Mid Sussex( Haywards Heath Burgess Hill and East Grinstead) Adult Mental Health
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1 Sussex Partnership NHS Foundation Trust JOB DESCRPTON Consultant Psychiatrist, Assessment and Treatment Service, Mid Sussex Post: Base: Contract: Professionally Reports to: Consultant Psychiatrist General Adult Psychiatry in Community settings and Liaison Psychiatry Mid Sussex( Haywards Heath Burgess Hill and East Grinstead) Adult Mental Health 10PA s per week (8 PA community psychiatry and 2 PA Liaison psychiatry at Princess Royal Hospital Haywards Heath) Clinical Co-Director Coastal and NW Sussex Dr Bucur Operationally reports to: Accountable to: Jo Scott, Service Director, Coastal & N W Sussex CDS Executive Medical Director Revalidation Office: Dr Tim Ojo, Executive Medical Director 1. ntroduction Sussex Partnership NHS Foundation Trust was formed in April 2006 and provides mental health, learning disability and substance misuse services to the people of Brighton and Hove, East Sussex and West Sussex, and is a Teaching Trust in association with Brighton and SussexMedicalSchool. We are part of a wider network of health and social care and are working in partnership with other Care Groups within the Trust, volunteers, education and other agencies. Closer links are being developed with the universities of Brighton and SussexMedicalSchool and there is a thriving Sussex-wide training scheme in psychiatry. The Adult and Dementia Services are divided into 3 Care Delivery Services (CDSs) of East Sussex, Brighton and Hove, Coastal and North West Sussex. North West Sussex is further split into two local assessment and treatment hubs where older people and dementia services and services for working age adults work closely together to provide a needs-led rather than an ageled service. This post is within the Mid Sussex Assessment and Treatment Service and covers the communities of Haywards Heath, Burgess Hill & East Grinstead. Social Care has for some years being moving towards a more integrated model within West Sussex and we have social
2 workers seconded into West Sussex services for working age. Senior managers from local authority social services participate in Sussex Partnership NHS Foundation Trust management at every level. Primary Care APT services within West Sussex are not delivered by the Trust, but by Sussex Community Foundation Trust, nor do we provide substance misuse services, which are run by a third sector organisation, Care, Grow, Live (CGL). Sussex Partnership also runs Children & Family Services, Learning Disability, Primary Care and Wellbeing Services (East Sussex & Brighton and Hove), Forensic Services, and Nursing Home services in Brighton & Hove. These are also structured as CDSs. All CDSs are operationally accountable to the Trust Chief Operating Officer, Simone Button. 2. Job nformation This is a post which is a wholly community-based 10-PA post working in the Assessment and Treatment Service based Haywards Heath. Within the post 2 sessions are dedicated to superviosn and joint assessments with SNPs of liaison cases at the local district Hospital. The local demographic is in the table below. The main area for this post is Haywards Heath but that work with in the Mid Sussex Assessment and Treatment Service (Burgess Hill, Haywards Heath and East Grinstead). This post includes 2 PA commitments for supervision of Senior Nurse Practioners providing liaison psychiatry at the Princes Royal Hospital
3 The local needs of the population based are in the table below PbR Cluster Description F2F Contacts per month (based on actual activity recorded Apr-Jun16) PbR Cluster Caseload Current Mix % Patients by Cluster Av Total contacts per month % Medic % Total contacts by profession % Psychology % Core Team % Social workers % MHLP N/A - variance % 0.0 Common mental health problems (low severity) % % 6% 35% 0% 6% Common mental health problems (low severity with greater % % 0% 50% 4% 9% Non-psychotic (moderate severity) % % 3% 36% 7% 10% Non-psychotic (severe) % % 2% 58% 1% 8% Non-psychotic disorders (very severe) % % 5% 61% 4% 7% Non-psychotic disorder of over-valued ideas % % 16% 34% 10% 0% Enduring non-psychotic disorders (high disability) % % 10% 62% 2% 2% Non-psychotic chaotic and challenging disorders % % 6% 67% 7% 0% First episode psychosis % % 0% 71% 0% 4% Ongoing recurrent psychosis (low symptoms) % % 2% 60% 10% 0% Ongoing or recurrent psychosis (high disability) % % 1% 71% 6% 0% Ongoing or recurrent psychosis (high symptom & disability) % % 3% 54% 13% 3% Psychotic crisis % % 0% 72% 10% 0% Severe psychotic depression % % 0% 70% 0% 0% Dual diagnosis % % 0% 68% 0% 0% Psychosis and affective disorder - difficult to engage % % 0% 63% 7% 0% Cognitive impairment (low need) % % 0% 38% 0% 5% Cognitive impairment or dementia complicated (moderate ne % % 3% 47% 0% 0% Cognitive impairment or dementia complicated (high need) % % 0% 64% 0% 0% Cognitive impairment or dementia (high physical or engagem % % 0% 54% 1% 0% TOTAL Clustered % % 4% 58% 5% 3% Not Clustered % % 6% 52% 2% 6% TOTAL Caseload % 4% 57% 4% 3% DNA Rate 5% npatient Services are provided at Langley Green Hospital, a purpose-built psychiatric hospital in Crawley. There is a well staffed Crisis Resolution Team providing intensive community support and a gate-keeping role with regards to inpatient admissions. The post holder will work closely with the npatient Consultants, the Crisis teams and Mental Health Liaison Practitioners to ensure smooth transition between services. The Trust has already implemented New Ways of Working, Under One Roof Ageless Service and the functional model. There have been a number of ongoing changes within the Trust to reconfigure service delivery in order to consistently provide high-quality, evidence-based care. There is an expectation that the post-holder will work closely with senior managers to implement these changes. All job plans will be subject to review as part of service development and career progression. Local mental health services include Dementia Services, CAMHS, AOT, Crisis Team, Personality Disorder Specialist day hospital, Early ntervention Service. n addition, there is a local substance
4 misuse service run by the third sector as well as a local APT service and third sector support for tier 2 patients. Princess Royal Hospital is a district general hospital serving the population of Mid Sussex is a district general hospital in Haywards Health with A&E facilities. The liaison service at Princess Royal Hospital is provided 7/365 by a team of Senior Nurse Practioner (SNP). The SNP will assess; following a referral and screening, patients from PRH acute wards and those patients in PRH A&E. SNPs are based at Princess Royal and Crawley Hospital 7:30 9pm 7/365 from 8pm 7:15am all SNPs are based at LGH. On occasion when there are two SNP if required one can be released on request and on receipt of referral to attend PRH. At all other time the SHO at PRH seconded with SPFT will follow up on all requests for assessments. The role will provide consultation and supervision for SNPs working at PRH for complex medical/psychiatric patient issues. There are plans to develop the A&E liaison function in the near future. SNPs 9am-8.15pm Juniors 8.15pm 9am on call rota 7/365 There is also a dementia crisis service that can support A&E with dementia patients (but not wards). Annual leave and study leave are to be taken by arrangement with the Locality Medical team, subject to approval by the Clinical Lead. The post holder will provide reciprocal cross-cover for colleagues as appropriate. 3. Job Purpose To provide specialist medical/psychiatric assessment, treatment and aftercare services to a working age adult population in Horsham, the catchment area being defined by registration at particular GP practices. To provide specialist medical advice and consultation to a range of health and social care staff as appropriate to promote effective delivery of person centred mental health care. To offer training to professional audiences as appropriate. To participate in the planning and development of local Mental Health Services and to contribute constructively to improving the standards of mental health care within Sussex. To provide medical supervision when required for the SNP based at Princess Royal Hospital for adults and occasionally review jointly with the SNP cases admitted on the wards at Princes royal Hospital
5 4. Resources Available to the Post Holder Mental Health services in Mid Sussex have close links with primary care. There are also links to other specialist mental health services including Child and Adolescent, Learning Disabilities, Substance misuse, Forensic, Assertive Outreach and Recovery (Rehabilitation), Psychological Therapies and Dementia Services. npatient Services are provided at LangleyGreenHospital in Crawley and there is a well staffed Crisis Resolution Team. The Day Service at LangleyGreenHospital provides recovery-oriented input. The consultant has a dedicated office at Linwood Haywards Heath with secretarial/administrative support and full access to T facilities. There is an active post graduate programme and teaching facilities in Crawley. The Assessment and Treatment Service is multidisciplinary comprising a wide range of professional and supporting roles including; Band 7 Team Leaders (covering Mid Sussex communities (East Grinstead, Burgess Hill and Haywards Heath). Senior Social Workers, Senior Social Care Practitioners, Band 6 Community Mental Health Nurses (CMHNs), Band 5 Community Mental Health Nurses, Band 6 Occupational Therapists Band 6 Mental Health Liaison Practitioners, Band 8a Clinical Psychologists Band 7 Clinical Psychologist Community Support Workers. Vocational Worker The Consultant is supported for medical input in the Mid Sussex ATS by 1 consultant colleague, 3 Speciality Doctors and a slot is available for an ST4-6 trainee and 2-3 rotational Trainees. 5. Responsibilities 5.1. Good Medical Care To provide a high quality of specialist assessment, treatment and care to users and their careers in a range of settings. To operate within guidelines, policies and procedures relevant to the post. To provide clinical advice, liaison and consultation as required to colleagues in primary care, community services and acute specialities Maintaining Good Medical Practice
6 All medical staff are expected to participate in continuing professional development, annual appraisal and revalidation. The consultant will also join appropriate supervision and PDP groups for the role. Consultants are actively encouraged to take their study leave entitlement in line with Royal College Guidelines and to support the development needs identified in their PDP, Peer Group reviews and appraisal. There is a dedicated study leave budget and a process of approval which considers the individual personal development plan Relationships with Others To work in partnership with users and carers so that they are fully involved in, and empowered to make decisions about their treatment and care. To work constructively with managers and clinical colleagues to maintain effective team working and service improvement. Establish good communication and effective working relationships with all relevant agencies in relation to individual patients and service development. Build knowledge of and links with voluntary and independent service providers locally. 6. Training, CPD and Educational Supervision To provide training to junior medical staff, and to other professionals on a multidisciplinary basis, and with other mental health organisations where appropriate. To regularly attend the local post-graduate academic meeting which is held at LangleyGreenHospital in Crawley. To participate in the Trust s training programme for senior medical staff and the regional Foundation and Specialist training schemes, if required.t is expected that the successful candidate will be in good standing in terms of CPD and revalidation. To provide supervision to junior medical staff in line with the Trust s supervision strategy. The post holder may be responsible for individual supervision of a GP vocational Trainee. To ensure that the post holder and supervised junior staff are regularly updated on professional developments as required by their professional body. To contribute to corporate training initiatives within the Trust. 7. Audit, Medical Research, Health and Social Care Governance The post-holder will be expected to participate in clinical audit meetings as well as to participate in clinical audit, clinical trials & other medical research as well as other health and social care governance activity 8. Management
7 The Consultant will be expected to work constructively with other clinical leaders and managers on developing, monitoring and improving services. 9. Research The post has no specific research responsibilities other than those which are inherent in clinical duties. There are however opportunities for clinical and other basic research through Sussex University and the Brighton and the Medical School there, where Professor Hugo Critchley is Chair of Psychiatry. 10. Job Plan The job plan is under review and will be agreed with the Clinical Director on appointment. There is a local weekly academic meeting. Consultants are encouraged to develop a special interest, and eligible candidates may hold a senior lecturer s post at the local medical school, subject to job plan review. All consultants are expected to belong to a PDP peer group, attend governance meetings, contribute to service development, business planning and share in audit and research activities (as part of their SPA activities).often it is also expected that the consultant would undertake certain external duties (as with the Royal College) A draft Job Plan is below (subject to discussion with colleagues). Monday Tuesday Wednesday Thursday Friday AM Outpatient Clinic (DCC) Outpatient Clinic (DCC) SNP Liaison supervision (1 h) Care Decision Meeting Urgent R/V (DCC) SNP Liaison supervision (1 h) Outpatient Clinic (DCC) SNP Liaison supervision (1 h) SNP Liaison supervision Joint review with SPNs of cases at PRH PM SNP Liaison supervision (1 h) Outpatient Clinic (DCC) SPA SPA weekly academic meeting) SPA 2 hours Admin 2 hours Supervision of SHO/SG Admin
8 Admin 11. On-Call Commitments The post holder will take part pro rata in a 1:11 on call rota in line with established intensity and frequency - covering adult psychiatry in North West Sussex. The current on call annual supplement amounts to 3% of the gross annual salary. There is a junior medical rota supported by Senior Nurse Practitioners covering out of hours. During office hours each consultant is expected to provide emergency cover within his or her own team in response to requests from wards and Care Co-ordinators. The consultant is expected to swap on call dates that clash with annual or study leave with other consultant colleagues; at times of unexpected sickness when on call locum cover will be sought by medical staffing during the working week or the manager on call at weekends/ bank holidays. 12. Leave Entitlements The post holder will be entitled to 32 days + Bank Holidays for the first 6 years of their Consultant service and 34 days + Bank Holidays for 7 years or more Consultant service thereafter. They will also be entitled to 30 days study leave in any period of 3 years. 13. Rehabilitation of Offenders Act 1974 Because of the sensitive nature of the duties, the post-holder will be expected to undertake an ENHANCED disclosure and the post-holder will be required to declare details of any criminal convictions, cautions, reprimands and final warnings and any other information that may have a bearing on their suitability for the post. Only relevant convictions and other information will be taken into account do disclosure need not be a bar to obtaining a position.
9 14. General All Staff are required to abide by the relevant code of conduct for their profession and the standards of behaviour expected of all staff in the Trust Disciplinary Procedure for doctors All staff are required to adhere to all Trust policies and procedures and are responsible for making themselves are of these policies and procedures All staff are required to treat information relating to patients, employees and businesses of the Trust in the strictest confidence. Under no circumstances should such information be discussed with any unauthorised person(s) or organisations. At all times employees are required to comply with the provisions of the Data Protection Act All staff are required to maintain their own awareness of, and comply with, policies and procedures relating to Health and Safety (whether statutory or Trust), and assist in ensuring the compliance of other staff All staff are required to support the Trust s vision of promoting a positive approach to diversity and equality of opportunity, to eliminate discrimination and disadvantage in service delivery and employment, and to manage, support or comply by adhering to the Trust s Equality and Diversity Policy Alternative transport arrangements can be made for non-drivers for essential journeys. Mileage claims can be made for travel in line with Trust policies, details of which are available from the Medical Staffing Department Managerial accountability is to General Manager and Service Manager Advice about Trust sick/professional/compassionate leave policies can be obtained from the Medical Staffing Department The service is under development and configuration of posts may be subject to change. Bilateral negotiation and consultation will take place in the event of the job nature or content changing.
10 Person Specification A QUALFCATONS Basic Medical Training Full GMC / UK Registration MRC Psych or equivalent CCST and entry on to the GMC Specialist Register expected within 6 months. Approval under section 12, Mental Health Act Essential Desirable Evidenced by A/C B EXPERENCE Broad based training in psychiatry Experience & training in management of severely mental illness A/ A/ C KNOWLEDGE, SKLLS AND COMPETENCES Good understanding and knowledge of the organic aspects of psychiatry Thorough knowledge of legislation relating to Mental Health Ability to work in a multi-disciplinary team and with other agencies Demonstrable evidence of effective communication skills Evidence of teaching skills including for teaching of medical and nursing staff from non-mental health disciplines Evidence of participation in Clinical Audit Experience in liaison psychiatry Experience in old age psychiatry A// A/ A//T A D VALUES Commitment to anti-discriminatory practice Commitment to the principles of equality and diversity in relation to all people Ability to embrace the principles of recovery Commitment to new ways of working E PERSONAL ATTRBUTES Mobility to travel across sites Member of a medical defence association Proven ability to liaise and maintain a professional relationship with a diverse range of people A/ Key: A = Application Form, = nterview, T = Test, C = Certificate Author s nitials/date
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