Job responsibilities
The team has an ST, shared with psychiatric liaison, that will be clinically supervised by the existing consultant. However, the post holder must have an educational supervisor portfolio in place in order to be considered for educational supervision of other trainees in the trust, and will provide clinical advice to the ST as required.
The post holder will work closely with the expanded multidisciplinary team including perinatal psychiatric nurses, nursery nurses, occupational therapist, social worker, link midwife, the psychologist in the team as well as the SLaM Clinical Service Lead.
The post holders core clinical work will include providing psychiatric input (during office hours) to patients referred from maternity services at Lewisham University Hospital, Primary Care, Secondary mental health Services and other agencies e.g. Health Visitors or Children & Families Social Care. Types of assessments include a comprehensive psychiatric assessment for women with either a history of or current severe mental illness during the pregnancy or postnatal period. Assessments may also be offered for preconception counselling. The post holder will regularly update their knowledge and skills in the use of psychotropic medication during pregnancy and breast feeding. They will also contribute to, and when needed lead, multi agency working and the importance of safeguarding issues related to the unborn child and the baby.
The post holder will oversee coordination with existing liaison services at Lewisham University Hospital jointly with the team manager and with the existing consultant. The post holder will be conducting an outpatient clinic, preconception clinic, pre-birth planning meetings and be available to conduct some domiciliary visits as needed, including Mental Health Act assessments in the community. The post holder will also work alongside colleagues at the Bethlem Mother & Baby Unit, facilitating admissions and discharges from the inpatient MBU.
The post holder must be approved or eligible for approval under the section 12(2) of the Mental Health Act. The post holder is accountable and professionally responsible to the Clinical Lead in Perinatal Psychiatry and the Clinical Director.
The post holder and Community Perinatal Team work closely with the MBU to prevent admissions and facilitate discharge of patients. The Ward is also managed by the Psychological Medicine and Integrated CAG.
There is a linked Parent Infant Psychotherapy Service in SLaM which is also part of the Psychological Medicine and Older Adults (PMOA) Directorate.
The post-holder will have an office space in the team base which is currently Lewisham Town Hall, though this is a temporary team base, as the permanent one is being identified. An office space will be available in the permanent teambase as well. The post is supported by the team administrators based at the team base. The team base is networked to the Trust Intranet with IT support from the central services of the Trust. The post-holder will have his or her own computer and will have administrative support.
The post-holder will be expected to participate in the National Units Consultant on-call out of hours rota. They will be asked to participate in the perinatal consultant day rota (working hours Mon- Fri 9-5 pm) for telephone advice 1 day per week. The post holder will also be expected to cover the Consultant Colleagues at the Mother & Baby Unit. The detailed job plan will be developed, agreed and regularly reviewed, including ad hoc should there be a significant workload change, with Dr Livia Martucci Perinatal Services Clinical Lead, and Dr David Okai, Associate Clinical Director, PMOA.
Duties of this post:
To Provide Clinical Leadership and Consultant input into the Lewisham Perinatal team
To participate in the framework of Clinical Governance as it develops in Psychological Medicine CAG and across the trust.
To take consultant responsibility for Community/Liaison Perinatal Team patients, assessing or supervising assessment of patients and devising or helping to devise appropriate treatment plans and medication regimes and providing prompt medical response for those patients under their direct care and advise and work closely with other members of the MDT.
To deliver on the quality and outcomes set by the PMOA directorate care pathways
To provide RC and section 12 responsibilities under Mental Health Act to patients where necessary or appropriate
Reviewing patients on the case load on a regular basis and in line with changes in new ways of working as they develop within local services
To provide intensive and expert intervention and management of acutely ill patients under the care of the team.
To work flexibly with the other consultants across the boroughs to ensure good transitions of care for patients delivering at Lewisham University Hospital and living in the boroughs of Lambeth, Southwark , Lewisham.
To offer advice and provide clinical and educational supervision to the resident ST in the Perinatal Team, and if covering for another perinatal consultant to offer clinical advice to CTs and STs in other perinatal teams.
To offer expert risk assessment and management skills
To promote and advocate for the principles and practice of Perinatal Psychiatry in the local and national arena
To work flexibly and creatively as part of a multidisciplinary team promoting informed risk taking and anti-discriminatory practice
To deliver Service Line management working with the team leader, Clinical Service Lead and Clinical Lead
Liaison with/advice to General Practitioners concerning service users subject to CPA.
To participate in training for medical students, FYs, CT and STs in SLaM
To provide reciprocal cover under Section 12 of the Mental Health Act for the leave, study leave and sickness of senior medical staff within the Community Perinatal Service.
To encourage and lead as appropriate service-based research and teaching.
Education and training of midwives and health visitors.
Provision of clinical advice to colleagues.
To maintain help to address clinical governance issues within the Community Perinatal Service and work alongside national standards for these service e.g. as outlined by the Royal College Psychiatry CCQI standards for Community Perinatal Services. This will include regular feedback to commissioners about progress of the continuing expansion, including participating in collection of outcomes measures and performance metrics for the service.
To agree and regularly review job plan objectives with the Associate Medical Director and Clinical Lead.
The post holder will carry a mobile during work hours and be contactable by members of the team.
Participation in, contribution to service audit and service evaluation.
Attendance at audit/academic/management meetings, appropriate to the needs of the service.
External duties to include participation in Pan London and national Perinatal Psychiatry events, Royal College Psychiatry peer review and accreditation of perinatal services, annual RCPsych Perinatal Psychiatry Scientific day; Marce Society events.
Annual leave will be agreed with the Clinical Director and Lead Clinician and communicated promptly to the Community Team Manager.
Communications and Working Relationships:
Daily
- Perinatal morning referrals and zoning meeting with team leader, other doctors, administrators, nurses, nursery nurses, social workers, OTs and psychologists as well as psychotherapists across the different parts of the community perinatal service
- Other SLaM staff / referrers/ allied professionals i.e. maternity, health visitors, CSC, GPs among others
Weekly
- Clinical MDT meeting with the MDT as described above
- Weekly meeting for perinatal psychiatrists
Monthly:
- SLaM consultant colleagues in PMOA (attendance at monthly Specialist Medical Advisory Committee, MAC; Clinical and business meetings)
- Monthly high complexity case discussion for senior clinicians from all parts of the community perinatal psychiatry service
- Perinatal business meeting
- Perinatal safeguarding supervision
- Reflective practice
- Complex case discussion
- Performance and quality meeting with senior management, clinical service lead, other consultant perinatal psychiatrists, team leaders, perinatal business manager
Ad hoc:
- Mental health team colleagues across SLaM and other trusts they may be asking for advice on patients under their care or contact the perinatal service to refer their patients
- Local GPs and other primary care staff
- Other third sector providers, community organizations as needed
- Local Commissioners
- IOPPN perinatal psychiatry research groups.