Consultant Psychiatrist Yeovil and Chard adult CMHS

Job description

Job responsibilities

The post holder is expected to provide the following:

The clinical work will involve the assessment and psychiatric treatment of patients either directly, or through the supervision of other team members.

The consultant caseload will include patients with SMI, complex cases with medical comorbidities, diagnostic assessments, joint worked cases, cases with specific medication supervision requirements, ADHD with significant comorbidity.

The Consultant will be expected to offer clinical leadership to the CMHT and to act as an advisor to the team, particularly with respect to patients whose mental health needs are complex and / or carry high risk.

Special interests can be developed through discussion and agreement in job plan review meetings. There are no external duties, however, these would be considered through job planning if necessary.

The post-holder can opt to join the senior out-of-hours on-call rota subject to availability. This is a 1 in 11 rota operating 5pm to 9am on weekdays; at weekends the rota operates from 9am on Saturday morning to 9am on Monday morning. This rota provides senior medical cover including Responsible Clinician duties to all the in-patient wards in the Trust. If the doctor does not have AC approval cover for this can be arranged. It therefore covers all inpatient services. Hence it includes duties for patients within the following specialties: general adult, old age, rehabilitation and learning disability.

The senior on-call rota also involves MHA assessments in the two Hospital Place of Safety suites (located in Yeovil and Taunton), the general and community hospitals, police custody centres and in the community. However, most of the work is in the Place of safety suites and ED. Assessments in the Hospital Place of Safety are not routinely undertaken at night for patients arriving after 1am (at the discretion of the nurse in charge).

The rota is frequently supported by senior trainees who accept calls before the consultant but require consultant supervision and stop work at midnight.

The rota attracts a payment of 1.25 PA (for the S12 component) and a 3% salary enhancement for the RC / senior medical cover for inpatient wards. Section fees are also paid for assessments (excluding current Trust inpatients).

This post provides senior psychiatric input to the Chard part of the community mental health team, which is aligned to 7 of the 20 GP surgeries in the Chard and Yeovil area.

Martock Surgery and South Petherton Medical Centre

Church View Medical Centre, Ilminster

Crewkerne Health Centre

Ariel Healthcare, Chard - L85030

Meadows Surgery, Ilminster - L85061

Summervale Surgery, Ilminster

Hamdon Medical Centre, Stoke-sub

The GP population catchment area for Chard CMHT is 58,822 which is within Royal College recommendations. The average number of new referrals to the Chard catchment area is 600 per year and a percentage of these are seen by doctors, either singly or jointly with another team member.

There is an office at Magnolia House on the Summerland's site, Yeovil, and in Bracken house in Chard. There is designated space for administration and seeing patients in both sites. The post holder is expected to work 2 days in Magnolia house in Yeovil and 2 days in Bracken house. Current post holder is working in Bracken House on Tuesdays and Wednesdays, while working in Magnolia House on Mondays and Thursdays. Both sites are under one community mental health team, and the FT medical secretary will organize clinics and client appointments. The current post holder works from home on Fridays. As the work involves working in two sites, having own transport will be beneficial.

The focus of the work is on patients with SMI, complex needs and diagnostic issues, higher risk, some ADHD work for which training will be provided, cases requiring multi-disciplinary input. Other diagnostic groups are largely managed by relational recovery staff and non-medical keyworkers.

We have an established system to support doctors to manage DNAs, support transfer of patients to other sources of support or discharge and maintain caseloads at a manageable size. This enables appropriate oversight of caseload. This creates more flexibility within the working week so that doctors can be more creative in service they offer to organisation and patient group.

There are several more specialised services within the CMHS following specific models that may require medical input to varying degrees.

May have a small number of patients in the Assertive Outreach Team (AOT). AOT follows a standardised operational policy to help manage admissions, recovery, treatment planning and discharge. There are dedicated managers and links with the community forensic service.

Connect 18 is a small team that works with young people transitioning from CAMHS to adulthood, over an 18-month period, and who have complex emotional or mental health needs. They follow principles of engagement and recovery and use a collaborative, strengths and solution focused, and trauma informed approach. Medical review is occasionally needed for a percentage of these patients.

The core CMHT works closely with the wider community mental health service. This consists of therapists, psychologists, occupational therapists, social workers, mental health nurses, psychiatrists, and several team managers. We work together, especially in complex cases and where there is higher risk, to support patients and colleagues. This working together includes within patient consultation, professionals' meetings, care planning, referrals meetings and multi-disciplinary team meetings. We have a clinical model that helps guide our service.

Community services have expanded across the Trust with concomitant expansion in staff as we have built up a new service called Open Mental Health in the last 5 years. This service works closely with primary care, the wider community, and the voluntary sector. This service is made up of psychologists, assistant psychologists, liaison staff, eating disorder leads and support workers. This staff body is closely linked with CMHTs through team meetings and supervision. This affords greater skill mix and appropriate input for patients depending on risk level, diagnoses, and previous mental health treatment. This gives many more options for patients referred or being discharged from mental health services. Linked software and interface meetings ensure all referrals have a considered and appropriate offer with reduced repeated assessments. We can provide a more holistic service with greater satisfaction for staff and patients. The development of the OMH service led to Somerset FT being awarded Mental Health Trust of the Year in 2022.

There is a Community Mental health reference guide which brings all relevant aspects of CMHS working priorities and practice together in one document with useful embedded links.

Specialist Psychological Interventions - these interventions include CBT, Cognitive Analytic therapy, Family therapy, Art Therapy, Dialectic behavioural therapy, EMDR, county wide CAT group and mentalisation based therapy.

Our directorate continues to improve the county-wide service to monitor our patients' physical health and prescribing. There are wellbeing, depot and clozapine clinics that follow a newly created standard operational policy. Yeovil's clinics are based in the south somerset hub and is a well-functioning service which facilitates appropriate physical health monitoring, risk factor modification and is managed by the CMHS team managers, with input from psychiatry. We have established referral and follow-up systems.

Other community teams operating in the area are the South Somerset Home Treatment Team and the Early Psychosis (STEP) team, with their own dedicated psychiatrist.

All the above teams are based at Magnolia House on the Summerland's Hospital site in Yeovil, where the post-holder will also be based.

There is no inpatient responsibilities attached to this post and inpatient beds for Yeovil are located on Rowan Ward 1, which is also based on the Summerland's Hospital site. This is a 15 bedded unit, providing assessment and treatment primarily for adults of working age where patients from the community are admitted.

All section 12 approved staff can contribute to the management of the Place of safety based on Rowan ward through contribution to section 136 assessments. There is remuneration for MHAA work.

Person Specification

Qualifications

Essential

• MBBS or equivalent medical qualification
• Mental Health Act Approved Clinician / Section 12 approval
• Entry on GMC Specialist Register; eligible for entry on Register or within 6 months of receipt of Certificate of Completion of Training (CCT) at time of interview or CESR.
• Evidence of competencies to be able to fulfil the role of a consultant in community psychiatry.
• MRCPsych passed
• Accredited for the training of junior doctors

Desirable

• An appropriate higher degree or qualification (MD, PhD or equivalent).

Experience

Essential

• 3 years supervised training in an appropriate ST4-6 equivalent training programme.
• Previous experience of working at consultant level
• Experience of front-line psychiatry in adult mental health services and ideally in community.
• Experience in the assessment and management of ADHD.

Additional Criteria

Essential

• Please see the job description for full details of the essential criteria required to undertake this position

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).

Employer details

Employer name

Somerset NHS Foundation Trust

Address

Magnolia House

56 Preston Road

Yeovil

Somerset

BA20 2BN

Employer's website

https://www.somersetft.nhs.uk/ (Opens in a new tab)