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

INTRODUCTION

The Learning Disability Health and Social Care Partnership has responsibility for all health and social care services for people aged 18 and above. Children's services are now part of a Children's Directorate. All services for people with a learning disability in Devon are subject to co-ordination and scrutiny by the Devon Learning Disability Partnership Board - a multi-agency forum which fully includes service users and carers. The Chief Executive of Devon County Council chairs this Board. The Partnership Board's task is to coordinate the implementation of the White Paper "Valuing People". This has four key principles:

  • Choice
  • Independence
  • Inclusion
  • Rights

The Health and Social Care Partnership is organized around three localities:

  • Exeter and East Devon
  • North and Mid Devon
  • South and West Devon

The Intellectual Disability service went through significant changes in 2015 with a service restructuring called “New Direction”, This came into operation in April 2015. The service now includes:

  • In patient Services - The Additional Support Unit (ASU) in Exeter provides inpatient care for people with learning disability who have psychiatric needs that cannot be met in mainstream adult mental health services.
  • Primary Care Liaison Nurses (PCLN) - who work with GP practices to ensure good access to Primary Care services for people with an intellectual disability.
  • Acute Care Liaison Nurses - who work within the District General Hospitals to ensure the hospitals make reasonable adjustments to meet the needs of people with learning disability.
  • Intensive Assessment and Treatment Teams (IATT) - these are multi-disciplinary teams comprising of the following professions: nursing, physiotherapy, occupational therapy, speech and language therapy, consultant psychiatry and psychology. These teams focus on people who are severely distressed.
  • Continuing Health Care Nurses (CHC) - these nurses are in complex care teams led by social care, who assess, monitor and review when continuing health care funding may be required.
KEY PEOPLE

Delia Wainwright              General Manager
Dr Victor Olotu                 Lead Consultant Psychiatrist
Dr Jane Suzanne              Lead Consultant Psychologist
Sarah Brady                     Lead Occupational Therapist
Heather Bewick                Lead Physiotherapist
Stephen Carter                 Senior Nurse Manager - ASU, Primary Care, DGH
Martin Ayres                     Senior Nurse Manager – IATT

INTENSIVE ASSESSMENT AND TREATMENT TEAM (IATT)

The purpose of these teams is to provide intensive, assessment and treatment to complex cases. Supporting and consulting to other teams in the Devon Health and Social Care Partnership for people with Intellectual Disabilities and the systems that surround them, for example family members and carers. It also includes people with Profound Intellectual and Multiple Disabilities.

The IATT will adopt an Ecological model of intervention. This recognises that a range of factors can be identified as contributing to and maintaining a situation that are potentially a cause for concern. It is therefore possible to identify individual responsibilities and gaps in the implementation of the care plan. This model is sensitive to the importance of initial and on-going rapport building with the person and their support networks and accepts that intervention may be a circular experience rather than a linear one. This enables a flexible application of the pathway to reflect the skills of the group or the person.

Purpose of the IATTs

  • The role of IATTs across Devon is to support people, services and their family in their delivery of health related interventions for people with a learning disability who are experiencing or causing in others high levels of distress.
  • To contribute to the education of support networks in order to increase the choices (Department of Health – DH, 2001)1available to people with a learning disability using a multi-disciplinary approach. Our goals include preventing out of county placement, placement breakdown, inpatient admissions or, if unavoidable, reductions in the length of admission.
  • People who are unavoidably placed in hospital out of county locally, will for the first 28 days remain the responsibility of the IATT team who will co-ordinate through core group working their discharge planning and return. This would include visiting the placement within 7 working days and reviewing the care plans. After the initial 28 days the Specialist Learning Disability Placement Team will lead on coordination and review.
  • IATT will always work closely with the Specialist Learning Disability Placement Team offering clinical involvement appropriate for the individual, joint working to meet requirements of Care Programme Approach and contribute reports to support joint funding applications for example S.117. Please refer to DPT Recovery & Wellbeing Coordination Policy C05 for guidance.
  • IATT are not a crisis intervention service, mental health, physical or social care crisis should be dealt with through universal services. However IATT will support and advise those services offering guidance where appropriate (please also refer to section describing consultation).

Core Tasks:

  • Safe Guarding Adults Responsible Manager
  • Implementation of Devon County Council Safe Guarding Adults Pathway
  • Implementation of the Mental Capacity Act (MCA 2005)2 and Deprivation of liberty Safeguards (DoLS)3
  • Care Programme Approach Co-ordination and/or managing core meetings
  • Health Action Planning
  • Supporting Inpatient Care and repatriation
  • Delivery and facilitation of Positive Behaviour Support Plans or similar tool dependent on individual needs and preferences.
  • Provide Multi-disciplinary training where necessary and proportionate to referral.

Process to deliver core tasks:

  • Multidisciplinary Assessment and formulation of the individual health needs
  • Monitoring and evaluation of health needs and treatment plans
  • Multidisciplinary Treatment of health needs
  • Liaising with the care management, Specialist Out of County Team and commissioners where necessary.
  • Facilitate colleagues in mainstream services to meet the needs of the learning disabled population irrespective of complexity

Aims & Objectives:

  • The IATT Teams aim to deliver individualized Assessment, formulation and intervention in the Community for whose distress or disability places them and/or others at risk of harm, exclusion or restrictive practice. These include:
  • To enable the person to remain at the centre of their care
  • To prevent unnecessary and avoidable admission to acute inpatient settings either in Devon or Out of County Placements
  • To facilitate joint working across the DPT Tiered Model of LD and Mainstream Services
  • To provide additional consultation and support to Mainstream services to enable holistic and effective Healthcare for people with complex needs
  • To avoid inappropriate placement breakdown
  • To create Positive Behavioural Support Plans or similar to support a person to maintain their home
  • To minimize to use of restrictive and end aversive practice
  • To Facilitate Partnership working across all agencies and representatives involved
  • To co-ordinate the Care Programme Approach and/or Core meetings which includes discharge from inpatient settings as per DPT policy C05.
  • To support evidenced based commissioning
  • To contribute to core commissioning processes and pathways for the individual
  • Provide specialist assessment and data to commissioning teams

The IATTs are dynamic services that will adapt and develop pathways in response to recommendations made by National Institution of Clinical excellence (NICE), DPT Communities of Learning and Best Practice Support Groups. At this time the Communities of Learning for Learning Disability services are:

  • Dementia
  • Autistic Spectrum Disorder
  • Trauma
  • PMLD
  • Total Communication

Interdependencies with other services

  • The service will work closely with others to improve outcomes, including:
  • All areas of secondary care provision
  • Intensive Assessment & Treatment Teams.
  • Specialist Out of County Team
  • Care Management Teams
  • Primary Care Liaison Nurses & Primary Care Services
  • Care providers.
  • Support
  • Screening Services
  • Health promotion services

Professional relationships
Dr Victor Olotu                  LD Consultants working in the Additional Support Unit (Only 5 bedded LD inpatient facilities in Devon). He also works with the IATT Exeter and East Devon as part of the MDT. He is the Associate Clinical Director for the service and is the trainer to a CT1-3 based at Franklyn House, Exeter. He has specialist interest in epilepsy management, medical education and Forensic issues. He works with a Specialty Doctor as well

Dr Caroline Smith             Locum consultant psychiatrist working with the North and Mid Devon IATT. She has experience in the management of Autism and Dementia Care in individuals with LD

Dr Stephen Chan              Consultant Psychiatrist working with the West Devon IATT. Interest in MCA/BI

Dr Panos Bitsios                Recently appointed Consultant Psychiatrist working with the South Devon & Torbay IATT. He has experience in general adult psychiatry, academia, and psychopharmacology

THE POST

The post-holder will work closely with the Consultant Psychiatrist Cover the |Exeter & East Devon area as well as the inpatient unit (Additional Support Unit, Exeter). The consultant is supported by a CT3 trainee and one full time specialty doctor. The post-holder’s primary responsibilities will be adults with Intellectual Disabilities, aged 18 or older living in the East Devon and Exeter areas. The population for the area as of 2015 (Devon County Council Mid-Year Population Estimate) is 272200 with the breakdown as follows:

  • Exeter 127300 (predominantly urban area)
  • East Devon 144900 (predominantly rural area)

The post is a 10 Pas. The Team was created from the amalgamation of 2 previous teams after the service went through a re-organisation. The consultant is embedded within the team structure, allowing for an approach best described under the “new ways of working” model, where the routine follow up and monitoring will no longer be done by the consultant as well as the higher specialty trainee (ST4 – 6) who will then be expected to be more available for consultation and involvement in those patients presenting with the greatest needs.

There is inpatient responsibility associated with this post. The inpatient unit is a 5-bedded specialist Assessment and Treatment unit called the Additional Support Unit based in Exeter (ASU) for adults with Intellectual Disabilities and complex mental health problems. There is the expectation that individuals with mild-to-moderate intellectual disability and who have predominant mental health needs and require psychiatric hospital admission where they can are cared for in local acute psychiatric units. The respective local IATT team liaises closely with the in-patient team to facilitate a quick discharge. The provision of the assessment and treatment unit (ASU) is currently under a trust review

The re-organisation of the service was meant to also assist patients to access mainstream services, where realistic adjustments can be made. This will be the role of the liaison nurses, but will further reduce the need for long term follow up of conditions such as epilepsy within the LD services.

The trainee will be based with the consultant at Franklyn House in Exeter along with a full-time PA, CT3 doctor and the specialty doctor. This is where the Exeter arm on the IATT is based. The East Devon arm is based at St. Michael’s Honiton.

Altogether this is an innovative trust, which welcomes trainees and promotes a climate of co-operation and

Clinical and administrative duties of post holder

  • Providing a good standard of practice and care by participating in the psychiatric assessments, risk assessments, reviews and providing brief interventions including prescribing appropriate pharmacological and psychosocial treatments of new referrals and to perform medical reviews as and when required for patients with Learning Disability.
  • To regularly review or follow-up patient known to the team as and when care planned.
  • To attend outpatient clinics for relevant areas and for patient unable to access outpatient clinics to carry out home and/or domiciliary visits.
  • To attend 117 aftercare/CPA reviews as and when necessary.
  • To undertake emergency/urgent assessments on behalf of the Consultant.
  • To liaise and work closely with the Intensive Assessment and Treatment Team across the 2 areas (Exeter and East Devon) and regularly be involved in referral meetings, core group meetings, best practice support meetings, service development meetings, business meetings, etc.
  • To attend ward for clinical review meetings, CPA’s, Discharging planning meetings, MHT, Hospital Managers reviews, CTR’s
  • To work with patients, professional carers and families in providing support and also education on specific issues.
  • To complete internal and appropriate external referrals and to liaise with mental health professionals and other agencies regarding continuity of care in a timely manner.
  • To maintain good medical practice by maintain and using systems to update knowledge and its application to any aspect of your professional practice
  • To participate in clinical audit activities and other Trust arrangements for Clinical Governance.
  • To participate in Mental Health Act Assessments (if Section 12 approved) if necessary and liaison work with GPs and other professional and non-statutory bodies under the direction of the responsible consultant.
  • To occasionally act up for the Consultant’s annual leave under nominal Consultant cover
  • To appropriately assume, delegate and devolve responsibility as directed by Consultant
  • To contribute when appropriate to education and supervision for junior psychiatry trainees, when they are attached to the service
  • Administrative duties will involve maintaining timely, legible, contemporaneous and useful clinical records for all patients in whose care you are involved as well as ensure that reports, evidence and documents you have responsibility for are complete, honest and accurate.
  • Ensure that your health and the health of others do not put patients at risk by always obtaining advice and treatment for mental and physical health problems. You must comply with the Trust’s occupational health policy.
  • To participate in educational commitments as advised by the post graduate deanery.
  • All of the above duties will be under the direction of the consultant/clinical supervisor/trainer..
  • Assist the Directorate in the planning and development of services and clinical engagement in commissioning and business processes is strongly encouraged.

Secretarial Support and Office

The post-holder will have access to office/desk space, access to appropriate Medical Secretary Support, and office equipment including IT, fax, photocopying etc. The Trust operates a paperless electronic recording system named CareNotes, which can be accessed remotely via approved Trust Laptops. This greatly facilitates flexible working and home visits.

Supporting Professional Activities

The trainee will be expected to participate in SPA related activities

Education & Training

Teaching is seen as an important part of the service. The post-holder will be encouraged to:

  • Seek formal approval to teach, such as membership of the Institute of Learning and Teaching.
  • Actively support and take part in local programmes of case conferences, journal clubs, audit and other clinical governance related activity with an educational content, designed to serve the needs of junior doctors in training and the CPD needs of doctors in non-training posts as well as non-medical staffing
  • The new post-holder will be encouraged to teach Postgraduate GP/Specialty Trainees and Medical Students as required. There is ample space to expand the teaching role within the Peninsula Medical School.

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. For details: www.agwsha.nhs.uk

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