NW2017.6 (Final) Job description and person specification Post and specialty: Base: Contract: Accountable professionally to: Accountable operationally to: Specialty doctor in general adult psychiatry with the Manchester Early Intervention in Psychosis Service. This is a post which has become vacant following the previous post holder moving back into training. Manchester Early Intervention in Psychosis Service, Wilsons House, Manchester. Number of programmed activities: 10 There is no on call responsibility with this post, although it may be possible to negotiate on call work if preferred. Supervising consultant Dr Remy McConvey Clinical lead Dr Remy McConvey Line Manager : Dr Remy McConvey Service Manager: Mr John Sainsbury Team Lead : Mr Dan Cottam Key working relationships and lines of responsibility: Responsible Officer : Dr Chris Daly Lead Consultant Manchester and Trafford Clinical Network: Dr Taseer Kazmi Deputy Medical Director : Dr Margaret Campbell Medical Director : Dr Chris Daly Chief Executive : Ms Bev Humphrey
1. Introduction Greater Manchester Mental Health NHS Foundation Trust Greater Manchester Mental Health NHS Foundation Trust (GMMH) came into being on 1st January 2017 as a new large organisation after the acquisition of Manchester Mental Health and Social Care Trust by the Greater Manchester West Mental Health NHS Foundation Trust (GMW). Prior to being awarded Foundation Trust status GMW was known as Bolton, Salford and Trafford Mental Health NHS Trust, which came into being in April 2003. Prior to this, those services had been managed within a mix of Community and Acute Trusts. The development of the Trust reflected the National and Regional expectation that mental health services were best managed and delivered through specialist mental health provider arrangements. In June 2016, GMW received a good rating from CQC. The GMW Trust achieved a fully integrated Health and Social Care Service across all three Local Authority areas for Adult, Older People and Substance Misuse Services. Since 2000, Manchester s secondary care mental health services were provided by a city-wide Mental Health Trust (Manchester Mental Health and Social Care Trust or MMHSCT). The Trust was co-terminous with the city of Manchester and provided services to a total population of half a million people. The Trust was established in 2001, and was one of only three in England which existed as an integrated Health and Social Care Trust, the others being Kent and Medway NHS Social Care Partnership Trust and Sheffield Health and Social Care Foundation Trust. Services were provided from three acute Trusts, North Manchester General Hospital, Manchester Royal Infirmary and University Hospital of South Manchester, as well as several smaller community bases. Services were commissioned jointly by the Manchester Clinical Commissioning Groups and the Local Authority (Manchester City Council). There were three GP commissioning groups for the city, with one of these (North CCG) providing a lead role in mental health. In April 2011, the Trust took over the provision of a range of primary care, prison health care and other community services for the city. The Trust was one of six key players in the Manchester Academic Health Sciences Centre and was the second most successful Trust in the UK for mental health services research publications. It was also a leading provider of teaching and training in mental health at undergraduate and postgraduate level. The new Trust Greater Manchester Mental Health Foundation Trust (GMMH) therefore now provides a wide range of local services to Bolton, Salford, Trafford and the city of Manchester. In addition to its mainstream acute and community services, the Trust provides a range of innovative arts and rehabilitation services based around the principles of recovery, and is committed to models of partnership working with local voluntary and third sector organisations. The Trust also provides a number of specialist mental health services supporting all of Greater Manchester, the North West and beyond. These include Forensic Mental Health services, Substance Misuse services, Child and Adolescent Mental Health services, Mental Health and Deafness, Health and Justice providing a service into the prison estate in Greater Manchester and Lancashire, Specialist Psychological services providing services to veterans and supporting probation services, as well as perinatal services. [2]
The Trust has reconfigured its management structures into three directorates or networks managed jointly by an Operational Director and an Associate Medical Director supported by a senior leadership team. The management culture is that of a clinically led, operationally supported, academically informed management team. The three directorates are: Specialist Services; Bolton, Salford and Greater Manchester wide services; and Manchester, Trafford and Manchester city-wide services. Each Associate Medical Director is supported by a number of Lead Consultants. The current post supports North, South and Central Manchester Services as well as the Homeless Team and will come under the Manchester, Trafford and City-wide services Directorate. The City of Manchester Manchester is a vibrant city with a wealth of nationally acclaimed museums, art galleries and theatres. The city is also known internationally for its music and sporting reputation, and for its shops, restaurants and lively night life. There are many lifestyle options open to those living in the city, with city centre apartments, semiurban areas with an arty student atmosphere and more developed suburbs with excellent schools and housing options. The city has an excellent transport network with motorways, rail and the International Manchester Airport linking it to many important cities and resorts. Road and rail links make it easy to get out into the fantastic surrounding countryside, with the National Parks of the Peak District, Lake District and Snowdonia all within easy reach. [3]
Cultural diversity Manchester is culturally diverse and we welcome applicants from a similarly diverse range of backgrounds to gradually shift the profile of our workforce to match the population we serve. There are localities across the city with large communities identifying themselves as of African, Caribbean, Chinese or Indian sub-continent ethnic groups as well as many smaller ethnic and national groups covering most of the main world religions. As a result of this diversity there are thriving communities in many parts of the city with voluntary and community groups playing an active role in providing services. All consultants in the Trust will work with culturally diverse communities, but, in addition, development work with ethnic minorities and associated research programmes may form part of job plans for some posts. Population information for Manchester While Manchester is a well-developed and thriving city, it does have areas of significant deprivation and there is considerable inequality within the city as a whole. In addition, there are relatively high levels of homelessness, drug and alcohol use and other social problems associated with the inner city. Traditionally the Mental Health Needs Index (or MINI) has been used to predict population need for mental health services, taking account of measures of deprivation. The national weighted capitation formula gives a total Mental Health Needs Index for Manchester of 1.69 (where the ratio for England as a whole equals 1.00). On this measure, Manchester PCT ranks as having the fifth highest level of mental health need in England, behind Islington, Liverpool, City and Hackney, and Knowsley. In 2015 population was 530,330. People aged 16-65 counted approximately 377,752 (slightly more men than women). Services in Manchester are currently commissioned jointly by the PCT (NHS Manchester) and the local authority (Manchester City Council). There are three GP commissioning groups for the city, with one of these providing a lead role in mental health. Teaching and training The Trust is also a leading provider of both undergraduate and post graduate training. Medical students are attached to the Trust throughout the year for clinical, research and special study modules and all consultants are expected to contribute to the undergraduate teaching program. [4]
The Trust has a higher than average number of psychiatry training posts both at core and higher training levels and most of the consultants are supported in acting as educational and/or clinical supervisors. The Trust currently hosts Health Education North West previously known as the NW School of Psychiatry and several of the key training posts across the Region are held by consultants working in the Trust. 2. Service details The Manchester Early Intervention Service recently transferred from Rotherham, Doncaster and South Humber NHS Foundation Trust as part of a move to rationalise and consolidate mental health services in Manchester. It forms part of the community mental health service in Manchester along with six community mental health teams, the Manchester Engagement Team (delivering assertive outreach and homeless mental health care) and the Review Team (overseeing the care of patients in long-term 24 hour staffed placements. As part of the reorganisation of services, clinical networks covering Manchester and Trafford; Bolton and Salford are being established. It is anticipated that the process of consolidation and transformation will continue over the next two years or so. Joining a large local Mental Health Provider offers opportunities to both service users and staff. 3. Local working arrangements This one of two specialty doctor posts within the Manchester Early Intervention Service. The service started accepting patients in 2007. The service is commissioned to work with people living in Manchester and experiencing a first episode of psychosis. It works with people between 14 and 65 years of age. The current commissioned caseload is approximately 400 patients. At present the service is split into two teams (North, covering north and east Manchester and South, covering south and west Manchester). The teams provide expert assessments and treatment for people presenting with a first episode of psychosis. The service is managed by the service manager, John Sainsbury. Each team is led by a team leader. A clinical practice lead post has been recruited to, and this person complements the work of the team leaders. The team also has a number of psychologists and therapists, a clinical pharmacist, and 2 sessions from a CAMHS consultant psychiatrist to support input to younger patients. Care coordinators come from a variety of backgrounds including nursing, social work and occupational therapy, and they are supported by a team of support, time and recovery workers. We are in the process of establishing an at Risk Mental State Service (EDIT), led by a clinical psychologist and a physical health pathway to improve care in this area. The service operates the following functions: - Assessment team - EDIT Early Detection and Intervention Team (for people judged to be at high risk of psychosis using the CAARMS tool) - North and South Teams delivering an Extended Assessment and First Episode Pathways - Physical health pathway [5]
- Psychological therapies including CBT for psychosis and family interventions - Individual Placement and Support vocational interventions - Welfare rights - Pharmacy Medical staff in the service include: Consultant psychiatrist and clinical lead Dr Remy McConvey Consultant psychiatrist Dr Michelle Wetherall Consultant CAMHS psychiatrist (2PAs per week) Dr Peter Sweeney Specialty doctor Dr Justine Croft We also have higher trainees on rotation and for special interest sessions and medical students on rotation. Other staff in the team include: WTE Band Job Title 0.9 8b Clinical Psychologist 0.8 8a Clinical Psychologist (ARMS Lead) 1 8a Clinical Psychologist Family therapist 0.4 8a Pharmacist 1 8a Service Manager 2 7 Team Manager 1 7 Senior Practitioner 5.8 7 Clinical Psychologist 25.8 6 Care Coordinator 1 5 IPS Worker 1 4 Associate Practitioner (Physical Health) 1.6 4 Assistant Psychologist 1 3 rd Sector - TUPE Welfare Rights Advisor 4 3 STR Worker 1.0 4 Senior Admin 4.8 3 Administrator/ Medical sec There are three Home Treatment Teams and inpatient units at Wythenshawe and North Manchester General Hospitals. 4. Continuing professional development (CPD) The post holder must be registered with the Royal College of Psychiatrists for CPD. S/he must be a member of a local peer group recognised by the College. Reasonable study leave requests will be met if sufficient notice is given, subject to the demands of the service. A maximum of 30 days study leave will be granted over a three year period. The trust provides electronic access to a variety of educational resources. In addition, the post holder will be expected participate in monthly educational meetings at the EI service and to make use of other educational opportunities within the wider trust. We are keen to support post holders considering making a CESR application for specialist registration and to provide relevant opportunities for development where these can be accommodated. [6]
5. Clinical leadership and medical management The post holder will be encouraged to take on management responsibilities suitable for their level of experience (eg overseeing an aspect of audit, leading on organising educational meetings). There will be opportunities to contribute to management and leadership activity within the wider trust, depending on the interests of the appointee. 6. Appraisal and job planning The post holder is expected to take part in annual appraisal and job planning and fulfil the necessary requirements for revalidation. 8. Teaching and training The post holder will be expected to contribute to the teaching and training of medical students, doctors in training and other staff. 7. Research The service is research active. The post holder will be encouraged to support the recruitment of service users to projects approved by the service. 8. Mental Health Act and Responsible Clinician approval The post holder must be section 12(2) approved, or be eligible and willing to apply for such approval within three months of appointment. 9. Secretarial support and office facilities The post holder will share a dedicated office with the other specialty doctor at Wilson s House. Secretarial time will be provided by the consultant s secretary. The post holder will be provided with access to IT facilities on the GMMH network. 10. Clinical duties of post holder The successful candidate will be expected to provide medical input to the Manchester Early Intervention in Psychosis Service; the majority of their work will pertain to the North team but cross cover with the other specialty doctor is expected. The team is based at Wilson s House, Wilson s Park, Monsall Road, Manchester. The post holder will be accountable to Dr Remy McConvey and via him to the service manager and the medical director. In addition, for day-to-day operational purposes, the post holder will work according to priorities agreed with the rest of the team and the team manager. The role mainly consists of the provision of daily medical input to the team including participation in clinical team meetings, outpatients clinics and community visits. The nature of the post means that there will be a substantial amount of community based work. Key tasks will include taking psychiatric histories, performing mental state examinations and physical examinations, prescribing and monitoring medication and undertaking Mental Health Act assessments. 11. Clinical governance The post holder will be expected to participate in clinical and service audit and related activities with the aim of ensuring and improve the quality and safety of services provided to patients. [7]
12. External duties, roles and responsibilities The Trust actively supports the involvement of the specialty doctors in regional and national groups subject to discussion and approval with the medical director and, as necessary, the chief executive officer. 13. Other duties From time to time it may be necessary for the post holder to carry out such other duties as may be assigned, with agreement, by the Trust. It is expected that the post holder will not unreasonably withhold agreement to any reasonable proposed changes that the Trust might make. 14. Work programme It is envisaged that the post holder will work 10 programmed activities over 5 days. Following appointment there will be a meeting at no later than three months with the clinical manager to review and revise the job plan and objectives of the post holder. The overall split of the programmed activities is 8 to be devoted to direct clinical care and 2 to supporting professional activities. The timetable is indicative only. A formal job plan will be agreed between the post holder and associate medical director or clinical manager three months after commencing the post and at least annually thereafter. On-call and cover arrangements The post holder will not be expected to take part in the on call rota or to provide care on any of the inpatient units in the trust. Normal working hours are Monday to Friday 09:00 17:00. However, if an applicant wishes to be considered to take part in the middle grade on call rota in Manchester, then this could potentially be negotiated. The post holder will arrange cover for absence in discussion with the consultant and other doctors working within the early intervention service. So far as is consistent with the proper discharge of the above duties the post holder undertakes to deputise from time to time for absent colleagues. The post holder undertakes, exceptionally, to perform additional duties in occasional emergencies and unforeseen circumstances.the post holder undertakes, exceptionally, to be available for such irregular commitments outside normally rostered duties as are essential for continuity of patient care. 15. Contract agreement This post is subject to the national Terms and Conditions of Service. The post holder must maintain full registration with the GMC, and be Section 12(2) approved, or seek such approval within the first three months in post. The appointment is exempt for the provisions of section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation Act 1974 (Exemptions) Order 1975. Post holders are not entitled therefore to withhold information about any convictions which for other purposes are spent under the provision of the Act, and in the event of any failure to disclose such conviction could result in dismissal or disciplinary action by the Trust. Any information given will be completely confidential and will be considered in relation to an application for positions to which the Order applies. [8]
Contracts have been agreed with the BMA local negotiators, but individuals may wish to discuss this further before acceptance 16. Leave The post holder will be entitled to 27 days of annual leave per year, rising to 32 days after two years service. Study leave entitlement is 30 days in each three year period. Sick leave, compassionate leave and professional leave will be in accordance with guidance set out by the Whitley Council. 17. Visiting arrangements If you are interested in applying for this post, you are welcome to call or email Dr McConvey, or to arrange a visit to the service. You can call Dr McConvey via his secretary on 0161 277 6845, or email him at remy.mcconvey@gmmh.nhs.uk 18. Draft Timetable AM PM Monday Team morning meeting Home visits Clinical admin Tuesday Team zoning meeting Home visits Clinical admin Wednesday Clinical leadership/ management CPD activities Supervision Thursday Service Morning Meeting Outpatients clinic at GP Surgery Friday Team morning meeting Home visits Admin Time for urgent visits etc. 19. Approval of this job description by the Royal College of Psychiatrists This job description and person specification was approved by the Royal College of Psychiatrists regional advisor. [9]
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Person Specification: Entry Criteria Essential Desirable Assess by Qualifications MBBS or equivalent medical qualification. MRCPsych Higher degree (eg MSc) Eligibility Eligible for full registration with the GMC at time of appointment. S12(2) Approval A A, HS Completed four years of full-time postgraduate training (or its equivalent gained on a part-time or flexible basis), at least two of which were in a specialty training programme in psychiatry or as a fixed term specialty trainee in psychiatry. Eligible to work towards s12(2) approval if not already held. Fitness To Practise Applicant s knowledge is up to date and fit to practise safely. A, R, HS Language Skills Health All applicants to have demonstrable skills in written and spoken English that are adequate to enable effective communication about medical topics with patients and colleagues. Such competence could be demonstrated by having the applicant having undertaken their undergraduate medical training in English, or by achieving scores in the academic IELTS test at the level required for entry to specialty training or an equivalent. Meets professional health requirements (in line with GMC standards in Good Medical Practice). A, I A, P, HS Application Completion ALL sections of application form FULLY completed. A [11]
Entry Criteria Essential Desirable Assess by Clinical skills (see notes) Acute care safe: The candidate will show an awareness of the need to provide safe care and will demonstrate up to date basic resuscitation skills. Relevant specialty clinical knowledge: Up to date knowledge and understanding of relevant mental health legislation (including the Mental Health Act and Mental Capacity Act). Knowledge of CPA process. Understanding of early intervention in psychosis. Previous experience in early intervention in psychosis. A, P, C, I, R Clinical judgement: Experience in making clinical decisions and managing risk. Knows when to seek help, able to prioritise clinical need. Understanding of clinical risk management including participation in multidisciplinary meetings, completion of risk assessment tools and development and monitoring of risk management plans. Proven ability to work effectively in different clinical settings required in the job (ie community and outpatients), able to demonstrate experience in working successfully in a multidisciplinary team. Able to work without constant direct supervision. Familiar with range of biopsychosocial interventions relevant to psychiatry. [12]
Entry Criteria Essential Desirable Assess by Commitment to clinical governance / improving quality of patient care Clinical governance: Capacity to be alert to dangers or problems. Demonstrates awareness of good decision making. Aware of own limitations. Track record of engaging in clinical governance: reporting errors, learning from errors. Audit: Evidence of active participation in audit. Research Skills: demonstrates understanding of the principles of research, evidence of relevant academic and research achievements. A, I Teaching: evidence of interest and experience in teaching. Communication skills Effective communication skills: Demonstrates clarity in written/spoken communication and capacity to adapt language as appropriate to the situation. A,I, P Empathy and sensitivity: Capacity to listen and take in others perspectives. Works in partnership with patients: Always considers patients preferences when discussing treatment options. Always considers the full impact of clinical decisions on the patients and practice shared decision making. Directs and supports patients to access the information they need to support decision making. Personal skills Team working: Demonstrated experience working in a team, values the input of other professionals in the team. Leadership skills: experience in A, I, R [13]
Entry Criteria Essential Desirable Assess by Managing others & team involvement: Capacity to work co-operatively with others and demonstrate leadership when appropriate. Capacity to work effectively in multiprofessional teams. leadership Probity Commitment to ongoing professional development Coping with pressure: Capacity to operate under pressure. Demonstrates initiative and resilience to cope with setbacks & adapt to rapidly changing circumstances. Problem solving &decision making: Capacity to use logical/lateral thinking to solve problems & make decisions. Organisation & planning: Capacity to organise oneself and prioritise own work. Demonstrates punctuality, preparation and self-discipline. Understands importance of information technology. Flexible approach to work: Able to adapt and work with employers to deliver improved patient care. Equality and diversity: Promotes equality and values diversity. To understand the need to safeguard children and vulnerable adults and to adhere to all principles in effective safeguarding Car driver with access to own transport. Has valid driving licence and appropriate vehicle insurance. Professional integrity and respect for others: Capacity to take responsibility for own actions and demonstrate a non-judgmental approach towards others. Displays honesty, integrity, awareness of confidentiality and ethical issues. Learning and personal development: Demonstrates interest in psychiatry. Demonstrates a commitment to maintaining professional skills and knowledge relevant to the job. Demonstrates a willingness to fully engage in appraisal. Self-awareness and ability to A, I,R A. I, P [14]
Entry Criteria Essential Desirable Assess by accept and learn from feedback. Key: A=application form HS = pre- employment check and health screening I=interview P=portfolio C=other documented evidence e.g. certificate, exam R=references [15]