SPECIALTY DOCTOR OLD AGE PSYCHIATRY EAST LANCASHIRE RAPID INTERVENTION AND TREATMENT TEAM BALLADEN HOUSE, RAWTENSTALL 10 PROGRAMMED ACTIVITIES JOB DESCRIPTION 1
JOB DESCRIPTION (SPECIALTY DOCTOR) OLD AGE PSYCHIATRY, RITT LANCASHIRE CARE NHS FOUNDATION TRUST Job Title: Post Type: Programmed Activities: Additional Programmed Activities: Specialty Doctor Old Age Psychiatry Substantive Community Post with RITT team 10 PAs per week To be negotiated separately Salary Range: As per new speciality doctors contract terms and conditions.. Existing discretionary points,ceas and merit awards will be honoured. Base: Accountability: Employer: Balladen House Union Road Rawtenstall BB4 6NE Accountability to the Medical Director via Clinical Director and Associate Medical Director and Deputy Network Director Lancashire Care NHS Foundation Trust Sceptre Point Sceptre Way Walton Summit, Bamber Bridge Preston PR5 6AW Tel: 01772 695300 2
This is a replacement post of a Specialty Doctor in the locality. It is part of a contingent of 3.0 Specialty Doctors and 7.0 Older Adult Consultant Psychiatrist posts in the locality, all of which now operate according to the Royal College of Psychiatrist s guidance on new ways of working, reflecting responsibilities in terms of clinical function rather than for comprehensive input across a defined geographical area. The clinical component of the post is focussed on the care of the patients referred to the newly formed Rapid Intervention and Treatment Team (RITT) covering all of East Lancashire and based at The Mount, Accrington. In keeping with the on-going nationally and locally driven policy changes in old age psychiatry this job description may be subject to change in the future via the job planning process. The academic component of this post is based at Burnley General Hospital and the Lantern Centre in Preston. About Lancashire Care NHS Foundation Trust Lancashire Care NHS Foundation Trust was established in April 2002 as a mental health provider for the county, a population of 1.5 million people. We achieved Foundation Trust status on 1 December 2007 and on 1 June 2011 took on health and well-being services from neighbouring provider organisations, extending our portfolio to include a range of community based services. This development has provided us with the opportunity to streamline patient pathways and deliver more holistic integrated care that will realise benefits by building on the wealth of experience of working with communities within the organisation. We employ around 7,000 members of staff across more than 700 sites and have an annual turnover of 300 million. We have recently taken the opportunity to undertake a material refresh of the Trust s Strategy to respond to the clinical, operational and financial sustainability challenges and test the alignment to local health economy plans. The starting point in refreshing the strategy was the assumption that our Vision, Values and Strategic priorities are fit for purpose, as they were developed following wide consultation across the organisation to support the transformation of the Trust s portfolio from a mental health provider to a lead provider of health and wellbeing services. 3
Our Vision, Values and Strategic Priorities Vision Values Strategic priorities 21st century healthcare with wellbeing at its heart Compassion, Accountability, Respect, Excellence, Integrity and Teamwork To provide high quality services To provide accessible services delivering commissioned outputs and outcomes To become recognised for excellence To employ the best people To provide excellent value for money in a financially sustainable way To innovate and exploit technology to transform care The Trust is committed to delivering effective clinical services that reflect the relevant good practice guidelines within the NHS and promote evidence based medicine through the production and implementation of guidelines, policies and regulations. The Trust is also strongly committed to promote research, staff development, education and training. We have robust and longstanding links with the Department of Psychiatry at the University of Manchester and Lancaster University. Clinical Networks Our Clinical services are organised into 4 clinical networks: Adult Mental Health Network: Adult Mental Health Inpatient and Community services Community Network: Community nursing therapy, primary prevention services, older adult mental health and learning disabilities services. Secure Services and Specialist Network: Secure and forensic mental health services, prisons and substance misuse. Children and Families Network: Prevention, universal services for children and young people (including health visiting) and mental health and well-being services (including child and adolescent mental health services, early intervention services, substance misuse services and sexual health services). Mental Health Services are commissioned from the Trust on behalf of local population by 8 Clinical Commissioning Groups Lancashire North, Fylde & Wyre, Blackpool, Greater Preston, Chorley & South Ribble, West Lancashire, Blackburn & Darwen and East Lancashire. Lead commissioner arrangements are in place for the inpatient mental health services. 4
Service Configuration/Management Structure The Chief Executive is supported by a Board of Directors including the Medical Director. Senior positions within the Trust are held as follows Chairman: Chief Executive: Chief Operating Officer: Medical Director: Deputy Medical Director: Director of Finance: Director of Nursing Director of HR Mr Derek Brown Prof. Heather Tierney-Moore OBE Ms Sue Moore Prof. Max Marshall Dr John McKenna Mr Bill Gregory Ms Dee Roach Mr Damian Gallagher Lancashire Care NHS Foundation Trust is committed to ensuring that everyone involved in the Trust including staff, patients and carers, is treated equitably and with dignity and respect. The Trust is working hard to ensure the workforce reflects the diversity within Lancashire and that services meet the needs of all diverse patients and carers. The Trust has in place an agreed Single Equality Scheme inclusive of age, disability, ethnicity, gender, religion, belief and sexual orientation. There have been major developments of community services since the inception of the Trust 10 years ago. Now it is implementing a complete re-provision of inpatient services across Lancashire. Clinical services are currently organised in 4 Networks: Adult Community (which includes community services and older adult mental health), Adult, Specialist Services and Children and Families. Progress continues on the agenda for integration of service provision with local Social Services. In Blackpool there is an established integrated team for Older Adult Services. Social Workers and Health Teams share offices at the Shorelands base. Academic Department The Trust is committed to promote both undergraduate and postgraduate medical training. Medical undergraduate training within the Trust has students placed from Lancaster, Manchester and Liverpool University Medical Schools. The Trust s Medical Educators are actively involved in undergraduate and postgraduate teaching and training. Training is provided at the highest standards set by the respective Schools of Psychiatry, Academy of Medical Royal Colleges and the 5
GMC generic standards for specialty, including GP training. The Trust provides psychiatric training at all levels including higher specialist training in all major subspecialties of psychiatry. The tutor for East Lancashire is Dr Shahid Quraishi. The University Of Manchester Department Of Community Psychiatry (Guild Academic Centre) Academics: Dr Richard Gater (Senior Lecturer), Professor Jennifer Shaw (Senior Lecturer, Forensic Psychiatry); Professor Imran Chaudhry, Dr Nusrat Husain, Dr Salman Karim and Dr Waquas Waheed. The Guild Academic Centre was founded in 1992 as a joint venture between the Guild Trust and the University of Manchester and is based at the Lantern Centre, about a mile from the Royal Preston Hospital site. The Centre consists of a psychiatric library, 1 lecture theatre, 2 seminar rooms, a video suite, 9 research offices, 2 reception offices. There are 4 senior academic research nurses/research fellows, an administrator, a librarian and 3 secretaries (one university funded) based there. It is a major centre for psychiatric research in the North West and has attracted grants from the Medical Research Council and the Wellcome Trust. Past and current research activities include randomised controlled trials of new social interventions for bipolar disorder and schizophrenia; assessing suicide risk and managing somatisation in primary care; use of telemedicine in primary care and systematic reviews of the effectiveness of day care and vocational rehabilitation. The Centre is a focus for psychiatric teaching, continuing professional development, medical student teaching. It also hosts a weekly academic meeting involving case conferences, seminars, audit presentations and an evidence based journal club. There are regular Wednesday afternoon lectures from leading academics from the UK and abroad (2-3 per term). Trust academic staff participate in the Manchester University based research network, DENDRON, which co-ordinates research in neurological diseases and dementia on a national, regional and local basis. The Centre Library is the largest psychiatric library in the North West and offers online access (from the library itself and from desktop computers) to all the major medical and psychological databases. It currently takes 40 periodicals, including all the major psychiatric and medical journals and holds over 3,000 textbooks. The facilities are open to all staff within LCFT including this post-holder. THE ADULT COMMUNITY NETWORK This Network provides Older Adult Mental Health Services, both community-based and in-patient, across Lancashire. Following the enlargement of the Trust in 2011 additional community services provided include: Acute care in community service 6
Health and wellbeing services Long term conditions and rehabilitation Community and domiciliary care services End of life services Homeless team Chronic fatigue service Rheumatology service Learning disability services Dental services The Network Director has responsibility for the operational management of the clinical services. The Network Director has professional leads (including the Associate Medical Director for Older Adults) to support high quality governance of clinical services through the provision of advice and leadership in each professional area (medical, nursing, psychology, allied health professionals, social care and pharmacy). The network is supportive of the ethos of new ways of working in Mental Health Services to ensure the optimum use of professional expertise in the provision of services. This is seen as an important issue for all staff and not an exclusively medical one. Senior positions within the Adult Community Network are held as follows: Network Director Deputy Network Director Clinical Director Associate Medical Director (Older adults) Deputy Clinical Director Lead Nurse Lead Pharmacist Psychology Lead AHP Lead Emma Foster Louise Corlett Amanda Thornton Dr Alison Napier Tracey Cookscowen VACANT POST Amanda Parkinson Rachel Domone Sallyann Walker Older Adult Mental Health Services The service is increasingly needs based, breaking down the barriers for those people under the age of 65 who have clinical needs which would be met most appropriately by the Network and also, supporting those over 65 in general adult services if this is considered most appropriate. The Trust recently implemented a new, needs based, criteria Advanced Care to identify which service can best meet the needs of patients between 60 and 75 in line with the Royal College of Psychiatrist s advice on commissioning services for older adults. There is a commitment to improving wellbeing for the whole community, well-being in this case referring to a much wider policy agenda than simply health promotion and prevention. The core function of the Older Adult Mental Health Services is to provide a range of high quality community and in-patient mental health services to people (predominantly aged 65 and over) who are experiencing dementia and/or functional conditions associated with ageing. The service is also available to people under this age whose clinical need would be more appropriately met here. The Trust protocol 7
regarding transition between adult and older adult services supports this only when based on individual need, and some over 65 year olds have their service provided from the Adult Network. Whilst the Network moves towards service eligibility based directly on need and not on age alone, as a reference point, the over 65 population to which the Network relates is approximately 200,000. Older Adult Mental Health is managed on a 3 localities model and a structure of professional advice for the localities reflects the emphasis on multi-disciplinary contributions at locality and Network level. The medical aspect of this is through a Deputy Associate Medical Director, one of the Consultants within the locality. Their role is to advise on the optimum use of medical resources in implementing Network agreed clinical practice/care pathways and coordinate Consultant views in relation to clinical services. The Network actively seeks to involve clinicians in the development of services. Practice development groups, with Consultants integral to their function, are active in relation to In-patient Services, Community Mental Health Teams, Memory Assessment Services, Intermediate Support Teams and Liaison Services. The Deputy Associate Medical Directors are:- North Locality Central Locality East Locality Dr Andy Gallagley Dr Baljeet Saluja Dr Prashant Kukkadapu The responsibility for commissioning Older Adult Inpatient Mental Health Services is led by Blackburn with Darwen CSU on behalf of the other Lancashire CCGs. EAST LANCASHIRE LOCALITY The area of East Lancashire includes the urban and industrial towns of Blackburn and Burnley along with the vast rural and scenic Ribble Valley. The district is within easy reach of the Universities of Manchester and Liverpool, Preston and Lancaster and is well served with motorways and easy train journeys to London, Bristol, Manchester and Scotland. The Lancashire Coast, Lake District and Yorkshire Dales are all readily accessible within an hour. The international airport at Manchester is about 45 minutes away by car. LOCAL MENTAL HEALTH SERVICES / SERVICE MODEL In-patient Services The older adult in-patient provision has seen major reorganisation over the past decade which has enabled significant service improvements to occur. There are currently 2 inpatient hospital facilities for older adults in 2 sites, Burnley and Blackpool. 8
The new purpose built in-patient facility The Harbour in Blackpool opened in March 2015 and provides modern, comfortable and age appropriate in-patient facilities for both adults and older adults from Lancashire requiring in-patient hospital care. The Harbour has beds for those with dementia from all of LCFT. There are 3 wards for older adults with functional mental health conditions, 2 at The Harbour and the ward to which this post relates in East Lancashire. The in-patient unit in Burnley General Hospital, Ward 22, has 18 beds for patients with functional symptoms. Patients requiring assessment for dementia from East Lancashire would usually be admitted to the Harbour, Blackpool. Ward 22 staff comprise:- Senior Matron 1 Modern Matron 1 Administration 2 Ward Manager 1 Assistant ward managers 2 Staff nurses 10 HC Support Workers 17 Psychologist 0.5 Occupational Therapists 3 Consultant 2 ( with both providing community input as well to Memory Service and Hospital liaison team ) The Consultants are supported by 1 WTE CT1 grade doctor, 1 WTE Trust Grade Doctor, 1 WTE FY1 doctor and 1 WTE FY2 doctor. The number of patients admitted to and discharged from the ward each month averages 8-12, with around half being admitted under the Mental Health Act. The average length of stay is usually in the region of 50 days. There are two in-patient Consultants who also provide input to the Hospital Liaison Service (4 sessions) and the RITT team (3 sessions). There is a full multi-disciplinary complement of nursing, occupational therapy, pharmacy, support worker and administrative staff required to deliver excellent quality care to the patients on the ward on which there is also a ward manager. In addition to this, there is a Modern Matron who is the Lead Service Manager for the In-Patient Unit. The service also has access to psychology support. Regular ward governance meetings are held on the ward every Wednesday. There are also monthly governance meetings with the 2 other functional wards for older adult based at Blackpool, to support consistent standards of care and governance across these wards. There are also regular Interface Forums dealing with inter-team functioning which are also attended regularly by Consultant staff. 9
There are regular multi-disciplinary daily ward meetings to review patient progress and to assist with task management for each in-patient. Patients undergo regular CPA meetings in line with patient requirements, admission and discharge protocols. The pattern of ward meetings may evolve to meet patient and service needs. Ward Consultants are expected to review patients on a 1:1, face to face basis at least once a week and to provide clinical supervision to junior colleagues as required. The Trust operates an electronic patient record (ECR) for all patients and all staff are required to ensure these records are maintained accurately and securely. There are proposals for a new in-patient unit for East Lancashire for both general adults and older adults to be built in Blackburn. The older adult ward would be modern, age appropriate and purpose built taking into account needs of older adults. Community Services The elderly population (over 65 year olds) for the East Lancashire locality is approximately 77,000. Currently, the Community Services incorporate a Single Point Access Team (SPA), Community Mental Health Teams (CMHT), Rapid Intervention and Treatment Team (RITT), Memory Assessment Services (MAS) and Hospital Liaison Team. These are multi-disciplinary and incorporate psychiatrists, community mental health nurses, occupational therapists, support workers, clinical psychologists, social workers, carer support worker, case assessor, OT technical instructor and administrative support. Single Point of Access Team (SPA) A newly formed SPA based at Balladen House, Rawtenstall receives all the referrals to Older Adult Community Services from all of East Lancashire. The referrals are triaged, assessed and referred to the appropriate part of the service. Currently the team has 4 senior older adult practitioners who assess the patients, seek advice from doctors where appropriate and refer/signpost to appropriate teams or discharge to the care of GPs. Rapid Intervention and Treatment Team ( RITT) (Advertised post) This is a new team formed by merging the previous Intermediate Support Team (IST) and Care Home Liaison Team (CHLT). This team is based at Balladen House, Rawtenstall and provides input to patients requiring intensive support and treatment in the community, to prevent hospital admission and facilitates early discharge from the ward. Referrals from care homes are also supported by the RITT and the assessment incorporates working along the lines of the Newcastle Model to address challenging behaviours. This team works extended hours from 8am to 8pm during weekdays 8 am 5 pm over the weekend, and also provides gatekeeping services. The bed finding service is centralised with 3 Specialist Trust Nurses who assist in finding a bed if admission is indicated. 10
The Rapid Intervention and Treatment Team comprises:- Team Manager 1 Deputy Team Managers 2 Nurses 11 Occupational Therapists 3 Psychologist 1 Discharge Coordinator (Nurse) 1 Assistant Practitioner 1 Assistant Psychologist 1 Technical Instructor 1 Support Workers 3 Consultant Psychiatrists 2 Speciality Doctor 2 ( including advertised post) The RITT currently receives about 80 referrals a month, half of which are from care homes. The team receives about 20 referrals for gatekeeping assessment, most of which are managed in the community with intensive support. The team can hold cases for up to 3 months but most cases are discharged by 6 weeks with about 40 discharges per month. The team also provides rapid assessment when required, care co- ordination for brief interventions and facilitates early discharge from hospital. All referrals are allocated a Care Co-ordinator who conducts an initial assessment and consults a doctor for further assessment and treatment as required. Consultant and Specialty Doctors do not have any care coordination responsibilities. Community Mental Health Team (CMHT) CMHT is based at Balladen House, Rawtenstall and has 3 Consultants, each covering a designated geographic area. The team provides support to service users with severe and enduring mental illness and works along the CPA principles. Patients are seen by a nurse who is also allocated a Care Co-ordinator. Each Care Co-ordinator has about 25 patients on their case load. The team is supported by one Speciality Grade Doctor. The CMHT has the following staffing:- Manager 1 Band 6 nurses 8 Band 5 1 Band 4 1 Assistant Practitioner 0.5 Occupational Therapists 1.5 Psychologist 1 Support Workers 3 Consultant Psychiatrist 3 with each having 3.5 PAs input Specialty Doctor 1 with 5 PA input 11
Memory Assessment Service (MAS) This Service is currently provided on an Integrated Neighbourhood Team (INT) model, with each Neighbourhood Team consisting of 4-8 GP practices from the surrounding area. This model started about 8 months ago, providing a local and easily accessible service to patients in an area familiar to them, often a GP practice. Patients are assessed at the INT site. There are currently 9 INT sites with a view to expanding to 12 to cover all of East Lancashire. Each area has a nurse-led Memory Assessment and Monitoring Clinic supported by medical staff. Each INT has a nurse or a MAS Practitioner allocated who conducts an initial assessment, history and a cognitive testing using ACE III. Referrals to MAS are individuals of any age group who are experiencing difficulties with their memory and are seeking further assessment. MAS operate clinic or home based, single or extended assessment pathway depending on patient need. Following the initial assessment and appropriate tests, patients are seen by the Consultant at the Neighbourhood Clinic for case formulation and delivering diagnoses. The patients are followed up by the Non-Medical Prescriber if initiated on medication, or discharged back to Primary Care. Medical input to MAS is provided by the 4 CMHT Consultants. The MAS Team consists of Manager 1 Band 6 5 Occupational Therapists 3 Psychologist 0.3 Non Medical Prescriber 1 Support workers 4 Administrator 2 Consultant Psychiatrists 4 with each having 4 PA s input Specialty Doctor 1 with 3 PA MAS currently receives about 180 referrals a month. The service is able to accommodate an increase in the number of referrals over the last few months and has been achieving its target of assessing patients for the initial assessment under 4 weeks from the time of referral. The service also met a CQUINN target of 67% dementia diagnosis rate for the previous year. Hospital Liaison Service This is provided to Royal Blackburn Hospital, Burnley Hospital and the 3 community hospitals across the locality and are multi-disciplinary, with medical support provided through a consultancy model. The Team includes:- Team manager 1 12
Nurses 4 Occupational Therapist 1 Consultant 1 with 4 PAs input Consultant Establishment The current medical establishment includes-: Dr P Kukkadapu - Deputy AMD & Community Consultant with RITT and MAS Dr A Swana - Community Consultant with CMHT and MAS covering Pendle and Burnley Dr J Hussain - Community Consultant with CMHT and MAS covering Rossendale, Hyndburn and Ribble Valley Dr V Singh - Community Consultant with CMHT and MAS covering Blackburn with Darwen Dr S Waghray - Consultant in RITT Dr J Ngowi - In-patient Consultant + Hospital Liaison Services Locum - In-patient + MAS Other Medical Staffing:- Community teams: 1 x Speciality Doctor - CMHT 2 x Speciality Doctors (including advertised post) - RITT In-patient services : 1 x FY2, 1 x FY1, 1 x CT1 and 1 x Trust Grade doctor The RITT consultants are supported by 2 Specialty Doctors. The post holder will receive clinical supervision from one of the RITT Consultant. The Post holder has 1.5 PA s of Supporting Professional Activities ( SPA) for supervision, Appraisal, Revalidation and Academic activities. CLINICAL DUTIES This is a replacement post (1 WTE) for the RITT team in East Lancashire to support the Consultant and the existing Specialty Doctor in the RITT team in providing medical input. 13
General Principles The main duties of this post is to provide medical input to the Older Adult Rapid Intervention and Treatment Team. The requirement is for both direct care and advice/consultancy to members of the team, GPs and other practitioners. The setting in which patients are seen reflects their needs. The post holder will be expected to adopt a collaborative multidisciplinary approach to patient care according to the principles of new ways of working. The post holder has 8.5 Direct Clinical Care sessions for RITT and is supported by existing Consultants and 1 x WTE Specialty Doctor. Both the Specialty Doctors will cover the whole catchment area and the work is distributed equitably. RITT provides intensive support and treatment and is multidisciplinary with input from CPNs, Psychologists, OTs and support workers. RITT also facilitate early discharge and provide gate keeping service. Referrals from care homes for addressing behavioural problems in dementia and cross cover arrangements for Hospital Liaison Consultant are also supported by RITT team. There is close working relationships with in patient and CMHT Consultants and all the doctors meet for their PDP and Peer group meetings every week. RITT team meets every day to briefly discuss and allocate cases and also have their team business and clinical meeting once a week. Cross cover arrangements exist between the 3 Specialty Grade Doctors in the community to cover emergency duties and ECT. The post holder will collaborate with community Consultants to ensure an emergency response is available as necessary during normal working hours to services in the East Lancashire area. Responsibilities Include:- I. Support and where appropriate, clinical supervision of the multi-disciplinary team and any trainees or students on placements. II. Individual and joint assessments of patients on an emergency and nonemergency basis. Collaboration with colleagues to ensure availability for emergency assessments between 9 am and 5 pm within the locality. III. Assessment and management of patients under the Mental Health Act and Mental Capacity Act and DoLS where applicable. IV. Participation in care planning and review of patients under the care programme approach process, Mental Health Act and Mental Capacity Act V. Contribute to the ECT rota 1:3. Necessary training will be provided VI. There is currently no provision for on-call duties but participation in the out-ofhours Consultant duty rota( 3 rd Tier) covering East Lancashire may be required 14
in the future. If required this will not be more onerous than 1 in 11, appropriate remuneration for this will be discussed in job planning. The on-call duties cover general adult and old age psychiatric services. VII. There will be an annual job plan review in negotiation with the Associate Medical Director/Deputy Associate Medical Director. Supporting programmed activity will be distributed over the year to accommodate an increase in direct clinical activity when covering a colleague with a compensatory increase in SPA at another time. VIII. Leadership and co-ordination of both mental and physical health care of patients. IX. Medical leadership of MDT meetings. X. Regular review of patients mental state. In order to carry out these duties eligibility and maintenance of Section 12 Approval status is required. Necessary training will be arranged by the Trust. NON-CLINICAL DUTIES Job Plan, Appraisal, CPD and Revaluation/Mentoring There is a well-developed programme of annual appraisal and job plan reviews. The post holder will be required to show commitment to continuing Professional Development (CPD) and be to subject to an annual appraisal. A number of Consultants within this Trust have undertaken training in appraisal. Consultants have the opportunity to request appraisals with any trained appraiser within the Trust. A new electronic appraisal and revalidation system has been set up and all Trust Consultants have received training on its use. It is the responsibility of the individual doctor to achieve a satisfactory appraisal and work towards revalidation. The post holder will be allocated a mentor for the first 6 months of their employment to provide assistance and support in their new role. A job plan will be negotiated at least annually with the Associate Medical Director /Deputy Medical Director. The Adult Community Network holds Network-wide meetings with a CPD component once every 2 months which the post holder will be expected to attend. 15
The post holder will be expected to be part of a CPD peer group to assist in the development of an appropriate personal development plan. There is also a weekly local peer supervision group which the post holder would be expected to attend. Teaching and Training The post holder will be expected to engage in both formal and informal education of multidisciplinary colleagues. More specifically, fulfilling responsibilities for clinical and education supervision should be supplemented by participation in the weekly local education and postgraduate training programme. East Lancashire has its own academic programme every Wednesday PM held either at Burnley General Hospital or Royal Blackburn Hospital. The post holder will be expected to provide supervision to the junior medical staff working with them and generally participate in the academic and teaching programmes, teaching the medical students and other mental health professionals if they are attached to the clinical team. The post holder will have access to the library facilities at the Lantern Centre. The Trust has a special study leave policy for medical staffing and various in-house training activities take place both at locality and Trust level. The post holder is entitled to 10 days study leave per annum. An allowance which can be utilised over a period of three years with prior approval of the Associate Medical Director and Director of Medical Education. The Trust has an allocated medical budget for training that can be utilised by following the appropriated procedures in the study leave policy. Administration, Audit and Management The Network has an active audit programme and the post holder will be expected to participate and lead in local and Trust-wide audit activity and be involved in providing related training for medical staff and other disciplines. The Trust is committed to the full involvement of clinical staff in the management and development of the service. In the current arrangement a Consultant Deputy Associate Medical Director (Deputy AMD) and Clinical Manager support each part of the service. The Deputy AMD liaises closely with medical colleagues, the Medical Director/ AMD and the Deputy Network Director provides clinical leadership and direction to the service. The clinical line manager for this post is the Deputy AMD Dr Prashant Kukkadapu and the Associate Medical Director is Dr Alison Napier. PAs and On-Call and Additional PAs The standard contract is for 10 programmed activities. Currently there are no oncall commitments to this post. 16
The Trust retains the right to require all the doctors to take part in the on-call rota (In such a case, on-call will be negotiated and paid appropriately). Benefits of the Post The post holder will:- receive an appropriate salary on the new Specialty Doctor contract pay scale, in addition to carrying over any discretionary points/clinical excellence awards already awarded possibly be eligible for a lease car under the Trust s lease care scheme will have secretarial support at work base have access to office space be timetabled up to 1.5 sessions per week for defined supporting professional activities receive up to 32 days annual leave, depending on seniority and Trust policy. receive appraisal and revalidation training as required be appraised annually by a trained appraiser be entitled to 10 days study leave annually and a tri-annualised budget for this purpose as per the Trust study leave policy for medical staff support non drivers with travel arrangements ensure other professional leave is available as and when necessary subject to approval via Trust leave policies have access to a PC and IT support /informatics. Terms and Conditions The post holder must be a medical practitioner fully registered with the General Medical Council and have a licence to practice. The successful candidate will be expected to maintain existing service commitments and comply with Trust performance targets. The post holder will be expected to live within reasonable travelling distance of the main clinical base. If the appointee is required to move house to meet the residential clause of the contract, removal expenses will be payable in accordance with the terms and conditions of service of the Trust. Terms and Conditions of service state that the removal expenses shall be reimbursed and grants paid only when the employing authority is satisfied that the removal of the practitioner s home is required and that the arrangements proposed are reasonable. Therefore, successful candidates are advised not to enter into contractual agreement until such time as the formal approval of the Trust is confirmed in writing. The appointment is subject to a satisfactory Occupational Health Assessment. 17
Rehabilitation of Offenders Act 1974 Due to the nature of the work for which you are applying, the post is exempt from the provisions of Section 4(2) of the Rehabilitation of Offenders Act 1974. Applicants are, therefore, not entitled to withhold information about convictions which for other purposes are 'spent' under the provisions of the Act and in the event of employment, any failure to disclose such convictions could result in dismissal or disciplinary action by the Trust. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the order applies. The Trust welcomes applications from a wide range of candidates including those with a criminal record. It undertakes not to discriminate unfairly against any subject of a disclosure on the basis of a conviction or other information revealed. A full Trust policy on the recruitment of ex-offenders is available on request. DBS Clearance 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 to check for any previous criminal convictions. The Trust is compliant with the Disclosure and Barring Service code of practice, a copy of which is available on request. Standards of Conduct 1. Duties with regard to the Trust, your conduct should be in keeping with the Trust s stated values and objectives that patients have a right to privacy, dignity and choice. 2. Staff are vital to the Trust s success and it is their contribution that provides the Trust with its quality of service and reputation. 3. Focus should be on meeting the patients and carers requirements. 4. To achieve value for money by making the most effective use of available sources. 5. Ensure that personal action and conduct comply with the Trust policies and procedures i.e. health and safety, fire procedures, no smoking policy, equal opportunities, confidentiality etc. 6. The purpose of this document is to act as a guide to the duties which may be required. It is not an exhaustive list and other duties may be required in accordance with the grade of the post and competence of the post holder. The job description from time to time may be subject to review and change following reorganisation or reconfiguration of services in consultation with the post holder. 18
7. The Trust operates a no smoking policy. Annual/Sickness/Compassionate and Professional Leave All Specialty Doctors are entitled to leave as per National Contract and as per Trust Guidelines and Terms and Conditions of Service. It is accepted that the Specialty Doctors will be asked with other colleagues to provide emergency cover in case of sudden or short-term sickness or emergencies. This is not a reciprocal arrangement and it is aimed to provide continuity of care. Any long-term sickness will normally be covered by separate arrangements as per the Trust policy. Accommodation and IT facilities The post holder will have access to office space with desktop access. This may be shared office with other colleagues. They will also have IT access at all Trust laptops in clinical areas. In addition to the above the post holder will receive a Trust smart phone. The post holder is expected to use these facilities only for work related purposes and in conjunction with the Data Protection Act as well as the Trust policies that regulate the use of Trust IT equipment. Secretarial and IT Support The Specialty Doctors will have adequate administrative support allocated. This will be either medical secretary or a qualified administrative staff who are able to access and arrange the appointments, have full training on the Trust IT systems, be able to transcript audio recording, type clinical letters, have adequate customer service skills in answering and responding to telephone and email queries from service user and members of the public, as well as all the secretarial support required for the Consultant responsibilities. General Requirements of the Post These are specified within the person specifications. Satisfactory medical examination and health assessment is a condition of the appointment. Post is subject to Trust terms and conditions of employment. Visiting Arrangements For further information or to arrange a visit candidates should contact:- Professor Max Marshall, Medical Director Telephone No: 01772 695307 E-mail: max.marshall@lancashirecare.nhs.uk Dr Alison Napier, Associate Medical Director (Older Adults) Telephone No: 01524 550150 Email: alison.napier@lancashirecare.nhs.uk Dr Prashant Kukkadapu, Deputy AMD for Older Adults, East locality Telephone No: 01282 657786 Email: prashant.kukkadapu@lancashirecare.nhs.uk 19
Timetable: (Subject to review via job planning) MON TUES WED THURS FRI AM RITT/ ECT 1:3 RITT RITT RITT ( 0.5) RITT SPA (0.5) Supervision Appraisal/ Revalidation PM RITT Team Meeting CPD/ Teaching, Peer Group SPA RITT & Business Meeting RITT NB: The above job plan is for guidance only and a job plan will be agreed at commencement of employment. RITT team work can be unpredictable due to the nature of work it involves which generally tends to be crisis and intensive home support but a typical week consists of attending daily allocation meetings, assessment and follow up of up to 14 patients per week. All the patients would have previously been assessed by experienced practitioners in the team and assessments largely tend to be home visits. There is a weekly MDT meeting and other duties include supervision, attending in-patient or community CPA meeting and consultation sessions with RITT practitioners The job plan is based on 10 PAs (8.5 Direct Clinical and 1.5 PAs for Audit, Research, CPD and Educational Supervision). Currently there is no on-call commitment for this post. The Trust retains the right to require all Consultants to take part on the on-call rota (In such a case, on-call will be negotiated and paid appropriately). The job plan is subject to annual review with the AMD on behalf of the Medical Director/Chief Executive. 20