Senior Clinical Fellow - Psychiatry

Detailed job description and main responsibilities

CESR FELLOWSHIP SCHEME

The CPFT CESR fellowship scheme provides a personalised programme for doctors wishing to gain entrance to the specialist register through the CESR process (now renamed the Portfolio pathway). It allows experience in inpatient, community and emergency work depending on the individual doctor’s needs.

It further allows opportunity to gain other required experience including audit/quality improvement, psychotherapy, teaching, leadership and management, research competencies and involvement in clinical governance. Each fellow will have a job plan that provides a 70/30 split between clinical service commitment and SPAs including a special interest day.

Following successful appointment, discussions between the appointed CESR fellow and a CESR tutor/educational supervisor will take place to develop a programme based on the assessment of the individual’s specific strengths and needs.

The fellow will receive support from their clinical supervisor in developing and demonstrating clinical and non-clinical competencies and developing a robust portfolio. They will be offered 3 monthly educational supervision focusing on training needs and portfolio development. The trust has recently appointed a CESR Tutor Role to coordinate the fellowship programme and provide support and guidance for CESR fellows.

The Fellowship program is for up to 2 years and at the end of this time it would be anticipated that most successful candidates on the scheme would be eligible to apply for consultant posts. A further year can be arranged dependent on the professional and developmental needs of the candidate.

The fellows will be offered support in applying to consultant posts or in pursuing other career options. The scheme will allow them to become familiar with clinical teams where there may be opportunities for a future substantive consultant role and to be fully appraised of local opportunities for substantive vacancies at consultant level within the Directorate.

THE SERVICES

Adult Community Care

Adult Community services provide specialist, community based, mental health assessment and treatment for people with severe mental health problems. The teams are organised into locality teams aligned with GP surgeries and primary care.  In Cambridge there are two teams.

• Cambridge North Adult Locality team: Union House, Cambridge
• Cambridge South Adult Locality team: Union House, Cambridge

The locality teams have strong links with the GPs and primary care services through senior mental health clinicians (PRISM) working with groups of GP practices.

Specialist services working closely with all localities:

• CAMEO, which is an early intervention in psychosis service for people experiencing their first episode psychosis
• Personality Disorders Community Service – for people with personality disorders
• Perinatal Mental Health Service

The Personality Disorder Community Service

The Personality Disorder Community Service (PDCS) is a service designed around the principles in NICE guidelines, for patients who have severe personality difficulties and other complex needs. Many of them have exhausted resources within other statutory and non-statutory agencies. PDCS offers a treatment programme which includes psychological and occupational therapy interventions in groups, along with more tailored interventions for those that are on the more severe and complex end of the spectrum. We work in partnership with our patients, carers and other psychiatric services to manage high risk and impairment in a recovery focussed way.

This is in line with research indicating that evidence-based treatment can enable patients with a diagnosis of Personality Disorder to live with longer periods of wellness, with increased capacity to manage their illness and engage in meaningful social roles. It also indicates that treatment should be targeted at acute symptoms of self-harm, impulsivity and suicidality, as well as chronic symptoms of social isolation and difficulties in maintaining relationships. We provide a service which helps contain or reduce the high levels of stress and arousal which are generated at the level of the patients themselves and for other supporting services – this includes educational and liaison functions. We try to be reflective rather than reactive. We use outcome measures to monitor progress. We are structured but flexible and evolve according to the changing needs of patients or the services we interface with.

THE POST

Cambridge Adult locality team

This post is providing clinical leadership and patient care in our community mental health team in South Cambridge

The post is based in Union House in Cambridge. Alongside a team of substantive consultants, you will provide assessment and treatment for all patients in your area.  Consultant psychiatrists work with a sector team to cover a geographical patch. They also have aligned staff from the award-winning Primary Care Mental health Service (PCMH) team who support and assess patients in primary care and step patients up into the team when needed. Consultants are expected to form close working relationships with their allocated group of GPs and to provide support and supervision to the Primary Care Mental Health team in their area as well as to provide care to patients needing specialist mental health care.

Key Clinical Responsibilities

The post holder will provide clinical leadership to the team working alongside consultant colleagues. He or she will contribute to assessment of patients referred to the service for diagnosis and treatment of mental disorders and support MDT members who carry out assessment of patients both within the teams and in primary care. They will help to facilitate accurate diagnosis and timely interventions so that treatment can be delivered in a timely manner and in accordance with the recovery model. He or she will also provide ongoing treatments to patients that are evidence based and supported by NICE guidelines maintaining a bio psychosocial approach.

The post holder is expected to work towards gaining their Approved Clinician status and in time gain a comprehensive awareness of Mental Health, Mental Capacity and Care Act legislation.

The post holder is expected to be committed to a multidisciplinary approach to care and actively contribute to MDT meetings and formulation meetings and work in close collaboration with team members, care coordinators, other CPFT services and statutory agencies as required for the care of community patients. Alongside the locality consultant they are  expected to develop close working relationship with primary care, particularly General Practitioners, and support primary care clinicians to manage patients with mental health difficulties within the primary care setting where appropriate.

The post holder will be expected to contribute to the collection of clinical information to ensure further service development and to enable audit, participate in clinical governance activities and contribute to the day-to-day management and to the overall service development agenda through collaboration with managerial and clinical colleagues.

The Trust is developing its services in line with modernised psychiatric practice. There will be opportunity to be actively involved in planning and developing services, and there will be opportunities to engage in quality improvement and service development work that is ongoing in the Trust.

Personality disorder service

Main Duties and Responsibilities

This is an exciting and challenging post, offering opportunities for growth and development in a supportive and structured environment. The post holder will work alongside consultant colleagues in the PDCS team to deliver a service to patients with severe personality disorders and complex needs. The post holder will be expected to deliver skilled clinical care to patients, supervision and support to staff and liaison with the wider system that supports these patients.

In time the post holder will also supervise referral sources such as Primary Care Mental Health Service and locality teams in order to ensure that patients are referred appropriately to the service. In addition, they will support GP’s needing advice and support around management of patients with Personality Disorder.

There will be scope to develop innovative strategies that expand and develop provision in this area and to build on existing treatment and research programs conducted in the team.