Learning Disabilities Role Descriptions

Please note that these timetables and descriptions are indicative only and subject to change with service development and will be tailored to meet individual trainees learning needs after discussion and agreement from individual educational supervisor

Dr Simon Bonell ST4-6 in the Psychiatry of Intellectual Disability  Westbourne Unit
Dr Rohit Shankar ST4-6 in Learning Disability / Neuropsychiatry Chy Govenek Day Resource Centre
Dr David Cox Learning Disability/ Neuropsychiatry Chy Govenek Day Resource Centre
Dr Claire Smith ST4 0 6 Intellectual Disability Psychiatry

Franklyn Community Hospital

 


Post Information

POST ST4-6 in the Psychiatry of Intellectual Disability
TRAINER Dr Simon Bonell, Consultant Psychiatrist in Intellectual Disability
EMPLOYING TRUST Livewell South West
TRAINING BASE Westbourne Unit
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 Cornwall Partnership NHS Foundation Trust
BASE Chy Govenek Day Resource Centre
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

 


 Post Information

 POST

 Learning Disability/ Neuropsychiatry

 TRAINER

 Dr David Cox

 EMPLOYING TRUST

 Cornwall Partnership NHS Foundation Trust

 TRAINING BASE

 Chy Govenek Day Resource Centre

 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 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

 


 

 Post Information

POST

ST 4-6 Intellectual Disability Psychiatry

TRAINER

Dr Claire Frances Smith, Consultant Psychiatrist in Intellectual Disability

EMPLOYING TRUST

Devon Partnership NHS Trust

TRAINING BASE                       

Franklyn Community Hospital

Job Description

Facilities

The trainee will be working with the trainer who is the community consultant psychiatrist for the ID Exeter and East Devon Intensive Assessment and Treatment Team (IATT) based at 2 locations - Franklyn House (Exeter IATT) and at St. Michael’s, Honiton (East Devon IATT). The trainer also works into the Devon wide 5 bed ID Assessment and Treatment Unit, the Additional Support Unit (ASU), Whipton Hospital, Exeter when a patient from either Exeter or East Devon is admitted. There are offices available at The Rowan, Whipton Hospital. There are IT and admin facilities at all locations.

The trainee may wish to gain competencies and skills in an ID inpatient setting. This would be possible on a sessional basis. Supervision would be provided by the consultant psychiatrist on ASU who will provide feedback to the trainer.

The trainee’s primary responsibilities is to ID adults aged 18 or older living in the community or admitted to ASU in the East Devon and Exeter areas. The population estimate for the area as of 2015 (Devon County Council Mid-Year Population Estimate) was 272200 (Exeter 127300 - predominantly urban area and East Devon 144900 - predominantly rural area). The trainee will work alongside a Specialty Doctor and ID Core trainee (if in post). The teams (inpatient and community) are multidisciplinary comprising of Psychologist, ID nurses, occupational therapist, Speech and Language Therapist, Physiotherapist and with access to a range of therapeutic services and resources

The community team was created in 2015 after the DPT ID service went through a re-design. 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 who will then be expected to be more available for consultation and involvement in those patients presenting with the greatest needs. The re-design of the service was also meant to assist patient’s with ID (when appropriate especially mild to moderate ID) in accessing mainstream services with reasonable adjustments. Apart from the IATT there is an ID primary Care Liaison Service, ID Acute Liaison Team and ID Specialist Epilepsy Nurses to support and facilitate this process. The IATT is not a 24 hour service and are only available 9-5 Monday to Friday.

The ASU is for adults with ID and complex mental health problems who are presenting with significant risk to themselves and others. Similar with the community provision it is expected where possible that ID patient (in the mild-to-moderate range) who have predominant mental health needs will be supported in accessing mainstream acute psychiatric inpatient settings. The appropriate IATT are expected to liaise with the ASU or other settings when an ID patient is admitted to facilitate a seamless and quick discharge.

2. Medical Staffing

There is 1 full time consultant Psychiatrist covering the Exeter, East Devon. The ASU has adopted an in reach model. In addition a part time consultant psychiatrist currently works two days into the ASU. There is placement for 1 CT 1- 3 trainee. There is also 1 Specialty Doctor.

3. Other neighbouring Local Services

There are 3 other ID IATT’s across the county – North & Mid Devon IATT, West Devon IATT and South Devon & Torbay IATT. There are also other mainstream mental health and specialist services (General adult Psychiatry, Forensic, Older people’s mental health, CAMHS, Liaison, and Eating Disorder etc.)

4. Future service developments

As mentioned above the service went through a redesign in 2015. This was eventually followed by a review of the inpatient service provision subject to further discussions.

This placement aims to help the trainee to gain an understanding of the problems individuals with intellectual disabilities frequently experience. Trainees will be encouraged to assess patients with learning disabilities and become involved in the management of individuals with associated psychiatric disorders, autistic spectrum disorder and epilepsy. The trainee will be expected to participate in outpatient clinics, home/domiciliary/nursing/residential visits, inpatient clinical reviews when appropriate, memory clinic, IATT referral meetings, STOMP meetings etc.

This is an interesting and highly variable post, and participation in audit and research is actively encouraged/expected. This placement is suitable for trainees seeking a specialised and challenging but rewarding experience.

 

 

TIMETABLE:

TRAINEE TIMETABLE:

 

 

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

A.M

In-patient ward review – for patient/s admitted for Exeter and East. (Or if trainee elected to gain inpatient experience) · Admin/ Emergency assessments. · CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings. · DPT MAC meeting every 3 months.

OPC/Home visit

Referral Meeting - Exeter

OPC/Home visit.

Monthly - memory clinic

IATT nurse meeting - re STOMP – monthly.

In-patient clinical review meeting (including 117/CPA/Pre-discharge or discharge planning meetings) - for patients admitted from Exeter and East. (Or if trainee elected to gain inpatient experience).

Trust LD consultant business meeting followed by CPD peer group meeting for South west LD consultants (full day) includes higher trainees.

SPA -Research/audit/training.

P.M

Admin/ Emergency assessments.

CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings.

Consultants/Associate specialist/Trust grade catch up/CT 1-3 and ST 4-6. · (Ward work if trainee elected to gain inpatient experience).

Weekly Exeter/East Devon IATT referral meeting

 ST4-6 Supervision.

Weekly supervision.

 Admin/CPA.

Monthly - memory clinic.

Clinical Education Programme via Microsoft teams

Ward reviews – for patient/s admitted from Exeter and East. (Or if trainee elected to gain inpatient experience)

CPA, Core group, multi-professional, 117, Hospital managers or MHT meetings.

 Emergency assessments/Admin/ward work.

SPA -Research/audit/training.

 

Dr Claire Smith

ST 4-6 Intellectual Disability Psychiatry

Exeter and East Devon Intensive Assessment and Treatment Team (IATT) Franklyn House, Franklyn Drive