JOB DESCRIPTION

TITLE: CORE (CT1-3) TRAINEE IN GENERAL (COMMUNITY) PSYCHIATRY

DIRECTORATE: East Sussex (Working Age Adult Psychiatry)

REPORTS TO: Dr Stavros Bekas, Consultant Psychiatrist

LOCATION: High Weald, Lewes, Havens Assessment and Treatment Service (ATS)

HOURS OF WORK: 09:00-17:00, Monday to Friday (Whole Time)

ON CALL RESPONSIBILITY: Yes, Resident Full Shift pattern (see appendix 2)

DBS DISCLOSURE REQUIRED: Yes

INTRODUCTION TO THE TRUST

Sussex Partnership NHS Foundation Trust consists of some 5,000 passionate and dedicated clinicians and support staff, working hand in hand with partners in the community to care for and support vulnerable people. Together, we provide mental health, learning disability, substance misuse and prison healthcare throughout Sussex, along with a range of specialist services across the South East of England and beyond. We are one of the largest mental health trusts in the country. As a teaching trust of Brighton and Sussex Medical School we have a national reputation for leading-edge research. During 2013-2014 our research activity generated £1.6m million income. We’re now one of the most influential, effective and well-respected mental health trusts in the country and, as a teaching trust of Brighton and Sussex Medical School; we’re developing a national reputation for leading-edge research. We started as Sussex Partnership NHS Trust in April 2006 and became a Foundation Trust with teaching status in August 2008.

JOB OUTLINE

Description of the post:

This is a 6 month placement, as part of the Health Education Kent Surrey Sussex (HEKSS) approved and governed Psychiatric Training Scheme. This is an approved training post under the RCPsych and counts towards the achievement of the relevant competencies required to gain the Membership of the RCPsych and the minimum 6 year training required to achieve a Certificate of Completion of Training (CCT) in a psychiatric speciality.

This is an exciting opportunity to join a busy multidisciplinary team working with the full gamut of mental health problems, primarily in the community. You will join a team of Community Psychiatric nurses, Occupational Therapists, Psychologists, Support Workers, Administration Staff and Doctors. Our catchment area is most of the Wealden District of East Sussex County, a mixture of rural and semi-rural, small communities totalling about 155,000 inhabitants. Wealden District has some of the most beautiful countryside in the country; covers the uplands of the High Weald, BETTER BY EXPERIENCE

1 the eastern part of the South Downs, the Vale of Sussex, and the Rivers Ouse, Cuckmere and Uck. The largest towns are Crowborough (20,000), Uckfield (20,000), Hailsham (20,000), Heathfield (12,000).

The majority of patients suffer chronic, stable psychosis, a wide variety of affective and neurotic disorders and personality disorder. There is fast turnover and heavy referral rate, and multidisciplinary/multiagency work and liaison with Primary Care is emphasised. Although crisis resolution and emergency work is not core component of the service, there is frequent interface with the acute parts of the pathway, and the occasional emergency intervention and Mental Health Act work does occur when it is in the interests of service users.

The base:

Millwood, Uckfield Community Hospital, Framfield Rd, Uckfield, East Sussex, TN22 5AW.

Although Uckfield is well connected with all the other residential centres of the County, having access to a car may offer some advantages (without being mandatory). As the trainee will often work with other members of the team, joining their car business journeys is also an option.

Clinical Responsibilities:

The post is designed to allow the trainee to follow the patient through their whole care pathway, from Primary Care referral, first assessment, follow up in the community, admission in Mental Health Unit or care under Crisis Team to the point of transfer back to Primary Care, and have opportunities to liaise with or shadow non-NHS agency involvement, e.g. Social Services, Third Sector and Accommodation Providers. As the trainee gains and exhibits competence there will be increased opportunities to assess and treat patients independently in an outpatient setting, always with close case supervision and support by the Supervisor and the MDT.

It is anticipated that the trainee will have opportunities to visit other related services, including other community bases, GP practices, psychiatric inpatient units and the local Acute Hospital, so that they keep in contact with their peer group and have as broad experience as possible.

Supervision:

The trainee will always have direct access to an appropriate senior colleague for advice in any clinical situation. In most situations between 9:00-17:00 this will be the Consultant of the team, who will also act as the clinical supervisor for training and quality assurance purposes and will offer on average one hour per week direct face to face clinical supervision.

On occasion this senior person may be a non-doctor competent to supervise and advise on the relevant activities. When working out of hours (on-call), there is always an arrangement where an inpatient MDT, Liaison Service, Senior Nurse Practitioner and more experienced trainees and/or a Consultant will be available for this supervision and advice, either on the phone or on-site.

Teaching and Competences expected to be achieved:

There is a formal educational program organised by the Trust most Wednesday afternoons at the Department of Psychiatry of the Eastbourne District General Hospital. The trainee is expected to gain in depth knowledge and experience in the assessment treatment and management of patients in the community, acquire the necessary competencies as specified in the RCPsych curriculum CT1-3, attend the local MRCPych course and sit the relevant exams. Psychotherapy Requirements are (if not completed in a previous rotation), compulsory attendance at Balint Group,

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2 one short case CBT relevant to level of training and a long case of psychodynamic psychotherapy relevant to level of training.

Work Based Assessments expected to be achieved:

It is expected that the following assessments will take place:  1x Mini-PAT: This is a Peer Assessment Tool and involves feedback from a range of Healthcare Professionals  2x Mini-ACE: This involves the evaluation of an observed clinical encounter with immediate feedback from the observer  2x CBD: Structured case-based discussions to allow decision-making and reasoning regarding the management of a case in detail  1x Assessment of teaching

Clinical governance and research opportunities:

There is opportunity to attend and participate in local clinical governance, audit and research meetings and involve in Quality Improvement or Audit projects, if allowed by the short time of the placement. The supervisor is the Trust Lead Tutor for Foundation Programme doctors attached to the Trust and has a special interest in Clinical and Medical Education, and any suggestions for a project of leadership, research or governance in an educational topic will be encouraged and supported.

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3 APPENDIX 1 Provisional Timetable:

The following was designed to maximise the presence of the Consultant on site for direct training and supervision, it can though be flexible and negotiated according to training and service needs on the particular week and the needs of the trainee. When ‘outpatient clinic’ is stated, it could also be visits to other services, or home visits or authorised tasters and attachments to other associated services etc.

MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

Millwood Woodside Woodside Millwood Millwood (Uckfield) (Uckfield) (Hellingly) (Hellingly) (Uckfield)

Outpatient Outpatient Outpatient MDT MEETING Outpatient Clinic clinic Clinic Clinic

SUPERVISION

Outpatient Outpatient Clinic Academic Outpatient Clinical clinic Meeting Clinic Governance and Eastbourne Or Acute Unit Research or teaching preparation

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4 APPENDIX 2 Full Shift Requirements:

Table A – Working Patterns Working Pattern Natural Breaks Minimum Rest Minimum Timing of (at least a 30 during the whole continuous rest continuous rest minute continuous of each duty guide break after period approximately 4 hours of continuous duty)

Full Shift Yes Natural break At least a 30 At least a 30 minute minutes continuous break (Brighton / Continuous break after approximately Crawley, Mid after approximately 4 hours of Sussex / East 4 hours continuous continuous duty Sussex and duty Coastal West Sussex)

Table B – Hours/Rest requirements under the New Deal Type of Day Hours of Total hours Working Days Work/Duty Full Shift Rota Normal Working 09:00 to 17:00 8 hours Monday to Friday Day (Brighton / Crawley, Mid Extended Days 09:00 to 21:15 12 hours 15 mins Monday to Sussex / East Thursday – 4 days Sussex and Coastal West Friday to Sunday – Sussex) 3 days

Nights 21:00 to 09:00 12 hours Monday to Thursday – 4 days

Friday to Sunday – 3 days

Zero Hour Days 0 0 Friday following Mon – Thu nights

Monday following Fri – Sun nights

Table C – Maximum number of contracted hours/actual hours and controls on duty period Maximum Duty Maximum Maximum Minimum Minimum hours per week actual weekly continuous duty continuous rest continuous off hours per week * between duty duty * * periods* Full Shift Rota 56 hours New Deal – 56 New Deal – 14 New Deal – 8 New Deal – 48 hours hours hours hours + 62 (Brighton / hours in 28 Crawley, Mid days Sussex / East EWTD – 48 EWTD – 13 EWTD – 11 EWTD – 24 Sussex and hours hours hours hours in 7 days Coastal West or 48 hours in Sussex) 14 days

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