9.30 to
11.00 am )
Clinical
work/Home visits
Clinical
work/Home visits
11 am : Clinical
work/Outpatient
clinic
12.30 to 1.30 :
Tutorials/Teaching
for FT/ST 1-3 at
Torbay Hospital
p.m.
Clinical
work/Outpatient
clinic
Clinical work/Home
visits
Regional Educational
meeting-Case
conference/Journal
Club ( monthly) &
Clinical Audit
Meeting ( every 2
months)
Clinical work/Home
visits
OR
StR(4 -6) Peer group
meeting ( monthly)
Special
Interest
session
Supporting
Professional
Activities
( SPA)/Emergency
assessments
The frequency of on calls would be 1 in 14 as part of the senior trainee/consultant rota at Torbay hospital.
The trainee would be expected to provide advice for (and attend if required) any emergencies and requests for
Mental Health Act assessments of patients at Torbay hospital, APOS suite, Police Custody and in the
community (Torbay, Teignbridge, part of South Hams area) . They would also be expected to advise/support
the junior doctors (FT/ST 1-3) who will be 1 st on call in psychiatry. There would be a consultant on call along
with the ST4-6 trainee, for clinical supervision and support. Trainees could also attend the out of hours
supervision group conducted by the new liaison psychiatry team at Torbay Hospital.
42

POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
General Adult Psychiatry
Dr Phil de Warren-Penny
Devon Partnership Trust
The Cedars, Wonford House Hospital, Dryden Road, Exeter, EX2 5AF
JOB DESCRIPTION Dr Phil de Warren-Penny is Consultant Psychiatrist for Exeter inpatients from: STEP (Early
Interventions in Psychosis Team); the Assertive Outreach Team; and the Rehabilitation Team. He also provides
cover for the Crisis Team covering Exeter, affording the trainee the opportunity of following patient’s transition
between Crisis/Home Treatment and Inpatient services. The ST4-6 trainee will work with him in providing
clinical, diagnostic and risk management of individuals admitted to the Cedars under his care; proactive liaison
with multidisciplinary teams regarding individuals using services; undertaking Mental Health Act Assessments;
the provision of reports for and attendance at Mental Health Review Tribunals and Managers’ Hearings (under
supervision); chairing CPA and 117 meetings; chairing ward rounds; clinical supervision and training of junior
doctors; and participation in the Consultant on-call rota. The St4-6 trainee will be encouraged to take an active
part in Audit.
As relatively newly appointed consultant, having trained in Peninsula Deanery as an ST4-6 in the aftermath of
MTAS, Dr de Warren-Penny is well aware of the tensions placed on Higher Specialist Trainees, and the need to
gain experience in a variety of domains outside the clinical for ARCP progression, gaining CCST, and obtaining a
Consultant post. He has previously been the Chair of the Peninsula Psychiatry SpR/ST4-6 group, and Chair of
the Regional Junior Doctor’s Committee for the BMA.
There is significant opportunity for exposure to Management and Leadership activities both within the Urgent
& Inpatient Care Governance structure, and with other activities Dr de Warren-Penny undertakes as Associate
Clinical Director for Younger Adults in Exeter. At present he is involved in working groups for: Medicines
Management regarding injectable prescribing and rapid tranquilisation; a review of Mental Capacity Act and
Deprivation of Liberty Safeguards arrangements in the Trust with a view to developing an Improvement plan;
the development of dedicated Psychological Services provision into acute inpatient units within the Trust.
Trainee participation in these activities, and others as they develop, would be both encouraged and welcomed.
Dr de Warren-Penny also undertakes medico-legal work independent from his role within Devon Partnership
Trust. Whilst not a core part of the role of any trainee with him, opportunities for developing this as a special
interest whilst a trainee (as he did) would be supported.
The post is supported by a F2 trainee covering the ward, providing the opportunity for both teaching and
mentoring. Regular placements of 3 rd and 5 th year medical students from Peninsula Medical School also
provide teaching opportunity.
Full secretarial support is provided. The post holder has timetabled regular consultant supervision and access
to a SpR office within Wonford House Hospital.
Weekly Timetables (see point 4 in Notes for Guidance)
43

TRAINEE TIMETABLE
Please complete the proposed timetable for the trainee. This timetable must indicate the arrangements for
Clinical and Educational Supervision
Monday Tuesday Wednesday Thursday Friday
a.m.
9am Ward MDT
Meeting
10 am Clinical
Reviews
9am Ward MDT
Meeting
10am UIC Clinical
Governance
Meeting
9am Ward MDT
Meeting
10am Rehab
Team Ward
Round
Special
Interest/Research
(Day subject to
negotiation)
9am Ward MDT
Meeting
10am Clinical
Reviews / CRS
Assessments
p.m.
STEP Team
Ward Round
12:30 – 1.30 Case
Conference
1.30 – 2.30 ST4-6
Supervision
2pm AOT Ward
Round
Special
Interest/Research
(Day subject to
negotiation)
Clinical Admin
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision
1:14 On Call, non-resident, with consultant cover as “First on” the Consultant rota
Clinical supervision available from Consultant on call, or through discussion with trainer afterwards.
TRAINER TIMETABLE
Please complete the timetable for the trainer. This should show:
a. regular scheduled Consultant supervision of one hour per week
b. a substantial overlap with that of the doctor in training
a.m.
Monday Tuesday Wednesday Thursday Friday
8am Clinical 8am Clinical 10-2 SPA for
Admin
Admin
CPD/
9am Ward MDT 9am Ward MDT Revalidation
Meeting
Meeting
10am UIC Clinical 10am Rehab
Governance Team Ward
Meeting
Round
8am Clinical
Admin
9am Ward
MDT Meeting
10 am Clinical
Reviews
8am Clinical Admin
9am Ward MDT Meeting
10am Clinical Reviews
p.m.
STEP Team
Ward Round
12:30 – 1.30
Case Conference
1.30 – 2.30 ST4-6
Supervision
12-1pm F2
Supervision
2pm AOT Ward
Round
Management SPA
(Management
Supervision/Appraisals/Job
Planning)
44

POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Old Age Liaison Psychiatry
Dr Colm Owens
Devon Partnership Trust
Wonford House Hospital Exeter/ Royal Devon and Exeter Hospital
JOB DESCRIPTION The Older People’s Liaison Psychiatry Service was set up in July 2010 it is provided by the
Devon Partnership Trust but commissioned and hosted by the Royal Devon & Exeter acute trust.
All patients aged over 65 (or patients of any age where a dementia is present) who require psychiatric input are
eligible to be assessed by the service. Patients with both functional and organic problems are seen.
The work is hugely varied and involves everything from advice on placement and psychotropic medications to
complex neuropsychiatric assessments and brief psychotherapies.
Team members also attend ward based multi-disciplinary meetings and are involved in teaching nursing and
medical staff about mental health and related matters
The team consists of a full time consultant psychiatrist, a band 7 Clinical Team Leader, three band 6 specialist
nurses, a part time specialty doctor and full time admin and secretarial support.
Medical SpRs join the team for attachments, as well as medical students.
The OPMH Liaison Service is co-located with the younger adults’ liaison service and the Research and
Development team at Wonford House Hospital in Exeter. Patients are seen in the Emergency Department,
Acute Admissions unit and inpatient wards at the Royal Devon and Exeter Hospital which is next door to
Wonford House.
This post would suit either an old age trainee or a trainee who was considering working in Liaison Psychiatry.
In addition to the allocated sessions for educational and clinical supervision, there will be regular clinical
contact with the consultant for discussion of cases etc. The timetable for the ST4-6 trainee is flexible and will
depend on the training needs of the doctor. It is anticipated that the workload will consist of a mixture of
reviews, consultation advice and support to the team and acute medical staff, together with single handed and
multi-disciplinary assessments.
The cornerstone of liaison psychiatry work is education and it is expected that the higher trainee would take
part in teaching programmes in the general hospital for junior doctors and nursing staff.
Audit projects would be strongly encouraged and fully supervised.
Any pre-existing special interest sessions and research projects would be fully supported.
Dr. Owens would be extremely happy to work with the trainee to develop special interests and research
projects. The team have close links with both the trust Research and Development department and medical
consultants and teams in the acute trust. Trainees in their final year may wish to consider management or
service development projects and this too would be supported.
There is a well-attended journal club and education meeting every week. The trainee may also wish to
consider attending medical grand rounds in the acute trust.
Dr Owens has been a consultant for two years and is familiar with the training needs of ST4-6s and the
preparation required for consultant interviews and transition. He is currently the chair of the national Trainees
and new Consultants’ group of Liaison Psychiatrists. He has interests in psychodynamic psychotherapy,
neuropsychiatry and medical education.
45

Weekly Timetables
TRAINEE TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. Liaison Work in
RD&E
Liaison Ward
Round
Liaison Work in
RD&E
Research/Special
Interest
MDT Team
meeting (monthly)
MDT Team
educational
meeting
(monthly)
11-12PM
Educational
Supervision
12-1PM Clinical
Supervision
p.m.
Liaison Work in
RD&E
12-2 PM: Local
Academic meeting
Liaison Work in
RD&E
Liaison Work in
RD&E
Liaison Work in
RD&E
Research/Special
Interest
1 in 14, Second on call, non-resident, with Consultant Cover
Monday Tuesday Wednesday Thursday Friday
Liaison Ward Liaison Work in
Round
RD&E
a.m. CPD MDT Team
meeting
(monthly)
MDT Team
educational
meeting
(monthly)
11-12PM
Educational
Supervision
12-2 PM: Local
Academic
meeting
p.m. Strategy/Leadership PA Liaison Work in
RD&E
12-1PM Clinical
Supervision
Liaison Work in
RD&E
Liaison Work in
RD&E
8.30-9.30
Monthly
Dementia
Strategy
Meetings RD&E
Liaison Work in
RD&E
12.50-2PM
RD&E Old Age
Medicine
Meeting
Liaison Work in
RD&E
46

POST
TRAINER
EMPLOYING TRUST
SPECIALIST INTEREST
Addictions Psychiatry
Dr Alison Battersby (Academic Secretary, Faculty of Addictions Psychiatry)
Plymouth Primary Care Trust
Recovery Agenda in Addictions, National Policy, Injectable Prescribing, Working with
the third sector, System Redesign
JOB DESCRIPTION This post offers the opportunity to work in an innovative partnership arrangement between
statutory and third sectors offering drug and alcohol treatment in a whole system approach. The system is
further developing to embrace the Recovery Agenda. This will enable a trainee to be involved in and develop
skills in implementing whole system changes including the third sector. Plymouth enjoys good working
relationships with its commissioners with an opportunity for a trainee to understand a commissioning
perspective. We work across the system seeing the most complex clients forming less than 20% of the
treatment community often on a consultancy basis. Although most clients are seen with Harbour Drug and
Alcohol Service, we also work with day services, general hospital, police, courts, mental health colleagues and
residential rehabilitation units offering a range of interventions covering both addiction and mental health
needs. We sit on the DAAT Strategy group offering clinical expertise to inform decision-making. We also have
a new multi-disciplinary Addiction Research Centre at Plymouth University and regularly participate in
research/national pilot projects. Trainees are invited to attend and participate in these meetings. Teaching is
undertaken across the treatment system and into the public domain. Trainees are encouraged to experience
open meetings of mutual aid groups eg AA/NA.
The Secondary Care Addiction Service offers flexible input based on the needs of the treatment system with a
rapidly changing mix of management and clinical activities. Trainees will be encouraged to actively participate
in and sometimes lead service developments with appropriate levels of support. Trainees will often have the
opportunity to pursue national opportunities in the field.
Addictions Psychiatry is a core skill for psychiatrists given the prevalence of dual diagnosis. This placement
offers a varied and challenging job affording an opportunity to work at the cutting-edge of national practice.
TIMETABLE
a.m.
p.m.
Monday 9am Trust Consultants Meeting Flexible clinical time
Tuesday 9.15am-11am MDT 2pm OPA
Wednesday
11.30am-1.30pm CPD
1.30pm Residential Rehabilitation
MDT/Clinic
Thursday Admin Session 2-3pm supervision with consultant
3-5pm OPA
Friday Special Interest Special Interest
On-Call 1: 14 with Consultant Cover
47

POST
TRAINER
EMPLOYING TRUST
General Psychiatry -Inpatient and Home Treatment
Dr Naresh Buttan
Plymouth Primary Care Trust
JOB DESCRIPTION This full time equivalent (FTE) training post provides an ample opportunity to gain
experience in managing acutely unwell mental health working age clients. The post is primarily based in
Glenbourne Unit and has close liaison work with Home Treatment Team as a part of gate keeping admissions to
this inpatient unit. This post is under Inner City Locality of HTT/Glenbourne Unit. The inner city locality caters to
people living and registered with GP practices within inner city catchment area and works in close association
with 2 Community Mental Health Teams (South East-Tamarside & South West- Waterfront localities). The
populace of nearly 98,000 people are covered by 14 GP practices in this catchment area. As this area is
deprived, the patients present with more complex psychosocial needs in addition to mental health needs and
often carry dual diagnoses (with comorbid substance use, personality disturbances, learning difficulties and
forensic involvements). The Integrated Care Pathways are being developed in lines with NICE & RCPsych
Guidelines to manage these complex conditions. The inpatients are managed as voluntary or detained under
Mental Health Act. Mostly admissions to Glenbourne are gate kept by HTT and discharged through the same
route under newly developed Nurse Led Discharge Policy & facilitated by Satellite Service of HTT.
The secondary mental health services are being redefined currently under QIPP & TCS agendas and apex
services like Glenbourne & HTT are at the forefront of leading some quality improvement changes. The post
holder would gain a greater understanding of these reforms and would provide a substantial support to teams
working here. The post holder can accompany educational supervisor in some of these administrative meetings
e.g., Consultant Psychiatrists Meetings on alternate Mondays and Glenbourne Development Meetings on once
a month Wednesday mornings.
The clinical responsibilities include assessment of new admissions to Glenbourne (Inner City Clients), reviewing
them on regular basis, liaise with GPs, carers or key workers, discharge planning and leading weekly
multidisciplinary ward rounds and community clinical reviews each under direct supervision of trainer.
Additional skills in preparing reports and representing RC in Mental Health Tribunal Reviews as needed. Sec. 12
(2) approval or training for the same would be required.
The post holder would be directly responsible to Dr. Naresh K. Buttan, Lead Consultant HTT & Glenbourne Unit.
Trainee would also have opportunities to interact with Dr. Mike Cooper, Consultant Psychiatrist covering outer
city division of Glenbourne & HTT. The clinical supervision during day time would be available from Dr. Buttan,
Educational Supervisor (in addition to protected 1 hr weekly session on Tuesday mornings) and his team at
Glenbourne & HTT.
The Glenbourne Unit has Foundation Year 2 Trainees posted for 4 months in each wards (Harford & Bridford).
The post holder would be expected to provide work based supervision to FY2 Dr. in Harford Ward. The other
teaching avenues e.g., teaching at MRCPsych programme being run locally can be negotiated. The Peninsula
Medical School sends 3 rd & 4 th year medical students for 3 weeks rotation in psychiatry and this post holder
would be expected to provide clinical bedside teaching to them.
Post holder would also be able to co-chair (Chair- Dr. Buttan) twice monthly case conferences presented by
other trainees. The Journal Club and Case Conferences are held twice/thrice in a month for 1 hrs each on
Wednesday mornings at Glenbourne Unit. Monthly once CPD and Grand Rounds each provide opportunities for
this post holder to demonstrate their presentation skills. The presentation slot in these academic activities can
be negotiated. The post holder would be expected to participate in an on-going or fresh audit to demonstrate
their research skills.
48

The trainer has special interest in Transcultural Psychiatry and would support & supervise trainee in developing
special interest in that area or any area of trainee’s choice depending upon the availabilities of resources.
Trainee would be encouraged to join Balint Group meetings held on Wednesday mornings as a part of
reflective practice. Dr. Cooper, College Tutor provides further support to trainees and organizes reviews of
ARCPs.
Other information regarding pay scales, hours of working, leave arrangements will be laid out in service
contract and can be obtained from Medical Staffing Department at Glenbourne Unit.
TRAINEE TIMETABLE: (Subject to variations)
Monday Tuesday Wednesday Thursday Friday
a.m. Visit Glenbourne Unit
for new
assessments/reviews,
support Satellite
service of HTT & F2
doctor in Glenbourne
Unit
Community
Clinical Reviews
at HTT & 1 hour
(protected) of
supervision with
Trainer
Academic activities at
Glenbourne Unit
(Balint group, journal
club, case conference)
Ward rounds with
Trainer at
Glenbourne
p.m.
HTT (Home visits/
assessments)
HTT/Glenbourne
(visits /
assessments)
Glenbourne Unit /
HTT as per the clinical
needs.
HTT
(visits/assessments)
Special interest /
research /
academics
Special interest /
research /
academic
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision
Currently 1 in 10 with consultants on call. The on-call cover is to provide psychiatrist cover for Plymouth Area,
A& E, HTT, Glenbourne and other peripheral units within the trust. The supervision as per the clinical need
provided by on-call consultants.
POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry working with North West PCLT
Dr Sara Cunningham (0.65wte)
Plymouth Primary Care Trust
JOB DESCRIPTION Dr Cunningham works as a Consultant Psychiatrist in the North West PCLT (Primary Care
Liaison team). The team consists of 1.6 Consultants, 1 CT1, 5 CPN's (one Band 7 team leader), 1 Occupational
therapist (Band 6), 1 social worker (AMHP), 2 support workers, 2 medical secretaries and 1 team secretary. The
catchment area is approximately 40,000 population and covers 8 GP surgeries in the Whitleigh/St Budeaux area
of Plymouth. We see a wide range of psychiatric problems from the major psychoses (depression,
schizophrenia and bipolar affective disorder) to adult ADHD, personality disorders and severe anxiety
disorders. The ST4-6 trainee will be expected to see patients with a variety of clinical problems of appropriate
complexity.
Dr Cunningham has trained in psychiatry since 1988 in Liverpool, Nottingham, Leicester and Plymouth. She has
been a Consultant Psychiatrist in Plymouth since 1999 and trained a number of ST4-6 psychiatrists. She has a
special interest in treating Occupational Health psychiatry problems within the South West Peninsular. She has
an interest in medical education (PGCMedEd) and regularly delivers training and feedback within the
Peninsular Medical School. The trainee will devise a programme suitable for their training needs, but focusing
on adult community psychiatry.
49

Opportunities for a Specialty Trainee:
Outpatient clinics, in patient care, emergency psychiatry – both day & night (on call), experience of a wellfunctioning
multidisciplinary team, writing Court and Tribunal reports under supervision, teaching for junior
medical staff and other disciplines, regular teaching programme, audit, protected research sessions and
psychotherapy training.
TIMETABLE
Monday
a.m.
Consultant Meeting
On call daytime
assessments/liaison work –
Derriford hospital
p.m.
Team referral meeting
Elmview
Tuesday
Outpatient clinic – medical student Special Interest Session
teaching clinic
Elmview
Wednesday
Supervision - Glenbourne
Emergency Assessments clinic
Case Conference / Journal Club
/CPD(Glenbourne)
Thursday
Outpatients
Admin
Elmview
Friday Flexible clinical/admin Research
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
General Adult Psychiatry
Dr M Cooper
Plymouth Primary Care Trust
Glenbourne Unit & Home Treatment Team (HTT)
JOB DESCRIPTION This full time equivalent (FTE) training post provides an ample opportunity to gain
experience in managing acutely unwell mental health working age clients. The post is primarily based in
Glenbourne Unit and has close liaison work with Home Treatment Team as a part of gate keeping admissions to
this inpatient unit. This post is under Outer City Locality of HTT/Glenbourne Unit. The outer city locality caters
to people living and registered with GP practices within outer city catchment area and works in close
association with 3 Community Mental Health Teams (Central North East, Plym and North West localities). The
populace of nearly 77400 people are covered by 27 GP practices in this catchment area. As this area is
deprived, the patients present with more complex psychosocial needs in addition to mental health needs and
often carry dual diagnoses (with comorbid substance use, personality disturbances, learning difficulties and
forensic involvements). The Integrated Care Pathways are being developed in lines with NICE & RCPsych
Guidelines to manage these complex conditions. The inpatients are managed as voluntary or detained under
Mental Health Act. Mostly admissions to Glenbourne are gate kept by HTT and discharged through the same
route under newly developed Nurse Led Discharge Policy & facilitated by Satellite Service of HTT.
The secondary mental health services are being redefined currently under QIPP & TCS agendas and apex
services like Glenbourne & HTT are at the forefront of leading some quality improvement changes. The post
50

holder would gain a greater understanding of these reforms and would provide a substantial support to teams
working here. The post holder can accompany educational supervisor in some of these administrative meetings
e.g., Consultant Psychiatrists Meetings on alternate Mondays and Glenbourne Development Meetings on once
a month Wednesday mornings.
The clinical responsibilities include assessment of new admissions to Glenbourne (Outer City Clients), reviewing
them on regular basis, liaise with GPs, carers or key workers, discharge planning and leading weekly
multidisciplinary ward rounds and community clinical reviews each under direct supervision of trainer.
Additional skills in preparing reports and representing RC in Mental Health Tribunal Reviews as needed. Sec. 12
(2) approval or training for the same would be required.
The post holder would be directly responsible to Dr. Michael Cooper, Consultant HTT & Glenbourne Unit.
Trainee would also have opportunities to interact with Dr. Naresh Buttan, Consultant Psychiatrist covering
inner city division of Glenbourne & HTT. The clinical supervision during day time would be available from Dr.
Cooper, Educational Supervisor (in addition to protected 1 hr weekly session on Monday afternoon) and his
team at Glenbourne & HTT.
The Glenbourne Unit has Foundation Year 2 Trainees posted for 4 months in each wards (Harford & Bridford).
The post holder would be expected to provide work based supervision to the F2 Doctors in Bridford Ward.
There are other teaching avenues. Local MRCPsych teaching can be negotiated. The Peninsula Medical School
sends 3 rd & 4 th year medical students for 3 weeks rotation in psychiatry and this post holder would be expected
to provide clinical bedside teaching to them.
The post holder would also be able to co-chair (Chair- Dr. Buttan) twice/thrice monthly case conferences
presented by other trainees. The Journal Club and Case Conferences are held twice/thrice in a month for 1 hrs
each on Wednesday mornings at Glenbourne Unit. Monthly once CPD and Grand Rounds each provide
opportunities for this post holder to demonstrate their presentation skills as well. The presentation slot in
these academic activities can be negotiated. The post holder would be expected to participate in an ongoing or
fresh audit to demonstrate their research skills.
The trainer has a special interest in Psychotherapies having trained in Cognitive Analytic Therapy and
Psychodynamic therapy and has links with the psychotherapy department which offers opportunities for
formal psychotherapy training across several modalities. There would be support and supervision for the
trainee in developing a special interest in that area or any area of trainee’s choice depending upon the
availabilities of resources.
Other information regarding pay scales, hours of working, leave arrangements will be laid out in service
contract and can be obtained from Medical Staffing Department at Glenbourne Unit.
51

Weekly Timetables
TRAINEE TIMETABLE: (Subject to variations)
Monday Tuesday Wednesday Thursday Friday
a.m
.
p.m
.
Visit Glenbourne
Unit for new
assessments/
reviews support
Satellite service of
HTT & F2 doctor in
Glenbourne Unit
Option to attend
Consultant Planning
Meeting
HTT (Home visits/
assessments)
1 hour (protected) of
supervision with
Trainer
Ward rounds with
Trainer at
Glenbourne
Special interest /
research /
academics
Academic activities
at Glenbourne Unit
(Balint group,
journal club, case
conference)
Community Clinical
Reviews at HTT
Glenbourne Unit
/ HTT as per the
clinical needs
HTT
(visits/assessmen
ts)
HTT/ Glenbourne
(visits
/assessments)
Special interest /
research /
academic
The Home Treatment Team Consultant Psychiatrist is the first point of call for Mental Health Act assessments
which the trainee will be encouraged to undertake as per their educational needs.
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision
Currently 1 in 10 with consultants on call. The on-call cover is to provide psychiatrist cover for Plymouth Area,
A&E, HTT, Glenbourne and other peripheral units within the trust. The supervision as per the clinical need
provided by on-call consultants.
TRAINER TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. Consultant
Meetings
Glenbourne
Ward Rounds
Academics/CPDs/
Peer reviews
Psychotherapy
supervision
HTT
p.m.
Glenbourne/ Home
Treatment Team
1 hour (protected)
of supervision with
Trainer
Glenbourne
Ward Rounds
Psychotherapy
HTT Clinical reviews HTT(visits/assessments) HTT
52

POST:
TRAINER:
EMPLOYING TRUST
Inpatient and Home Treatment
Dr Stephen Dinniss
Plymouth Primary Care Trust
JOB DESCRIPTION This post will allow the trainee to experience working with a high fidelity, large, well
established home treatment team covering Plymouth city. They will take a senior medical role, under the
supervision of the consultant, in the care of patients referred to and taken on by the team. They will perform
assessments (including mental health act assessments) and reviews of people in severe mental health crises
under the care of the team at the patient’s home. They will work with the multidisciplinary team including
nurses, OT, psychology, social workers and five other doctors to provide care at home as an alternative to
admission. The team are based at Mt Gould Hospital with inpatient services based at the Glenbourne Unit.
There is also an opportunity to develop a role within the inpatient unit, as patients admitted remain under the
care of the home treatment consultant including report writing and tribunal experience.
The trainer has a particular interest in medical education and is the locality lead for the Peninsula Medical
School and Lead Consultant for the Peninsula MRCPsych Course, providing opportunity for a trainee to gain
experience in these areas. He also is involved with local service development projects and would expect
trainees to become involved in this role. Research opportunities, particularly focused on service development
and evaluation, are also embedded in the team and trainees are involved in these processes, developing
projects towards poster presentations and publications. The trainer is also able to provide supervision for other
external research projects.
TIMETABLE
Monday
Tuesday
a.m.
Consultant Committee, Teaching,
Audit and Psychotherapy
Inpatient Ward round or HT
reviews
p.m.
HTT review and assessments/
MHAs
HT reviews and assessments/
MHAs
Wednesday
Supervision/ HT reviews/ Case Community Reviews (HTT Ward
Conference and Journal Club/ CPD Round with Consultant)
Thursday TBA Special Interest
Friday TBA Research
On-Call 1: 10 with Consultant Cover
53

POST
TRAINER
EMPLOYING TRUST
Core Old Age Psychiatry
Dr Rodney Ford
Plymouth Primary Care Trust
JOB DESCRIPTION The Specialty Trainee will be expected to carry out assessments of patients referred to the
service and to manage their care under the supervision of the Consultant Psychiatrist. An open referral system
is in operation. Most patients are assessed either as outpatients or at home in the first instance. There is a
liaison service for elderly psychiatric patients at Derriford and Mount Gould Hospitals run by experienced
nursing staff. Inpatients are based at Plympton Hospital, where there are beds for functional illness and organic
assessment. Outpatients are seen at Plympton Hospital.
Outpatients with dementia are managed through our memory service at Mount Gould Hospital. The catchment
area covered is that of the outer city, and there is a population of about 13,000 people of age 65 years or older.
At present the medical establishment consists of three Consultant Psychiatrists, one staff-grade and two SHO’s.
There is a well-staffed multi-disciplinary team with a full-time psychologist, CPNs and occupational therapists.
There are opportunities for teaching undergraduate medical students from the Peninsula Medical School. The
Specialty Trainee will also be expected to provide teaching to other members of the multi-disciplinary team
and to trainees on the local psychiatric rotation and to participate in the locally organised academic
programme. There are opportunities for up to two special interest sessions and two sessions for supervised
research.
The Specialty Trainee will take on increasing responsibilities for the management of patients under the
supervision of the Consultant in preparation for a Consultant post. There will also be opportunities to attend
meetings with the Consultant and to obtain management experience.
There is a full-time secretary as well as the usual IT facilities.
TIMETABLE
Monday
Tuesday
a.m.
Consultants’ meeting/
Community visits
09-00 to 10-00 Team meeting.
10-00 to 12-00 Oakdale ward
round.
p.m.
Administration.
14-00 to 15-30 Pinewood Ward
Round.
16-00 to 17-00
Supervision with consultant.
Wednesday
Academic Programme
11-30 to 13-30
Community visits/liaison psychiatry
(Derriford Hospital).
Thursday Memory-service 09-30 to 12-00. Outpatients (Plympton Hospital)
(Mount Gould Hospital).
Friday Study day Study day
On-Call 1: 14 with Consultant Cover
54

POST
TRAINER
EMPLOYING TRUST
Primary Care Liaison General Adult Psychiatry
Dr Fiona Murphy
Plymouth Primary Care Trust (currently – shortly to become a social
enterprise, under new management)
JOB DESCRIPTION This is a post in general adult (community) psychiatry, working at Elmview, Plympton
Hospital, as part of the Plymouth Community Mental Health Team, covering the Plympton and Plymstock areas
of Plymouth. The catchment area is approximately 40,000, the majority of which is relatively affluent, and
predominantly suburban, though there are some small rural patches; it is served by seven GP practices. The
post is purely community based as care for all inpatients is provided by the specialist inpatient/home treatment
consultant.
There is only one consultant working in the Plymouth CMHT. There are four other consultants (3.6 WTE)
working at Elmview, in the two other CMHTS’s based there (Central North East, and North West). The five
consultants have a daytime duty rota to cover emergencies across the whole locality, and also to provide a
consultation service to Derriford hospital (red top referrals). The trainee will have the option of participating in
this rota.
The Plymouth team consists of one band 7 CPN team leader, one band 6 deputy team leader (post currently
held by an OT), four band 5 CPN’s, one OT, two support workers, and two AMHP’s (social workers). There is
also a full time team secretary, in addition to a medical secretary. There are three psychologists based at
Elmview who work collectively to provide a service to all three teams at Elmview. We have access to other
psychological therapies, including CBT and family therapy, through the psychotherapy department. There is a
full time specialty doctor working with the Plymouth CMHT. Sometimes there is also a core psychiatric trainee
in post, but this cannot be guaranteed.
The trainee will work closely with other members of the team and provide assessments to new referrals which
require medical input, either at base, or at the patient’s home. He/she will also be expected to carry a small
caseload of patients requiring follow up/ continuing care. We do not currently have the facilities to provide
clinics at GP surgeries but it is hoped that this will change in the near future. However the trainee will be
encouraged to link in with a small group of primary care practitioners. The trainee will also be expected to
attend the multidisciplinary team referral meetings, provide advice and support to staff in accordance with
degree of experience and participate in Care Planning meetings with other members of the team. In order to
help with transition arrangements with the home treatment team, the trainee will have the option of attending
the weekly discussion meetings held by the home treatment team, and may also attend the weekly ward round
for Plym patients, by agreement with the ward consultant.
There is an active teaching programme for junior medical staff with weekly case conference and journal clubs.
The trainee will be expected to take an active part in this and to help with its organisation. There will also be
opportunity to provide teaching to other professional groups.
Dr Murphy is a trained group therapist and runs a number of staff and patient groups. The trainee will
therefore be given the opportunity to co-facilitate one or more groups, according to his/her interest.
55

TIMETABLE
Monday
Tuesday
a.m.
Consultants committee meetings,
Building one boardroom
New patient clinic, Elmview
12 – 1 Supervision with Consultant
p.m.
Follow up outpatient clinic,
Elmview
Multidisciplinary team meeting
Elmview
Wednesday
Academic Teaching programme Special Interest
Glenbourne
Thursday Home visits with team members Outpatient clinic, Elmview
Friday Admin Research
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Assertive Outreach Service/Rehabilitation,
and Early Intervention Psychiatry, Plymouth
Dr Simon Payne
Plymouth Primary Care Trust
JOB DESCRIPTION This post provides core adult experience with the opportunity to manage patients on both
the acute inpatient unit at Glenbourne, and in the community. The inpatient (Bridford) ward is fully accredited
by the Royal College of Psychiatrists under the AIMS project. The Assertive Outreach Service supports
approximately 100 clients. There are typically 10-15 patients either on the ward or on leave from the ward at
any one time. The Trainee would also have the opportunity of gaining experience in managing patients at
Syrena House – a community-based rehabilitation unit for younger people, and/or patients at our 12-bedded
low-secure unit at Lee Mill. There is a junior doctor on Bridford ward, and Staff Grade cover for Lee Mill,
Syrena House, and the Assertive Outreach Service.
Dr Payne has been a Consultant since 1993 and moved from Nottingham to Plymouth in 2002. He is currently
Medical Director and Lead Consultant Psychiatrist for Plymouth Primary Care Trust. Subject to the Interest of
the Trainee, there would be the opportunity to be involved in the development of psychiatric services locally
and the wider work of the Plymouth Primary Care Trust. Full Secretarial support is available for the post with
office accommodation, both at Glenbourne and the Assertive Outreach Team base at Mount Gould Hospital.
Trainees may welcome the opportunity to work with Dr Dawe in the Early Intervention Service – either as a
Special Interest, or in place of work at either Syrena House or Lee Mill. The Plymouth Early Intervention Service
was one of the first in the country. It is based in the City centre along with other youth services and has an
excellent reputation.
56

*TIMETABLE
a.m.
p.m.
Monday Consultant Meetings AOS Ward Round at Glenbourne
Tuesday Flexible – to be confirmed AOS m.d.t.
Wednesday
AOS/Rehabilitation Medical
Meetings/Journal Club/Case
Conference
Flexible – to be confirmed
Thursday Early Intervention Service m.d.t. Flexible – to be confirmed
Friday Lee Mill m.d.t. Flexible – to be confirmed
On-Call : To be confirmed
* Subject to the particular Interest of the Trainee.
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Old Age Psychiatry
Dr Sadir Altaan
Cornwall Partnership Trust
Banham House, Bodmin Hospital, Cornwall/ Elfordleigh community resource centre,
Launceston, Cornwall
JOB DESCRIPTION This post will provide training opportunities in both organic and functional disorders for the
older adult population of North coast of Cornwall, (Launceston, Bude, Boscastle, Tintagel, Camelford and
Callington). The population of this catchment area is about 13,000 spreading out through historical coastal and
rural towns and villages. The senior trainee will be an active member of the multi disciplinary team who will be
working with the consultant to supervise and manage complex cases and provision of diagnosis in the Memory
Assessment Service. The trainee will have opportunities and will be encouraged to participate in audits and
research. Should the trainee wish to have further training and experience in ECT this can be facilitated through
the ECT team which is led by an old age colleague and based in Bodmin Hospital. Dr Altaan has a special
interest in CBT in older adult and should the senior trainee wish to enhance their psychological skills this can be
facilitated and arranged accordingly.
There will be ample opportunities for participating in providing teaching to undergraduate medical schools,
post graduate teaching and training provision to the multi disciplinary team and general practitioners. There
are also opportunities to develop management and leadership skills appropriate to the trainee’s level of
experience.
Weekly Timetables (see point 4 in Notes for Guidance)
57

TRAINEE TIMETABLE:
Please complete the proposed timetable for the trainee. This timetable must indicate the arrangements for
Clinical and Educational Supervision
a.m.
p.m.
Monday Tuesday Wednesday Thursday Friday
Community Work
Community Work
/Admin
Community MDT
Meeting
Clinical Supervision
In patients MDT
meeting
Teaching/ CPD
Training
Community Work
Research/ Special
interest
Research/ Special
interest
In patient work
Admin
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision
1:10 includes S12 work- on call work will be supervised by consultants
TRAINER TIMETABLE:
Please complete the timetable for the trainer. This should show:
a. regular scheduled Consultant supervision of one hour per week
b. a substantial overlap with that of the doctor in training
a.m.
p.m.
Monday Tuesday Wednesday Thursday Friday
Community Work
Community
Work/Admin
Community MDT
Meeting
Clinical
Supervision
In patients MDT
meeting
SPA Community work Community work
SPA CBT Clinic Community
Work/Admin
POST
General Adult Psychiatry
TRAINER
EMPLOYING TRUST
Dr Rick Bowers
Cornwall Partnership Trust
The Specialist Registrar will provide supervised medical input to a comprehensive mental health service for
patients registered with the Carrick Community Mental Health Team. The whole zone comprises seven general
practices totalling 44 GP’s.
Facilities / In-patients:
The acute in-patient beds are at Longreach House, Redruth where there are 32 beds shared between six
consultant psychiatrists. The Ward is divided into male and female bays. Continuing treatment beds are
58

available at Fettle House, Bodmin Hospital. Psychiatric intensive care is provided at Harvest Ward, Bodmin
Hospital by a consultant-led team. One full time CT1 trainee works with the Carrick in-patients.
Out-patients
Clinics will be held at 57 Pydar Street, Truro at the community mental health team base providing
comprehensive psychiatric assessments of existing CFT patients or new referrals following screening
assessment. Some joint screening assessments with other healthcare professionals when early medical need
identified.
Ongoing development
CFT provides weekly academic programme for trainees involving Grand Round (case conferences), critical
appraisals and lectures. There is monthly CPD sessions which trainees are encouraged to attend. Specialist
Registrars can attend local consultant peer group meetings and is also invited to consultant business meetings.
Consultants
The Consultant Psychiatrist for the Carrick area is Dr Richard K Bowers. He will provide personal supervision
regularly for one hour per week as well as additional clinical supervision when appropriate. The trainee will be
given a wide range of clinical experience in General Adult Psychiatry and work with sub-specialist teams, eg
Assertive Outreach Team and Home Treatment Team. The supervising consultant also provides support for the
Homeless GP Service in Carrick. The other consultant for adult psychiatry in Carrick is currently a locum.
There are consultants working in Child and Adolescent Psychiatry, Old Age Psychiatry, Learning Disability and
Drug Misuse covering west Cornwall. In addition, there are consultants working in Liaison Psychiatry, Recovery
and in the Early Intervention in Psychosis Teams.
Team Base
The CMHT is based at 57 Pydar Street, Truro, comprising of:
Consultant Psychiatrist
Clinical Trainee (1)
CMHT Manager (1)
Community Psychiatric Nurses (4)
Healthcare Practitioner (to be appointed)
Occupational Therapist (1 shared with South Carrick)
Clinical Psychologist (1 shared with South Carrick)
Approved Mental Health Professional (1)
Social Work Assistant (1 wte shared with South Carrick)
TRAINEE TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. Community
Postgraduate
Meeting Team
Supervision
11-12noon
Supervision
Admin
teaching at
Westheath House
or Consultants
meetings
Outpatient clinic Research /
Special Interest
p.m. Outpatient Clinic Ward Round with
Consultant
Admin Admin Research /
Special Interest
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision
59

1:18 on-call with supervising Consultant. Available to provide psychiatric assessments, mainly under MHA 2007
for 24-hour period. Also, advice to supporting medical staff and in-patient facilities. Day-time cover for
Consultant On-call the previous day.
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Liaison Psychiatry
Dr Adrian Flynn
Cornwall Partnership Trust
Department of Liaison Psychiatry, Well-Being Centre, Royal Cornwall Hospital
Trust, Treliske Hospital, Truro, TR1 2LJ
JOB DESCRIPTION The trainee will be based at Treliske Hospital, which is a 750 bedded hospital, within the
Liaison Psychiatry Department and will also have access to office space at the Carrick Community Mental
Health Team base where Dr Flynn’s medical secretary works. This is at 57 Pydar Street, Truro, TR1 2SS.
The trainee will be part of a medical and nursing team providing psychiatric services to the Royal Cornwall
Hospital, Treliske. The team comprises a full-time Consultant Psychiatric time, there is an ST2 trainee and an F1
doctor. There is a Team Manager, two Psychiatric Liaison Nurses, and Alcohol Liaison Nurse and a half time
Team Administrator.
The team accepts referrals for the full range of psychiatric presentations in the general hospital. The majority
of referrals are for self-harm and alcohol and substance misuse. The trainee will have an opportunity to see
these patients, particularly more complex presentations and to supervise more junior medical staff in their
assessments. They will be expected to provide advice and support to the senior nursing staff within the team
and joint assessments are encouraged where possible. The assessment of more complex referrals is where the
trainee will have their predominant role. These referrals include neuropsychiatric presentations, perinatal
psychiatric presentations, complex somatoform disorders and co morbid common mental health disorders that
are influencing the presentation of long term medical conditions. An outpatient clinic is available for the follow
up of these patients. The trainee will be directly supervised by the Consultant for one hour each week. The
Liaison Service is establishing links with many other hospital departments. There will be an opportunity to
establish a special interest in one of these areas and an excellent opportunity for service development and
research.
The timetable is flexible and can be adjusted according to commitments. It provides an opportunity to
supervise the F1 doctor.
TIMETABLE
a.m.
p.m.
Monday Liaison Ward work Administration / F1 supervision
Tuesday Liaison Ward Work Liaison MDT
Supervision (1 hour)
Wednesday Teaching/CPD Research or Special Interest
Thursday Research or Special Interest Liaison OPD clinic
Friday Liaison ward work Liaison ward work
On-Call 1: 15 approx with Consultant Cover
60

POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry, Bolitho House, Penzance
Dr Colin Hunter
Cornwall Partnership NHS Trust
JOB DESCRIPTION The Specialty Trainee will provide supervised medical input to a comprehensive mental
health service for patients registered with Morrab Road Surgery in Penzance within the South Penwith
Community Mental Health Team. The whole zone comprises five general practices totalling fifteen GPs. The
trainee will cover a surgery with five general practitioners.
The acute inpatient beds at Longreach House, Redruth where there are 30 acute beds shared between nine
consultant psychiatrists. The Bay Unit is divided into two wards; Perran and Carbis Wards generally gender
specific. Psychiatric intensive care is provided at Harvest Ward, Bodmin Hospital by a consultant led team. An
inpatient based junior doctor is shared with Dr Stefano Kustermann.
Clinics will be held at Bolitho House, Penzance at the Community Mental Health Team Base.
The total population of the catchment area is 36,539.
The Consultant Psychiatrist for the South Penwith area is Dr Colin Hunter. The supervising consultant also
provides medical cover to the Home Treatment Team, Assertive Outreach Team and some community forensic
patients.
TIMETABLE
Monday
Tuesday
a.m.
Community Meeting
11.00-12.00 Supervision with
Consultant
Admin
p.m.
Ward Round with Consultant
Outpatient Clinic
Team Supervision
Wednesday
Post-grad Teaching at Bodmin Special Interest
Hospital
Thursday Emergency clinic / home visits Special Interest
Friday Research Research
On-Call 1: 21 with Consultant Cover
61

POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry
Dr Stefano Kustermann
Cornwall Partnership NHS Trust
The Specialist Registrar will provide supervised medical input to a comprehensive mental health service for
patients registered with Marazion Surgery in Marazion within the North Penwith Community Mental Health
Team. The whole zone comprises five general practices. In addition to Marazion Surgery, it includes Cape
Cornwall (St. Just), Stennack (St. Ives), Bodriggy (Hayle) and Phoenix Surgery (Camborne). The trainee will
cover a surgery with five general practitioners.
Facilities / In-patients
The acute in-patient beds are at Longreach House, Redruth where there are 32 acute beds shared between
nine consultant psychiatrists. The Ward is divided into male and female bays. Psychiatric intensive care is
provided at Harvest Ward, Bodmin Hospital by a consultant-led team. A Foundation Trust 2 junior doctor works
with South Penwith in-patients as well as 2 part-time staff-grade doctors in the Community.
Out-patients
Clinics will be held at Bolitho House, Penzance at the community mental health team base providing
comprehensive psychiatric assessments of existing CPT patients or new referrals following screening
assessment. Some joint screening assessments with other healthcare professionals when early medical need
identified.
Population
The total population of the catchment area is approximately 40,000.
Ongoing development
CPT provides weekly academic programme for trainees involving Grand Round (case conferences), critical
appraisals and lectures. There is a monthly CPD sessions which trainees are encouraged to attend. Specialist
Registrars can attend local consultant peer group meetings and is also invited to consultant business meetings.
Consultants
The Consultant Psychiatrist for the South Penwith area is Dr S. Kustermann. He will provide personal
supervision regularly for one hour per week as well as additional clinical supervision when appropriate. The
trainee will be given a wide range of clinical experience in General Adult Psychiatry and work with subspecialist
teams, eg Assertive Outreach Team and Home Treatment Team. The other consultants for adult
psychiatry in the west of Cornwall are:
Dr Colin Hunter (South Penwith and Isles of Scilly)
Dr Prem Menon (North Kerrier)
Dr Darren Mackintosh (South Kerrier)
There are consultants working in Child and Adolescent Psychiatry, Old Age Psychiatry, Learning Disability and
Drug Misuse covering west Cornwall. In addition, there are consultants working in Liaison Psychiatry, Recovery
and in the Early Intervention in Psychosis Teams.
62

TRAINEE TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m.
p.m.
ON CALL
Community
Meeting Team
Supervision
Out-patient clinic
Ward Round with
Consultant
Out-patient clinic
or
Admin (once a
month)
Post-graduate
teaching at
Westheath House,
Bodmin
Admin
Supervision (4pm-
5pm)
Admin
Admin
Research/Special
Interest
In-patients review
Research/Special
Interest
1:20 on-call with supervising consultant. Available to provide psychiatric assessments, mainly under MHA 2007
for 24-hour period. Also, advice to supporting medical staff and in-patient facilities. Day-time cover for
Consultant On-call the previous day.
TRAINER TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m.
p.m.
Community
Meeting Team
Supervision
Out-patient clinic
Ward Round with
SpR Trainee
Supervision of
Staff Grade
Psychiatrist
Out-patient clinic
or
Admin (once a
month)
CPD
Consultant Meetings
MHRT/Managers
Reviews
Admin
MHRT/Managers
Reviews
Supervision (4pm-
5pm)
Admin
Admin
(off on alternate
weeks)
Emergency outpatient
clinic
In-patients review
POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry
Dr Richard Laugharne
Cornwall Partnership NHS Trust
JOB DESCRIPTION This placement provides experience in working with a multi-disciplinary team in a Rural
Locality. The Trainer has a particular interest in service organisation and this post will provide a good
experience in Core General Adult Psychiatry with a Consultant who is a member of the Academic Department
of Mental Health at Exeter University. Trainees will have an opportunity to develop their research skills, teach
others and acquire the necessary knowledge and skills to work as a General Adult Psychiatrist in a rural setting.
63

DAY a.m. p.m.
MONDAY
9 – 10 Bed Management Meeting
10.30 – 12 Ward round Fletcher
ward
12 – 1 Supervision F2 doctor
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
On-Call 1 : 18 with Consultant Cover
Fortnightly meeting with
consultant colleagues also based at
Trevillis House
Fortnightly teaching medical
students 9 – 10am in term time
10 – 11.30 Weekly CMHT
meeting/referral meeting
11.30 – 12.30 Weekly supervision
of SpR
EMDR support group meetings
every 2 months
Attend monthly CPD sessions 4 th
Wednesday in month
Attend monthly SMSC
Peer Group
Work as lead clinician, General
Adult (East Cornwall)
Peninsula Medical School - Mental
Health Research Group, Exeter:
Research and Training Programme
Director work
Fortnightly feedback sessions with
medical students 9 – 11am in term
time
Ward Round – Fletcher Ward,
Bodmin Hospital
2 – 5 Admin/Home visits
Trevillis House
OPD clinic alternating between
Liskeard/ Looe/St
Blazey/Fowey/Lostwithiel
Flexible between:
Head of School of Psychiatry work
Clinical admin/extra patient
sessions
As morning or Head of School of
Psychiatry work or
Lead for Research Governance
*** Meetings/Visits
Ad hoc OPD clinics/home visits
Admin at Trevillis House
Supported activities fitted into timetable as opportunity arises.
*** Meetings/Visits
Quarterly Research Governance Committee meetings
Quarterly Regional Division meetings
Quarterly Research and Innovation Committee meetings (Lead)
EMDR sessions with patients and supervision group every 2 months
Visits to patients either in prison/detained in secure units/ residential support homes/rehabilitation
units
Roles
Head of South West Peninsula School of Psychiatry
Lead Clinician: General Adult (East)
Lead for Research and Innovation
(1PA)
(½ PA)
(0 PA)
64

POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
General Adult Psychiatry
Dr Mather
Cornwall Partnership NHS Trust
Bodmin Hospital, Bodmin, Cornwall
JOB DESCRIPTION: The specialist Trainee will provide supervised psychiatric care and input to working age
adults from 16 years upwards in an area of North Cornwall which includes a mix of deprived, affluent, urban
and rural areas. The patch covers Padstow, St Columb, Wadebridge, Bodmin and the Launceston area. This
busy post serves a population of approximately 31,000 adults. The CMHT enjoys good relationships with
primary care and has been a key contributor to the now completed and successful integrated care pilot project
currently being rolled out to the rest of Cornwall. Monthly ‘hub’ meetings occur between CMHT staff, the
Consultant Psychiatrist and GPs at GP surgeries.
Inpatients reside at Fletcher Ward on the same site as our administrative and out patient clinics in Bodmin
Hospital. Other teams such as AOT, EIP, HTT, Forensic, Complex Care/Dementia and HCAs/supported housing
workers also have staff based at this site which makes maintaining high quality and efficient relationships with
other teams easier.
Outpatient clinics are held at primarily at Bodmin Hospital and also in GP surgeries in Launceston and
Wadebridge. There is also ample scope for joint community working with other members of the wider team.
The Consultant for the post is Dr Greg Mather. The supervising Consultant also provides medical cover to the
Home Treatment Team and Assertive Outreach Team. The post enjoys the valuable support of a full time ST2
trainee. The ST4-6 post links well with the supervising consultant post providing good opportunities for readily
accessible support and supervision. The higher trainee will also have ample opportunity to develop their
interests and skills of independent working or of linking with other members of the wider team.
Weekly Timetables
TRAINEE TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. Administration
Clinical supervision
OPD
Bodmin
OPD Bodmin/
Community Visits
p.m.
HTT
Inpatient review
round Bodmin
Team Meeting
(monthly)
MDT meeting
CPD Sessions
(monthly)
SMSC (monthly)
Contribution to
Junior Doctor
training available
Special Interest or
Research
Research or
Special Interest
Inpatient review
round
Bodmin
Educational
Supervision
ON CALL – please state frequency of on-call and nature of duties plus arrangements for clinical supervision
1:18 with Consultant Cover
65

TRAINER TIMETABLE
Monday Tuesday Wednesday Thursday Friday
a.m. Administration
Clinical
supervision
(ST4-6)
OPD
Bodmin
CPD Sessions
(monthly)
SMSC (monthly)
Peer Gp (twice
OPD
Launceston/Wadebridge
Inpatient
review round
Bodmin
p.m.
HTT
Inpatient review
round Bodmin
Team Meeting
(monthly)
MDT meeting
Educational
Supervision
(ST2)
monthly)
Administration
Management:
MHA Section
12(2) panel work
OPD
Launceston/Wadebridge
Educational
Supervision
(ST4-6)
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Community Psychiatry (General Adult)
Dr Prem Menon
Cornwall Partnership NHS Trust
Trengweath Mental Health Unit, Redruth
JOB DESCRIPTION This post will provide the trainee the opportunity to delivery psychiatric care to adults of
working age (16-65) in North Kerrier, Cornwall. The population of approximately 30,000 is serviced by 6
General Practitioner surgeries which, unusually for Cornwall, are placed within close proximity to the base unit
(Trengweath, Redruth), allowing for close and well established working relationships. Inpatient services for the
West of Cornwall are located in Lorgreach House, Redruth. Intensive care, rehabilitation and low secure beds
for the whole of the county are located at Bodmin with separate medical cover. This post will require the
trainee to work mostly with the Community Mental health Team, but also with the Home Treatment and
Assertive Outreach Teams, adhering to the principles of members of the various teams. The trainee will not be
expected to care coordinate but will be required to provide high quality, timely medical input as necessary
under the supervision of the trainer. New assessments and follow ups therefore will be strictly needs led and
focussed and mostly conducted at Trengweath in conjunction with the service user’s care coordinator. This
post therefore does not allow for traditional routine outpatient clinics, unless the trainee chooses to do so (for
example for research of psychotherapy purposes).
The trainee will be provided with at least one hour of one to one discussions with the trainer on personal
development per week. However, as the trainee’s office will be located immediately adjacent to the trainer,
regular informal discussions will be encouraged.
Facilities
Identified office base at Trengweath. Secretarial support via the trainer’s secretaries based at Trengweath.
(The trust audit department is based adjacent to the trainer’s and trainee’s offices, allowing a unique
opportunity to discuss and develop audit projects).
Training Opportunities
Dr Prem Menon has experience at a local and national level in the development and implementation of New
Ways of Working for Consultant Psychiatrists. Trainees interested in medical management will be invited to
‘shadow’ the trainer at appropriate management events as well as participating in any management projects
the trainer may be involved in.
66

TIMETABLE
Monday
Tuesday
a.m.
1000–1200 CMHT Allocation Mtg
1200-1230 Supervision
Community – New
Assessments/Reviews (usually lowmoderate
risk service users)
p.m.
Ward (Longreach House)
New assessments, Reviews,
Discharge Planning
Patient Admin
(letters, reports etc)
Wednesday CPD/Teaching TBA
Thursday
Friday
On-Call 1: 21 with Consultant Cover
Special Interest
Community - New
Assessments/Reviews (usually high
risk service users)
TBA
POST
TRAINER
EMPLOYING TRUST
Early Intervention in Psychosis
Dr Michael Metcalfe
Cornwall Partnership Trust
JOB DESCRIPTION: The Cornwall Early Intervention in Psychosis Service has approximately 180 clients and is
divided into two teams, one based at Bodmin Hospital and the other based at Trengweath Unit in Redruth. In
addition to nursing staff, the service includes Occupational Therapists and a Psychologist. There is a full time
Consultant Psychiatrist (Dr Michael Metcalfe). The team receives referrals of individuals with a suspected first
episode psychosis between the ages for 14 and 35 years. Consultant responsibility for those under 16 years of
age remains with the Child and Adolescent Consultants.
The trainee will be based at the Trengweath Mental Health Unit in Redruth. They will have dedicated office
space and a computer and will be co-located with one of the Early Intervention Teams and with the Consultant
Psychiatrist and his full-time secretary. The duties of the trainee will be only in the western part of the County
of Cornwall, working with the West Cornwall Early Intervention Team, based at Trengweath. The caseload of
this team is approximately 90 individuals. The trainee will be expected to take part in initial assessments for
individuals referred to the service as well as working with those individuals taken on by the service during their
three years contact with Early Intervention. This work will involve significant multi-disciplinary and multiagency
liaison and the majority of clinical consultations will be carried out in conjunction with another member
of the team. The trainee’s work will be fully and comprehensively supervised by the Consultant Psychiatrist.
There is no direct inpatient commitment involved in this post. The majority of Clinical contacts will take place
in outpatient clinics, general practice settings and at individuals’ homes. The experience gained and skills
learned will primarily be focused on identification and treatment of psychosis. The range of referrals will
enable the trainee to fine-tune their ability to distinguish early psychosis from other problems and disorders.
The work with those already on the caseload will enable the trainee to develop their skills and knowledge in
the treatment of psychosis, both in terms of medication and non-medical approaches. There are particular
opportunities to have clinical experience and training in Cognitive Behavioural Therapy for psychosis under the
supervision of the clinical psychologist. The trainee will also be expected to train in the use of the Positive and
Negative Symptoms Scale (PANSS), again under the supervision of the Clinical Psychologist.
67

The team works in line with the principles of the Whole Life Approach and also strives to promote Recovery for
all its clients. There are dedicated vocational workers with the team as well as support workers who focus on a
range of non-clinical activities. The trainee will have the opportunity to work alongside these individuals and to
develop their skills in using social approaches in addition to the psychological and biological approaches already
described.
TIMETABLE
Monday
a.m.
10.00 – 11.00 Supervision
Audit
p.m.
Clinical
Tuesday Special Interest Clinical/Admin
Wednesday Teaching, Bodmin Hospital Research
Thursday 9.30 – 1.30 Team Meeting, WEST Clinical
Friday Clinical Clinical/Admin
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
Old Age Psychiatry
Dr Steven Naylor
Cornwall Partnership Trust
Trengweath, Redruth
The older person’s psychiatric service for Redruth and the Lizard provide care for the over 65 year olds with
functional or organic disorders and under 65s with dementia.
There is a memory clinic and liaison psychiatric services provided to Helston Community Hospital (GP run
hospital) and Camborne/Redruth Community Hospital (eldercare medicine). There are two inpatient wards.
Cove Ward in Redruth is an organic assessment unit with 20 beds. Functional patients are admitted to the
functional adult psychiatric ward (Bay Ward) in Redruth. For functional psychiatric outpatients there is an acute
Home Treatment Team who will work with patients intensively for short periods of time.
The specialist trainee will be a member of the community mental health team and be given a role matching
his/her seniority and experience. When trainees have appropriate competency they may medically manage a
proportion of the catchment area (under supervision) to enable them to experience a full range of the day to
day issues arising for senior psychiatrists.
Specialist interest experience can be arranged with the old age psychiatric liaison service at Treliske, ECT at
Bodmin, and Parkinson’s Disease Clinics in Redruth. There are opportunities to teach junior doctors, nursing
staff and medical students. There are grand rounds/journal clubs held at the weekly Wednesday morning
teaching.
68

TIMETABLES
Trainer a.m. p.m.
Monday
Team meeting and junior doctor Functional ward round
supervision
Tuesday Organic ward round Clinic
Wednesday Meetings/Training Administration
Thursday Visits Visits
Friday Clinic Visits
Trainee a.m. p.m.
Monday
Team Meeting and supervision Functional ward round
with Consultant
Tuesday Organic ward round Clinic or visits
Wednesday Teaching or meetings Administration
Thursday Visits Visits
Friday Specialist Interest/Research Specialist Interest/Research
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Old Age Psychiatry
Dr Giles Richards
Cornwall Partnership Trust
JOB DESCRIPTION The placement in Old Age Psychiatry would be an excellent training opportunity. Dr
Richards has a great interest in teaching and experience at undergraduate and postgraduate training (Associate
Clinical Tutor and Locality Lead in Cornwall for PCMD). His clinical work is comprehensive and varied and offers
excellent preparation to be a Consultant. Dr Richards is involved in current research (linked to DeNDRon
research org) and audit. Any research undertaken by the SpR can be supervised by himself or alternatively
research-active members of the Mental Health Research Group at the Peninsula Medical School.
Role of the Trainee
To assist in the provision of medical care to the inpatient and community service for patients with a mental
illness who are 65 years of age or suffering from dementia in the Caradon area of Cornwall.
Facilities
There is a 20 bedded dementia assessment unit at Bodmin Hospital for patients from the East of the county.
Our functionally ill patients are admitted to Fletcher Ward, Bodmin Hospital, where we have a limited number
of beds on an adult inpatient ward. We average a total of 2-8 inpatients. The community team based at
Trevillis House comprises of 6.5 community psychiatric nurses, 1 occupational therapist and 4 health care
assistants. There is one CMHT meeting per week for review of referrals, allocation and discussion of clinical
issues and any business matters that affect the team. We also provide a memory clinic, for the patients of
Caradon, comprising a staff nurse, an occupational therapist and health care assistant. The medical team is a
consultant psychiatrist and a shared SHO.
Population Served
We cover the population of ten GP practices in Caradon with an elderly population of 12,500. This is a rural
farming area with a low income and poor transport facilities. The consultant carries out the vast majority of
assessments and follow up appointments in the patient’s home with the exception of the weekly review of the
memory clinic patients.
69

Number of Consultants for the Service
There is an overall elderly population of just of 110,000 which is served by 10 Consultant Old Age Psychiatrists
that are based throughout the county. We meet weekly as a group to discuss clinical, education and business
matters.
Opportunity for Teaching
Medical students from the Peninsula Medical School have clinical placements with our team and feedback
sessions. There are also regular internal team training days, teaching staff in the local community hospitals and
the SpR would be encouraged to be involved in the academic meeting for the junior doctors, both in house and
on the MRCPsych course in Exeter.
Opportunity for Research
Specialist Registrars will have the opportunity to develop their own research project under supervision from an
appropriate supervisor or joining an established research project. There is a South West older person’s
research group that meets regularly and currently the inpatient team are gaining great experience in the use of
alternative approaches in managing dementia, including aromatherapy, art and drama.
TIMETABLE
a.m.
p.m.
Monday Clinical work/Admin (community) Clinical work/Admin (community)
Tuesday Clinical work/Admin (community) Inpatient Ward Round
Wednesday Management CPD Clinical work/Admin (community)
Thursday
Team Meeting
Clinical work/Admin (community)
11.30 – 12.30 Supervision
Friday Research and Special Interest Research
On-Call 1: 10 with Consultant Cover
POST
TRAINER
EMPLOYING TRUST
Substance Misuse Psychiatry
Dr Rupert White
Cornwall Partnership Trust
JOB DESCRIPTION Cornwall Drugs and Alcohol Team (CDAT) provides treatment and support to problem drugusers
across Cornwall, a relatively poor rural county with a total population just under 500,000. CDAT medical
staff comprises 1 SHO wte, 1.8 Staff Grade wtes, 1 Clinical Assistant wtes, 3 Consultant wtes. The Specialty
Trainee would be attached to the team in the mid-zone PCT, with a catchment area population of around
150,000. It is one of three Consultant-led teams for the county as a whole, and has an office based in Redruth,
with clinics in Truro, St Austell, Newquay and Falmouth. There is also a smaller cohort of amphetamine users
on dexamphetamine. The Specialty Trainee would be expected to gain experience in prescribing methadone,
buprenorphine and dexamphetamine and would be encouraged to take a small caseload as key worker in order
to do this.
70

Alcohol and other specialist teams
There are a number of specialist services also provided by CDAT. As well as successful youth and criminal
justice teams, there is a small but rapidly-evolving alcohol team co-located with the larger core drug team. This
alcohol team works closely with the CMHT’s in co-managing clients with complex needs. Although it is a
prescribing service there is more emphasis on psychosocial interventions, especially motivational
enhancement. The alcohol team also has a detoxification bed in the local DGH.
Links with other agencies
There would be opportunities to link to local CMHTs, and provide some training and support to them. In
general, supporting recently developed dual diagnosis initiatives would be encouraged, and it is imagined that
a Specialty Trainee could contribute a lot in this area. CDAT has close links with local GPs, and indeed some
have clinical sessions with the team. Shared care initiatives are being taken up by GPs all over the county, and
there would be opportunities for the trainee to have experience of supporting and advising local doctors re the
management of their clients.
Research
CDAT is an authority on substitution treatments for amphetamine users. It has also pioneered the use of
buprenorphine substitution therapy in the UK. There have been a number of peer-reviewed research
publications relating to these areas, and more evaluations are planned. Research and audit is a particular
strength of this team, and this will therefore be encouraged. The Specialty Trainees timetable would be
adapted to suit their training requirements. Assuming that the Specialty Trainee had had little experience in the
field they would be encouraged to take a small case-load of both drug and alcohol clients, and act as their keyworker.
As well as formal time-tabled supervision, adequate informal supervision would be assured as all the
sessions on the attached timetable are also attended by the supervising Consultant.
Monday
Tuesday
a.m.
Home Detoxification Assessment
and prescribing (Redruth)
Drug Outpatient Clinic (St
Austell/Truro)
p.m.
Alcohol Team Meeting (Redruth)
Special Interest (?psychotherapy-
Redruth)
Wednesday CPD Programme Research
Thursday
Friday
On-Call 1: 18 with Consultant Cover
Alcohol Clinic (Truro/St Austell
alternating)
Drug Team Meeting
11.00 - 12.00 Supervision with
Consultant
Special Interest (?psychotherapy)
Research
71

POST
TRAINER
EMPLOYING TRUST
General Adult Psychiatry, East Caradon
Dr James Quinn Scobie
Cornwall Partnership Trust
JOB DESCRIPTION The trainee will assist in the provision of medical care to the inpatient service and
community support in a catchment area of 50,000 people. Patients are aligned to seven GP practices in
Saltash, Callington, Gunnislake, St Germans, Torpoint and Millbrook. This is a rural area with very low
population density and low average income.
Facilities include four beds in an acute inpatient unit with a total of eighteen beds. Two ward rounds take place
each week. The CMHT comprises of five community psychiatric nurses, two occupational therapists, two social
workers and two psychologists. There is one Consultant Psychiatrist, Dr Scobie, and one CT2 doctor. A CMHT
meeting is held weekly for referral allocation and discussion of clinical issues. The medical team also provide
input into the Assertive Outreach and Home Treatment teams. The trainee will be expected to conduct ward
rounds, complete new assessments and joint visits with community colleagues under direct and indirect
supervision from the Consultant.
Teaching opportunities are available in the form of medical students attached to the inpatient unit. Teaching
at the academic meetings for junior doctors will be encourages as will teaching on the MRCPsych course in
Exeter.
Dr Scobie has an interest in the treatment and management of Severe Personality Disorder within community
psychiatry including psychodynamic factors. He is also Associate Medical Director for Cornwall partnership
Trust and has responsibility and accountability for Clinical Governance for the East Network. The trainee will
have opportunities to be involved in the strategic planning and management of mental Health Services in
Cornwall.
TIMETABLE
Monday
Tuesday
a.m.
HTT and Inpatient Reviews
Bodmin Hospital
Community Assessments for HTT,
CMHT and AOT
p.m.
Supervision 2-3pm
Community Admin/Urgent
Assessments
CMHT team and referral meeting
Wednesday
Thursday
Friday
Senior Medical Staff Committee,
CPD and Junior Doctor Teaching
Community assessments and
follow up
HTT and inpatient reviews, medical
student training OR Special
Interest/Research
On-Call 1: 18 with cover by Dr Scobie but plans to increase to 1:10 with Consultant Cover
Optional Management experience
including attendance at Trust
Business Strategy Group, Quality
and Risk Committee and Network
Board Meeting
Community assessments and
follow up OR Special
Interest/Research
Special Interest/Research
72

POST
TRAINER
EMPLOYING TRUST
TRAINING BASE
General Adult Psychiatry
Dr Darren Mackintosh
Cornwall Foundation Partnership Trust
Trengweath, Penryn Street, Redruth, Cornwall TR15 2SP
JOB DESCRIPTION The Specialty Trainee would undertake an apprenticeship role, learning psychiatry through
joining both an inpatient and community team and taking a responsible clinical role. They will provide
supervised medical input to a comprehensive mental health service for adults of working age registered with
GP Surgeries in Camborne, North Kerrier, and in the South Kerrier region. The trainee will be expected to
conduct ward rounds, complete new assessments and joint visits with community colleagues.
The acute inpatient beds are based on Bay Unit at Longreach House, Redruth where there are 32 acute beds
shared between eight consultant psychiatrists. Bay Unit is divided into two wards; Perran and Carbis Wards,
generally gender specific. The wards are served by an FY2 trainee attached to the team, who also assesses
community patients in the outpatient clinic.
The CMHT is spilt between Trengweath, serving the Camborne population, and Helston, serving South Kerrier;
though joint meetings are held weekly in Helston for referral allocation and discussion of clinical issues.
Outpatient Clinics are held at both Trengweath, in Redruth, and at the Community Mental Health Team base in
Helston.
The supervising consultant also provides medical cover to the Home Treatment Team, Assertive Outreach
Team, the Eating Disorders Team, and some community forensic patients. Intensive care, rehabilitation and
low secure beds for the whole of the county are located at Bodmin with separate medical cover; though the
supervising consultant is called on to provide cover when colleagues are away. Close liaison with the Early
intervention team is required, as the catchment area consultant provides inpatient care for that team’s
patients when required.
Teaching opportunities are available in the form of medical students attached to the inpatient unit. Teaching
at the academic meetings for junior doctors will also be encouraged. The Audit department is located close to
the trainee’s office, facilitating audit projects if desired.
The trainee will be provided with at least one hour direct supervision per week. The trainee’s office is located
immediately adjacent to the trainer so regular informal discussions should also be possible.
73

Weekly Timetables
TRAINEE TIMETABLE:
a.m.
p.m.
Monday Tuesday Wednesday Thursday Friday
Research Training 0930-1300
Outpatient Clinic
0915-1000 bed
management
1200-1300 CT4-6
Supervision
1400-1700 Ward
Round
Special Interest
Flexible session-
DVs/MHRTs
1400-1600 CMHT
Allocation
0930-1200
HTT/Emergency
Clinic
1400-1500 Ward
Review
ON CALL
The trainee will participate in a rolling rota which incorporates general adult, old age and learning disability
psychiatry county wide, on a 1:9 basis. An accredited trainer will second you for on call purposes. When you
are absent on leave and scheduled for duty the seconding consultant will pick up your duty as a matter of
course.
TRAINER TIMETABLE:
Monday Tuesday Wednesday Thursday Friday
a.m. 0915-1000 bed
management
1200-1300 CT4-6
Supervision
0930-1300
Outpatient Clinic
Peer
Group/CPD/Senior
Medical Staffing
Committee/Working
Practices Meeting
0930-1300
Outpatient
Clinic
0930-1200
HTT/Emergency
Clinic
1100-1300 Med
Student Teaching
(alternate weeks in
p.m.
1400-1700 Ward
Round
1400-1500 F2
Supervision
1400-1600
CMHT
Allocation
term time)
1400-1500 Ward
Review
74