Post Information

POST ST4-6 in the Psychiatry of Intellectual Disability
TRAINER Dr Simon Bonell, Consultant Psychiatrist in Intellectual Disability
EMPLOYING TRUST Plymouth
TRAINING BASE Plymouth CLDT, Westbourne Unit, Scott Business Park, Beacon Park Road, Plymouth PL2 2PQ
JOB DESCRIPTION

The learning disability service in Plymouth has a high reputation nationally in particular areas of its work. The total population served by Livewell Southwest is approximately 258,700.  The prevalence of learning disability is similar to elsewhere.  Medically, the population of people with learning disabilities is served by two consultant psychiatrists.  The psychiatrists form a key part of a wide-ranging multi-disciplinary team of health and social care professionals.

THE PLYMOUTH COMMUNITY LEARNING DISABILITIES TEAM (CLDT)

The majority of the health care professionals, including the psychiatrists, are based at the Westbourne Unit just north of the city centre, forming a single team serving the whole city.  

For more detail about the profile of Livewell Southwest and its main services please refer to Appendix A.

 

CLIENT PROFILE

Clients accessing health support services from the Plymouth Community Learning Disabilities Team include the following -

 

  • those with additional mental health problems
  • those with complex additional health problems (e.g. epilepsy, dementia)
  • those with risky/offending histories including those in need of forensic services
  • those with autistic spectrum disorders
  • those with challenging behaviour
  • profoundly disabled special care clients with multiple needs and high levels of physical dependency

 

There is a consultant psychiatrist within the CAMHS service who has dedicated time to provide a service for children with learning disabilities. There are good links between the services to ensure good transition when required.

 

SERVICE PROVISION

The Plymouth Learning Disability service is a community based one with a strong philosophy supporting people’s continuing presence in the community.  Approximately half the adults with learning disabilities live with parents or other family members.  There is a healthy range of independent sector providers across the city providing for the other half.  Housing opportunities range from supported living to fully staffed registered residential homes – all are in the independent sector.  There are several specialist providers catering for those with high risk/forensic problems, often staffed one to one.  There are several independently provided day-care services, although most day opportunities are directly provided by social services.

 

There is an independent advocacy scheme funded by the local authority and a robust Adult Protection strategy and system shared between health and social services.

 

PLYMOUTH CLDT PROVISION- MEMBERSOF THE TEAM

  • Full-time service manager for the community health services
  • Consultant Psychiatrists (2 wte) (Dr Bonell and Dr Bhate)
  • ST4-6 psychiatry trainee (1wte) (this post)
  • Core psychiatric trainee (1wte)
  • Clinical and Forensic Psychologists (4.8 wte)
  • Speech and Language Therapists (3 wte)
  • Occupational Therapists (3.5 wte)
  • Behaviour therapists and support staff
  • Community Nurses – 17 qualified wte, some with specialist interests (dementia, incontinence, forensic, epilepsy) and 5 support staff
  • Part time Dietitian (0.5 wte)

 

There is good administrative support to these staff.

 

Services provided by these professionals include individual assessment and therapy and group therapy.  In addition particular client needs are met through multi-disciplinary groupings as follows:

 

  • Mental Health Liaison nurses who provide care co-ordination of patients with more complex mental health needs and learning disabilities and work closely with adult mental health services when required
  • Memory clinics and dementia screening programme for adults with Down ’s syndrome (one of few services in the UK conducting prospective screening of all adults with DS).
  • Community Sex Offender Treatment Programme (SHEALD) in partnership with the NSPCC and Devon and Cornwall Probation Service.
  • Dialectical behavioural therapy informed groups for people with learning disabilities and borderline personality disorder.
  • Acute Services Liaison Unit.   A small team of nurses with additional admin support supporting clients attending the general hospital.
  • Specialist Parenting Team for assessment and training for parents with learning disabilities.
  • Primary care liaison nurses

 

THIS POST

The post will be full time, ie 10 sessions per week, with Dr Bonell being the supervising Consultant (or part time hours as negotiated).

 

LOCATION

The post is based at the Plymouth Community Learning Disabilities Team, Westbourne Unit, ScottBusinessPark, Beacon Park Road, PlymouthPL2 2PQ. Office accommodation and secretarial support are provided at Westbourne Unit.

 

WORKING RELATIONSHIPS

The post holder will be professionally accountable to Dr Simon Bonell.

The post holder will relate to and work with other front-line staff, providing services across Plymouth.

 

DUTIES OF THE POST

The post holder will be working with Dr Bonell and Dr Bhate and will be responsible for assisting with the provision of outpatient and community-based care for people with learning disabilities and mental health and behavioural issues. This will include outpatient clinics, home visits and core team / CPA review meetings. There is a strong ethos of multi-disciplinary team (MDT) working and this will be actively encouraged and developed.  The post holder will be expected to attend the weekly MDT meetings.

 

The post holder may be required to make emergency assessments during the working day at the request of the supervising Consultant, and it would be advantageous to be approved under Section 12(2) of the Mental Health Act.

 

The post holder will also be expected to take part in liaison with general adult mental health services for inpatients with learning disabilities, along with other team members.

 

The post holder will be expected to communicate appropriately with Primary Care services with regard to the advice and changes in treatment initiated by the service.

 

Particular opportunities will be available to trainees, depending on their interests, including dementia clinics, epilepsy, forensic case work and personality disorder in LD work etc.

 

EDUCATION, RESEARCH AND DEVELOPMENT

The holder of this post will be encouraged to participate in special interests, research, postgraduate activities and audit.

 

There is an active academic programme including journal clubs and case presentations which take place weekly at Mount Gould Hospital.  The post holder will be encouraged to attend and participate in these activities regularly.

 

Training of medical and non-medical staff on the psychiatry of intellectual disability will be encouraged and a number of opportunities are available.

 

Study leave allowance will be in keeping with the Terms and Conditions of Service.

 

APPRAISAL AND SUPERVISION
There will be annual appraisal and weekly supervision. Duties and timetables for this post will be reassessed on an annual basis in conjunction with the post holder and the supervising Consultant.

 

HOURS OF DUTY

The sessional allocation will be 10 sessions per week on a Monday to Friday basis.  For part time applicants the contents and timetable will be negotiable pro rata, where possible taking into account the applicants preferences and the share of the duties involved.

 

TRAINEE TIMETABLE

 

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

AM

Consultant meeting / CPAs Outpatient Clinic Supervision Academic Programme Research / special interest Home visits / admin

PM

Home Visits MDT Meeting Outpatient Clinic Research / special interest Home visits / CPAs / admin

 

ON CALL:

1 in 8 on call for general Psychiatry. Consultant psychiatrist always available on call.

 

QUALIFICATIONS AND EXPERIENCE:

The post holder must have full registration with the General Medical Council

 

CONTINUING PROFESSIONAL DEVELOPMENT

All medical staff are encouraged to maintain their medical education. the Post holder will be entitled to study leave as provided within the ST4-6 rotational scheme. Training to gain Section 12 Approval and other competences related to Psychiatry and this post will be encouraged if the successful post holder does not hold these.


CLINICAL AUDIT AND CLINICAL GOVERNANCE

The post holder is required to be aware of the quality standards of care within the Trust and to contribute equitably and regularly to the auditing of clinical performance according to the principles and practice of clinical governance set out for the speciality

 


 

Post Information

 

POST ST4-6 in Learning Disability / Neuropsychiatry
EMPLOYER Dr Rohit Shankar MBE, FRCPsych
EMPLOYING TRUST Chygovenek, Truro
BASE Chygovenek, Truro, TR4 9LD. Office accommodation and secretarial support will be provided from Chygovenck.
SPECIALITY Neuropsychiatry / Learning Disabilities
JOB DESCRIPTION

LEARNING DISABILITIES SERVICE

The Learning Disabilities Service consists of 2 community teams, based in the East and West of the county. Each team consists of psychologists, community nurses together with a range of Allied health Professionals and provides community-based service for clients of adult age. Services for children with a learning disability are provided by the Child & Family Service with which the Learning Disabilities Service has close liaison. In addition, within the Learning Disabilities Service there is also a county-wide Intensive Support Team and there is association with Learning Disabilities Health Facilitation Service within the Primary Care Trust working to liaise with primary care practitioners. Service users with learning disabilities who require admission for a mental health problem use the general mental health in-patient services of the Trust, within reach from relevant learning disability practitioners. There is a specialist epilepsy service for adults with learning disabilities, and a specialist memory/older persons’ service for people with learning disabilities; these constitute the Neuropsychiatry, Epilepsy & Memory Service which are embedded in the larger LD service. 

 

The post holder will be based with the East team at Bodmin with Dr Shankar. Outpatient services are provided from this base and from other community locations and transition epilepsy clinics in special schools across the county. The epilepsy nurses also carry out vagus nerve stimulator ramping and follow-up as part of the community-based epilepsy service.

 

MEDICAL STAFFING  IN  LEARNING DISABILITIES

Consultant Psychiatrist (currently vacant) based in West Cornwall and Chygovenck (sees LD adults with mental health and behaviour issues and LD patients with epilepsy and dementia)

Dr Rohit Shankar Consultant Neuropsychiatrist based in East Cornwall and Chygovenck (sees adults and LD adults with epilepsy and dementia and is also the clinical director for LD services)

Dr David Cox, Consultant Psychiatrist based at Chy Govenek and East Cornwall (sees adults and patients with complex epilepsy and dementia)

Dr Anu Shyam, Consultant Psychiatrist in the Child & Family Service with special responsibility for learning disabilities

There is also one CT1-3 post in the service and another ST4-6 post.

 

DUTIES OF THE POST

The post holder will be working with Dr Shankar and will be responsible for assisting with provision of outpatient care and community-based services in the Learning disability patients for mental and behavioural issues, dementia and Neuropsychiatry Epilepsy Service. This will include outpatient clinics and home visits, and working with different members of the community teams. There are excellent links with mental health colleagues, local neurologists and GPs.

Joint assessment and joint working with other members of the team is encouraged and expected. The post holder will be expected to attend the weekly allocation and MDT meetings.

The post holder may be required to make emergency assessments during the working day at the request of the supervising Consultant, and it would be advantageous to be approved under Section 12 of the Mental Health Act.

The post holder would also be expected to take part in liaison with general adult mental health services for inpatients with learning disabilities, along with other team members.

The post holder will be expected to communicate appropriately with Primary Care services with regard to the advice and changes in treatment initiated by the service.

 

EDUCATION, RESEARCH AND DEVELOPMENT
The holder of this post will be encouraged to participate in special interests, research and postgraduate activities and audit.
 

There is an active education programme at Bodmin Hospital, which the post holder will be encouraged to attend and regular multidisciplinary case conferences in localities also take place.
 

Study leave allowance will be in keeping with the Terms and Conditions of Service.  Cornwall Partnership NHS Trust supports Continuing Professional Development and life-long learning and to support clinical governance one session per week is dedicated to training and peer review.

Dr Shankar is an honorary associate professor (senior clinical lecturer) with the Exeter Medical School and deputy chair for the Trust’s research and governance committee. He is also the innovation lead for RCPsych south west division and on the national ID Faculty executive. He leads and chairs national initiatives in ID and epilepsy.  The post holder would be encouraged to take the opportunity to join and work with him. His research interests include SUDEP, epilepsy, autism, dementia in Down’s syndrome, forensic aspects of learning disability and sensory processing disorders.  The post holder will be encouraged to complete at least 1 audit, 1 international peer r/w poster presentation and a peer r/w publication during their tenure.

 

PROVISIONAL TIMETABLE

 

MONDAY 

TUESDAY 

WEDNESDAY 

THURSDAY

FRIDAY 

AM 

 

General LD MDT meeting & Outpatients

Core LD
 

Outpatients

Epilepsy
 

Academic

Programme/

CPD/SMSC
 Admin/emergencies  

Doctors peer group once a month meeting/IST MDT once a month/ fortnightly IST patient r/ws

 PM

 

home visits/

Dementia clinic
 

Outpatients

epilepsy
 

Epilepsy MDT

Supervision

 

Research/ special interest

 

Research /Special Interest

 ON CALL: 1 in 14 with consultant on call

 

TRAINER TIMETABLE

 

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

AM

General LD MDT meeting & Outpatients Core LD

Outpatients

Epilepsy

CPD/SMSC/ twice  a month home
visits/BI meetings/ GP surgery work/risk meetings etc
IST reviews IST/PEER GROUP/ emergencies - Truro

PM

home visits/

LD Dementia clinic

Outpatients

Epilepsy

EPILEPSY MDT 13.00-15-00 Truro

Supervision

15.00- 16.00
Clinical Admin - Truro research

 

 


 Post Information

 POST

 Learning Disability/ Neuropsychiatry

 TRAINER

 Dr David Cox

 EMPLOYING TRUST

 Cornwall Partnership Trust

 TRAINING BASE

 Chy Govenek, Threemilestone, Truro, TR4 9LD

 JOB DESCRIPTION

 LEARNING DISABILITIES SERVICE

The Learning Disabilities Service consists of 2 community teams, based in the East and West of the county. Each team consists of psychologists, community nurses together with a range of Allied health Professionals and provides community-based service for clients of adult age. Services for children with a learning disability are provided by the Child & Family Service with which the Learning Disabilities Service has close liaison. In addition, within the Learning Disabilities Service there is also a county-wide Intensive Support Team and there is association with Learning Disabilities Health Facilitation Service within the Primary Care Trust working to liaise with primary care practitioners. Service users with learning disabilities who require admission for a mental health problem use the general mental health in-patient services of the Trust, with in-reach from relevant learning disability practitioners. There is a specialist epilepsy service for adults with learning disabilities, and a specialist memory/older persons’ service for people with learning disabilities; these constitute the Neuropsychiatry, Epilepsy & Memory Service which are embedded in the larger LD service. 

The post holder will be based with West Team in Redruth with Dr Cox. Outpatient services are provided from this base and from other community locations. The epilepsy nurses also carry out vagus nerve stimulator ramping and follow-up as part of the community-based epilepsy service.

 

MEDICAL STAFFING  IN  LEARNING DISABILITIES

Dr David Cox Consultant Neuropsychiatrist based in West Cornwall and Chygovenck (sees LD adults with mental health and behaviour issues and LD patients with epilepsy and dementia)

Dr Rohit Shankar Consultant Neuropsychiatrist based in East Cornwall and Chygovenck (sees adults and LD adults with epilepsy and dementia and is also the clinical director for LD services)

Dr Rajendra Pande Consultant Neuropsychiatrist based at Chy Govenek and East Cornwall (sees LD adults with mental health and behaviour issues and LD patients with epilepsy and dementia)

Dr Anu Shyam, Consultant Psychiatrist in the Child & Family Service with special responsibility for learning disabilities.

Dr Eve Corson, Specialty Dr (part time) based in West and Mid Cornwall and Chy Govenek (sees LD adults with mental health and behaviour issues and LD patients dementia). There is also one CT1-3 post in the service currently vacant East Cornwall and another ST4-6 post.

 

LOCATION

The post is based at Chy Govenek, Threemilestone, Truro, TR4 9LD.  Office accommodation and secretarial support will be provided from Chygovenck.

 

DUTIES OF THE POST

The post holder will be working with Dr Cox and will be responsible for assisting with provision of outpatient care and community-based services in the Learning disability patients for mental and behavioural issues, dementia and Neuropsychiatry Epilepsy Service. This will include outpatient clinics and home visits, and working with different members of the community teams. There are excellent links with mental health colleagues, local neurologists and GPs.

Joint assessment and joint working with other members of the team is encouraged and expected. The post holder will be expected to attend the weekly allocation and MDT meetings.

The post holder may be required to make emergency assessments during the working day at the request of the supervising Consultant, and it would be advantageous to be approved under Section 12 of the Mental Health Act.

The post holder would also be expected to take part in liaison with general adult mental health services for inpatients with learning disabilities, along with other team members.

The post holder will be expected to communicate appropriately with Primary Care services with regard to the advice and changes in treatment initiated by the service.

 

EDUCATION, RESEARCH AND DEVELOPMENT

The holder of this post will be encouraged to participate in special interests, research and postgraduate activities and audit.

There is an active education programme at Bodmin Hospital, which the post holder will be encouraged to attend and regular multidisciplinary case conferences in localities also take place.

Study leave allowance will be in keeping with the Terms and Conditions of Service.  Cornwall Partnership NHS Trust supports Continuing Professional Development and life-long learning and to support clinical governance one session per week is dedicated to training and peer review.

Dr Cox is psychiatry lead in Cornwall for the Exeter Medical School and core Training Program Director for the Peninsula. He is also the lead for the LD epilepsy service. He is active in reseach in ID and epilepsy.  The post holder would be encouraged to take the opportunity to engage in research which might include SUDEP, epilepsy.  The post holder will be encouraged to complete at least 1 audit, 1 international peer r/w poster presentation and a peer r/w publication during their tenure.

 

WEEKLY TIMETABLE

TRAINEE TIMETABLE

  MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM

Clinical time in West Cornwall. Venue: clinic base or home visits.

IST, general, epilepsy or memory assessment/formulation/

management

West Team meeting at Trengweath, RedruthFollowed by educational supervision 1 hour Teaching/Management Training/ Additional Supervision  Alternating CPD/ working practice meeting/ SMSC Special Interest IST meeting monthly
PM Clinical time in West Cornwall. Venue: clinic base or home visits.

IST, general, epilepsy or memory assessment/formulation/

management

Clinical supervision then Flexible clinical trime for primary care liaison/ professionals meetings/ specialist assessments with MDT colleagues (e.g. HCR20) Alternating 50:50 Medical Peer group incorporating clinical supervision with epilepsy MDT Special Interest Administration

ON CALL: Section 12 on call

 

TRAINER TIMETABLE

  MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM

Clinical time in West Cornwall. Venue: clinic base or home visits.

IST, general, epilepsy or memory assessment/formulation/

management

West Team meeting at Trengweath, RedruthFollowed by educational supervision 1 hour Alternating CPD/ working practice meeting/ SMSC Flexible clinical/ medical school/ TPD role. IST meeting monthly
PM Clinical time in West Cornwall. Venue: clinic base or home visits.

IST, general, epilepsy or memory assessment/formulation/management

Clinical supervision then Flexible clinical trime for primary care liaison/ professionals meetings/ specialist assessments with MDT colleagues (e.g. HCR20) Alternating 50:50 Medical Peer group incorporating clinical supervision with epilepsy MDT Flexible clinical/ medical school/ TPD role Administration

 

 


POST INFORMATION

POST

ST4 - 6 in Psychiatry of Intellectual Disability

TRAINER

Dr Victor Olotu, Consultant Psychiatrist in Intellectual Disability

EMPLOYING TRUST Devon Partnership NHS Trust
TRAINING BASE                      

Exeter & East Devon ID IATT, Franklyn House, Franklyn Drive, Cowick Lane, St. Thomas, Exeter, Devon EX2 9HS

QUALIFICATION AND EXPERIENCE

The post holder must have full registration with the General Medical Council

The post holder must have demonstrated competencies to ST4 level as required by the Peninsula School of Psychiatry Scheme.

PERSONAL AND PROFESSIONAL DEVELOPMENT

Continuing Professional Development

The post holder would be expected to construct a personal development plan with the support of Clinical Supervisor.

Annual Appraisal and Revalidation

Annual appraisal will take place with a trained medical appraiser and this will include elements of performance review with performance data available. The annual appraisal process will provide all the information necessary for the General Medical Council revalidation process.

Clinical Governance

The post holder would also be expected to play an active part in the Local Delivery Group clinical governance arrangements. The clinical governance arrangements which have recently been reviewed are known as "Equip" (Ensuring Quality in Practice). There will be an expectation that the post holder will attend Equip afternoons and fully engage in contributing to the audit and Clinical Governance Programme. There is also ample opportunity to participate in medical management as delegated by the Associate Clinical Director or Clinical Director.

Annual Leave

The post holder will be entitlement to appropriate annual leave allowance

Study Leave

The post holder has entitlement to appropriate study leave allowance in keeping with terms and Conditions of Service, There will be opportunities to attend major psychiatric conferences. The South West Division for psychiatric training (SWDT) offers local training and opportunities for attending high quality CPD events. There will be flexibility regarding which conferences the post holder wishes to attend.

Library facilities

There is an excellent psychiatric library at the Wonford House site. There is an excellent specialist forensic psychiatry library based in Prentice House at Langdon. Mary Smith, the Librarian, provides excellent support in obtaining journals, articles and books on request. Trainee will have access to IT.

Section 12 Approval

Section 12 training will be available as part of Study Leave.

Supervision

Regular weekly supervision will be available for both clinical and professional matters.

Research

There is an active research and development department within the Trust which is based at Wonford House Hospital and has close links with the local Peninsula Medical School. The local Department would welcome participation in research and the development of the recovery model in the Intellectual Disability Service.

Improving Working Lives

The Devon Partnership Trust is working towards full compliance with Improving Working Lives.

 

TRAINEE TIMETABLE:

 

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

A.M

  • Ward Review
  • 3 monthly Trust Consultant meeting (all day) includes higher trainees (Medical Advisory Committee – MAC)
  • 11.00 - 13.00 Outpatient clinics and/or Home visits (Exeter/East Devon)
  • Referral Meeting - East Devon
  • Outpatient clinics and / or home visits (Exeter / East Devon
  • Academic programme at Wonford House 11.45 –13.00 (Term time)
  •  Referral Meeting - Exeter
  • Emergency assessment / admin
  • home visits (Exeter / East Devon)
  • Clinical Ward Round– Inpatient unit
  • 1st Friday of each month - Trust LD consultant business meeting followed by CPD peer group meeting for South west LD consultants (full day) includes higher trainees
  • SPA (research / teaching / Audit / Management / Special Interest)

P.M

  • CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings
  • Emergency assessment/admin
  • CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings.
  • Home visits (Exeter / East Devon)
  • Emergency assessment / Admin
  • Admin/SPA
  • 3rd Wednesday of each month- Inpatient governance meeting
  • 4th Wednesday of each month- inpatient safeguarding meeting
  • 15:00-26:00 supervision- ST
  • Ward related work
  • CPA, core group, multi-professional, 117, Hospital managers or MHT meetings (Exeter / East Devon)
  • Emergency assessments / Admin
  • SPA
  • SPA (Research / Teaching / Audit / Management /Special Interest)

ON-CALL           

The current on-call rota is 1 in 25 (TBC with medical staffing) covering general adult, older people’s mental health and intellectual disabilities and the trainee will also undertake Section 12 assessments at the request of the duty AMHP whilst on-call. Please refer to the Trust’s medical on-call policy for further details. The post-holder is responsible for maintaining their S12 approval and the Trust will fund training for this.

 

TRAINER TIMETABLE:

 

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

A.M

  • Ward Review
  • 3 monthly trust consultants meeting (all day) includes higher trainees (Medical Advisory Committee – MAC)
  • 11:00 - 13:00 Outpatient Clinics and/or Home visits (Exeter/East Devon) 9-12 CPAs x 2 Supervision (Educational/ Clinical) (Cove Ward)
  • Referral Meeting - East Devon
  • Outpatient Clinics and / or Home visits (Exeter / East Devon)
  • Academic Programme at Wonford House 11:45 - 13:00 (Term time)
  • CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings
  • Home visits (Exeter / East Devon)
  • Emergency assessment / admin
  • Clinical Ward Round – Inpatient unit
  • SPA (Research / Audit/ Teaching / Management
  • 1st Friday of each month Trust LD consultant business meeting followed by CPD peer group meeting for South west LD consultants (full day)

P.M

  • CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings
  • Emergency assessment / admin
  • CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings
  • Home visits (Exeter / East Devon)
  • Emergency assessment / Admin
  • Admin
  • 3rd Wednesday of each month - inpatient governance meeting
  • 4th Wednesday of each month- impatient safeguarding meeting
  • 15:00 - 16:00 supervision- ST
  • 16:00 - 17:00 supervision- CT doctor
  • Ward related work
  • CPA, core group, multi-professional, 117, Hospital managers or MHT meetings (Exeter/East Devon)
  • Emergency assessments / Admin
  • SPA
  • SPA (Research / Audit/ Teaching / Management
  • 13:00 - 14:00 Supervision- speciality doctor