Consultant Psychiatrist in Community Older Persons Mental Health

Detailed job description and main responsibilities

The Clinical Role

There is an emphasis on members of the CMHT seeing the majority of initial assessments with a day time duty rota dealing with urgent referrals. This helps to minimise consultant emergency work and keeps their individual community caseload at a manageable size. The CMHT will seek advice from the post holder in order to guide management for the patient; this is achieved through formal team meetings, as well as ad hoc discussions with the team when required. 

Staff from within the memory assessment service currently see all initial referrals; these are discussed with the consultant and a decision is made as to who is best placed to see the patient for further assessment and treatment. We are encouraging colleagues in primary care to make memory assessments in less complex cases and the post holder will be expected to work with colleagues in primary care in order to advise and support these diagnoses.

There are approximately 200 CMHT referrals each year, and approx. 150 Memory Assessment Service referrals. With the increase in primary care diagnosis of dementia the number of memory assessment service referrals is expected to reduce.

The post holder will hold regular clinics in Minehead and Taunton, as well as undertaking domiciliary visits when required.

The community mental health teams are part of wider integrated teams. Each team is collocated with staff from district nursing and the integrated rehabilitation team (community OT and Physiotherapists). These links are very helpful when managing a patient from a holistic view point. The links will also allow the post holder to work towards closer integration between physical and mental health care, as well as primary and secondary care. Being collocated with this team allows for a free flow of advice and ideas between the services.

Transfers from general adult services to older adults are made in discussion between the teams, and with the patient and their carer. Our aim is that the right treatment is delivered by the right people at all times.

CMHT and MAS team Staffing  (all figures WTE)

                                        Taunton                            Minehead
Band 7 Team Lead           1                                      1

Band 6 Nurse                   1                                      1.4

Band6 OT                        1                                      1 (0.5 CMHT / 0.5 Day Hosp)

Band 6 MAS Lead            1                                      1

Band 5 Nurse                   2.4                                   2

Band 3 ST&R                                                           1.4

The aim of having the post holder supporting and being supported in Taunton with three other OPMH consultant colleagues, is to ensure that community consultants, including the post holder are mutually supportive in their practice.
There is no inpatient responsibility associated with this post; however the post holder will be expected to discuss possible admissions and discharges to our older adult’s inpatient unit with the inpatient consultant or their deputy, to ensure safe transfer of care, into and out of the inpatient setting.  The post holder may also by agreement offer mutual leave cover to the inpatient consultant.

KEY RESPONSIBILITIES

In addition to the above mentioned responsibilities, the post holder will:

• Provide visible and clear clinical leadership to the mental health service both locally and across the Trust;
• Work collaboratively with inpatient staff to ensure smooth transition for patients admitted and discharged from the wards;
• Join a peer group for CPD purposes: this can a Trust group or other local peer group depending on the post holder’s preference;
• Identify areas for personal development, that will allow the post holder to improve the care they provide
• Maintain good standing for Continuing Professional Development (CPD); the Trust actively encourages continuing professional development and appropriate study leave and expenses will be supported by the Trust (up to 30 days study leave every three years);
• Undertake annual appraisal and job plan reviews;
• Develop the services around them, in collaboration with management and other team members to continue to improve patient care
• Participate in the local arrangements for peer supervision with consultant colleagues, including case based discussion;
• Provide mutual cross cover for planned leave with the other medical staff;
• Fulfil the duties agreed in the job plan;
• Comply with all Trust policies;
• Work within the financial and other constraints decided upon by the Trust

Secretarial support and office facilities:

• The post holder will have an individual office in the Barnfield unit in Minehead and will also have shared office space available in Pyrland, Taunton
• Within these office spaces the post holder will have access to IT and a telephone, as well as locked cabinets as needed.
• The post holder will be supplied with a smart phone and laptop for use in relation to Trust work.
• Administrative cover is provided by a part time dedicated secretary in Minehead and access to a shared medical secretary in Taunton.

OUT-OF-HOURS ON-CALL DUTIES:

• There are no compulsory Out of Hours duties as part of this role.
• The post holder can opt to join the senior out-of-hours on-call rota subject to availability. Duties include senior medical and RC cover for the inpatient wards and S12 MHA work both in Trust premises and in the community.
• This is a 1 in 12 rota operating 5pm to 9am on weekdays; at weekends the rota operates from 9am on Saturday morning to 9am on Monday morning.
• This rota provides senior medical cover including Responsible Clinician duties to all the inpatient wards in the Trust except the child and adolescent ward (Wessex House). It therefore covers inpatient services for adults of working age (Rydon 1 and 2 Wards in Taunton, Rowan Ward in Yeovil and St Andrews Ward in Wells), older people (Pyrland Ward in Taunton), the PICU (Holford Ward in Taunton), and the rehabilitation and low secure wards (Willow and Ash Wards respectively in Bridgwater).  Hence it includes duties for patients within the following specialties: adult general, old age, rehabilitation and learning disability.
• The senior on-call rota also involves MHA assessments in inpatient wards, the two Hospital Place of Safety suites (located in Yeovil and Taunton), the district general and community hospitals, police custody centres and also in the community.
• The rota attracts a payment of 1 PA (for the S12 component) and a 3% salary enhancement for the RC / senior medical cover for inpatient wards. Section fees are also paid and retained for assessments (excluding current Trust inpatients).
• The rota is occasionally supported by senior trainees who undertake the Consultant Role under supervision until midnight.
• The trust is currently piloting an all age rota ( as above but including CAMHS Inpatient and community ) and if successful the trust will plan to move towards this for provision of cover out of hours.