NHS Lothian

CONSULTANT PSYCHIATRIST General Adult Psychiatry

VACANCY

Consultant in General Adult Psychiatry Acute Care, Royal Hospital 40 hours per week £80,653 (GBP) to £107,170 (GBP) per annum Tenure: Permanent

This is full time (10 PA) post in General Adult Psychiatry. The previous post holder has changed responsibilities to take on the intensive care unit. The post is available from appointment.

Are you what we are looking for? Are you enthusiastic and forward thinking? If so, we look forward to your application to be part of our team.

Applicants must have full GMC registration, a licence to practice and Completion of Higher Training in General Adult Psychiatry and inclusion on the GMC Specialist Registrar or within six months of CCT or CESR (General Adult Psychiatry) at time of interview.

For further information or to apply for this exciting role, please contact the NHS Scotland International Recruitment Service:

Telephone: +44141 278 2712 Email: [email protected] Web: www.international.scot.nhs.uk

GLOSSARY

AHP Allied Health Profession CAMHS Child and Adolescent Mental Health Service CAPA Choice and Partnership Approach CBT Cognitive Behavioural Therapy CCT Certificate of Completion of Training CESR Certificate of Eligibility for Specialist Registration CPD Continuing Professional Development DCC Direct Clinical Care EEA European Economic Area FBT Family Based Treatment GIRFEC Getting it Right for Every Child GMC General Medical Council HR Human Resources HSCP Health and Social Care Partnership LD Learning Disabilities MRCPsych Member of the Royal College of Psychiatry NHS National Health Service OOH Out of Hours PA Programmed Activity PVG Protection of Vulnerable Groups RMN Registered Mental Nurse SCA Scottish Centre for Autism SPA Supporting Professional Activity UK United Kingdom WTE Whole Time Equivalent

JOB DESCRIPTION

NHS Lothian

Consultant Psychiatrist General Adult Psychiatry

Mental Health Services General adult mental health services Edinburgh Adult Mental Health Services are separated into North and South Edinburgh areas, having community mental health and acute/unscheduled care components. Consultant psychiatrists work within one of these broad functional areas. Community based consultants are currently aligned to CMHT structures mapping onto GP practice catchment populations.

Community Mental Health Service Community General Adult Psychiatry Services within the City of Edinburgh are separated into four sectors aligned to the four Integrated Joint Board (IJB) localities. These localities are aligned with all other health services and each locality comprises 2 GP clusters. Community Psychiatric Services are managed by the Edinburgh IJB, which combines funding from health and social care budgets into one structure. Each locality has a substance misuse and mental health manager who is responsible for the budget, staffing and governance of the locality. They manage all staff in the community teams except medical staff and clinical psychologists. Senior medical staff, consultants and specialty doctors who work full time in the community are managed together with based doctors. There is one Clinical Director for community, acute and rehabilitation psychiatry and there is a well attended monthly general adult psychiatry meeting encompassing all the different consultants.

Community services encompass three main components:

Community Mental Health Teams (CMHT)  Community Mental Health Teams are consultant led and managed by a nurse team leader.  The teams care for patients with the more severe mental disorders requiring longer term input, typically for over 6 months in duration.  All patients will be under the care of both a nominated consultant and a key worker who is expected to be responsible for arranging clinical reviews with  patient’s consultant when necessary (minimum once annually).  CMHTs currently operate a “Fast Track” re-entry system to the team for patients sufficiently recovered to no longer require active CMHT input.

Primary Care liaison Teams (PCLT)  Primary Care Liaison Teams provide a time-limited psychological therapy service for persons with the more common ‘mild to moderate’ mental disorders, for example moderate depression and anxiety.  Patients taken on by the teams have a nominated psychological therapist who will liaise closely with the patient’s general practitioner.  The teams deliver a range of evidenced based psychological interventions.  Consultants and other specialist medical staff are required to liaise with the PCLTs, being available for specialist assessment and advice without the necessity of re-referral from primary care services.  Referrals to the service are triaged and allocated to the most appropriate service and professional based on the information provided by the referrer. Community consultants will support the PCLTs in triage of more complex cases and maintaining appropriate clinical focus and boundaries. Referrals requiring assessment by a psychiatrist will be seen in the medical out-patient clinics

Outpatient Service  Psychiatry out-patient clinics operate in each locality. Patients attending clinics typically are those requiring specialist psychiatric assessment and treatment over a short term period, with care being transferred back to the general practitioner.  Patients with more severe, long term illnesses may also attend clinics as the sole contact with specialist mental health services.

Acute & Unscheduled Care Services The Acute and Unscheduled Care Service consists of the Mental Health Assessment Service (MHAS), the Intensive Home Treatment Team (IHTT), and Acute In-patient unit, currently the Andrew Duncan Clinic of the Royal Edinburgh Hospital.

Mental Health Assessment Service (MHAS)  MHAS is a nurse led service providing a 24/7 emergency and crisis mental health assessment service to Edinburgh and the A&E Department of the Royal Infirmary of Edinburgh (RIE).  MHAS takes direct referrals from NHS 24, GPs, the out of hours GP service (LUCS) and A&E.

 The service can also be accessed by self-referral for current patients in contact with mental health services.  MHAS is supported by medical staff at both junior and senior levels through the IHTT in hours and the out of hours team out with that.

Intensive Home Treatment Team (IHTT)  The IHTT is a multidisciplinary team providing a viable alternative to hospital  admission.  The team is based at the newly built Royal Edinburgh Building.  The various functions include o providing 24/7 cover to the City of Edinburgh o Gate keeping all admissions to the REH o Facilitating early discharge from the REH acute admission wards o See below for more details.

The In-Patient Unit  North and South Edinburgh each have one 16 bed male acute admission ward and one 16 bed female acute admission ward  This equates 64 bed allocated to patients from Edinburgh  A further 16 bed ward is allocated to patients from East and Mid-Lothian but all the beds are managed together to enable risk sharing of fluctuations in demand in the different areas.  In-patient consultants are responsible for a specific locality eg NW Edinburgh and supported by team of junior doctors (see below)  There are separate daily rapid rundowns at 0900 for the North and South Edinburgh on the wards.  Any issues that require senior management input eg delays in finding appropriate housing or support packages are escalated to a daily meeting between inpatient staff and community managers. There is a patient coordinator who facilitates the cases for escalation.  There is a 10 bed intensive care unit in the same building to support the acute wards.  The wards were all newly built in 2017.

Rehabilitation Services The rehabilitation service has both inpatient and community functions. The 3 consultants and 1 specialty doctor work with both inpatient and community teams.

Inpatient Rehabilitation  60 inpatients across 4 wards

Community Rehabilitation Team  Case load of c100 placed in supported accommodation  Work with current inpatients to plan discharge

Medical staffing configuration Community Mental Health – North Edinburgh

North West Dr Premal Shah

THIS POST Dr Rebecca Sharpe, Specialty Doctor (0.8) CT 1-3

North East Dr Linda Dickens Dr Rob Waller – starting 1/8/18 0.6 WTE Consultant Dr Chris Mathias, Specialty Doctor CT 1-3 GPST CT 1-3 (0.5)

Community Mental Health – South Edinburgh

South West / South Central Dr Deborah Cooper Dr Sharon Smith Dr Geoffrey Wolfe 0.5 WTE Dr Mark O’Connor, Specialty Doctor FY 2 CT 1-3

South East Dr Tim Wheeldon Dr Lorna Donnelly Dr David Hayward CT 1-3 GPST

Acute / unscheduled care

North Edinburgh wards / IHTT TO BE RECRUITED TO (North West) Dr Arun Chopra(North East) Dr Ihsan Kader (IHTT) Specialty Grade (0.4 IHTT) FY 2 CT1-3

South Edinburgh Wards / IHTT Dr Norman Nuttall (South East) Dr Pauline McConville (South West) Dr Rachel Brown (IHTT) Specialty Grade (0.4 IHTT) FY 2 CT 1-3

Intensive Care Unit Dr Jane Cheeseman CT3 FY2

NB: Higher trainees (Specialist Registrar/ST4-6) can be placed in any of these posts individually or as split posts (e.g. IHTT + Inpatients, Inpatients + community)

NHS Lothian and University of Edinburgh NHS Lothian also has a range of specialist services, mostly based at the Royal Edinburgh Hospital with a few at St John’s Hospital in Livingston (approx 30 mins away).  Extensive liaison psychiatry services o National and local services have 7 consultants working across the two main hospitals: the Royal Infirmary of Edinburgh and the  Regional Medium Secure Unit  Regional Young Persons in-patient Unit  Regional Adult Eating Disorders in-patient Unit (St John’s)  Community Eating Disorder Team  Perinatal Services o Mother Baby Unit (St John’s) o Community Perinatal Team  Substance Misuse Services o Includes 8 bed inpatient unit o 3 consultants working in Edinburgh  National Brain Injury Unit

NHS psychiatric services within Lothian are supported by the University Of Edinburgh Department Of Psychiatry, the department being located within the grounds of the Royal Edinburgh Hospital. This offers the opportunity to work closely with world class researchers on site and a regular special lecture series is well attended by clinical staff and academic staff. Napier University also supports services and has Scotland’s only mental health law department with a particular interest in reviewing legislation, capacity and supported decision making.

Main duties and responsibilities This is a full time position working alongside other consultant colleagues providing an in- patient general adult psychiatry service to North West Edinburgh IJB locality. The post will be based at the Royal Edinburgh Hospital.

Full secretarial support will be made available, as will office space.

The post holder will share 3.5 WTE trainee with the other consultant covering the North of Edinburgh and will be the clinical supervisor for one of the trainees.

The post holder will be allowed to work flexibly including working compressed hours providing the needs of the service are met. This will need prior agreement with the Clinical Director.

Clinical  To contribute to the provision of a community psychiatric service within the defined catchment area to individuals ages 18-64 with serious mental health problems.  To provide expertise in the assessment, diagnosis and management of adult patients with complex mental health needs.

 To contribute to and work as part of the multidisciplinary team to ensure a comprehensive approach to patient care.  To work in close liaison with the Intensive Home Treatment Team with a view to safe and timely transfer of patients between the teams when clinically appropriate.  To liaise with consultant colleagues in the inpatient unit especially with regard to care planning and discharge planning.  To hold Responsible Medical Officer status as defined within the Mental Health (Care & Treatment) (Scotland) Act 2003.  To lead on Mental Health Act work in the community and attend Mental Health Review Tribunals as required.  To use the Care Programme Approach where appropriate and as defined by CPA guidance.  To provide professional leadership to the Community Mental Health Teams including clinical supervision to the medical team working within the service.  To provide clinical support and expertise to the Primary Care Liaison Teams.  To work collaboratively with other parts of the Adult Service and with other specialist services within REAS and Edinburgh CHP.  To provide nominal cover for Consultant colleagues on annual leave and in emergencies for sick leave, adverse weather etc.

Out of Hours Commitments The post holder will take part in the consultant on call rota. This is an approximately 1 in 26 on call rota with junior trainees providing first on call and higher trainees providing second on call. The rota covers the City of Edinburgh, Midlothian and . The post holder when on call will attend the Mental Health Assessment Service at 9 AM on weekends and public holidays for handover following which they will, together with the Higher Trainee review all new admissions including patients admitted under the Mental Health Act as well as existing ones whose care may need to be reviewed, for example use of passes, as required medication etc. The on call consultant also triages calls to the Higher trainee between the hours of 3 and 8 AM (Monday – Friday) in order to ensure compliance with the Higher Trainee rota

Location  The principal base of work will be Royal Edinburgh Hospital  As part of your role, you may be required to work at any of NHS Edinburgh and the Lothian’s sites.

Provide High Quality Care to patients  Maintain GMC specialist registration and hold a licence to practice  Develop and maintain the competencies required to carry out the duties of the post  Ensure patients are involved in decisions about their care and respond to their views.

Research, Teaching and Training  Where possible to collaborate with academic and clinical colleagues to enhance NHS Edinburgh and the Lothian’s research portfolio, at all times meeting the full requirements of Research Governance.

 To provide high quality teaching to medical undergraduates and members of other health care professions as required by the Clinical Director.  To act as educational supervisor and appraiser as delegated by the clinical Director to ensure external accreditation of training posts with an appropriate allocation of SPA time for these roles.  To work with colleagues to ensure junior doctors’ hours are compliant in line with EWTD and New Deal.  To ensure that adequate systems and procedures are in place to control and monitor leave for junior medical staff and to ensure that there is appropriate cover within the clinical areas, including on-call commitments.  To participate in the recruitment of junior medical staff as and when required.  To participate in team objective setting as part of the annual job planning process.

Governance  Participate in clinical audit, incident reporting and analysis and to ensure resulting actions are implemented  Ensure clinical guidelines and protocols are adhered to by doctors in training and updated on a regular basis  Keep fully informed about best practice in the specialty areas and ensure implications for practice changes are discussed with the Clinical Director  Role model good practice for infection control to all members of the multidisciplinary team.

Strategy and Business Planning  To participate in the clinical and non-clinical objective setting process for the directorate.

Leadership and Team Working  To demonstrate excellent leadership skills with regard to individual performance, clinical teams and NHS Edinburgh and the Lothians and when participating in national or local initiatives.  To work collaboratively with all members of the team  To resolve conflict and difficult situations through negotiation and discussion, involving appropriate parties.  Adhere to NHS Edinburgh and the Lothian’s and departmental guidelines on leave including reporting absence.  Adhere to NHS Edinburgh and the Lothian values.

Indicative job plan Post: Consultant Psychiatrist Specialty: General Adult Psychiatry – In-patients (North West) Principal Place of Work: Royal Edinburgh Hospital Contract: Full time: 10 Programmed Activities Availability Supplement: 3% Out-of-hours: Yes – 1 /26 rota for full time staff. Shifts allocated on 0.6 WTE basis. Managerially responsible to Dr Andrew Watson, Clinical Director

Indicative Job plan timetable

AM PM Rapid Rundown Ward reviews/MHA work/Clinical Monday Ward reviews/MHA work/Clinical admin admin Rapid Rundown Ward reviews/MHA work/Clinical Tuesday Weekly MDT review/structured admin ward round Rapid Rundown Core SPA including programme Wednesday Ward reviews/MHA work/Clinical of consultant CPD, Special admin Lecture Series Rapid Rundown Case conference Thursday Ward reviews/MHA work/Clinical Acute / Community liaison admin meetings Rapid Rundown Ward reviews/MHA work/Clinical Friday Ward reviews/MHA work/Clinical admin admin

The Job Plan is negotiable and will be agreed between the successful applicant, and the Clinical Director. NHS Lothian policy dictates that initially all consultants are appointed with one core SPA. As a major teaching and research contributor, NHS Lothian would normally expect to allocate additional SPA time for activities to do with undergraduate education, educational supervision of trainee medical staff, research, quality improvement and other activities after appointment. These are all areas where NHS Lothian has a strong commitment and we recognise the contribution that consultants are both willing and eager to make. Precise allocation of SPA time and associated objectives will be agreed with the successful applicant and will be reviewed at annual job planning.

PERSON SPECIFICATION

NHS Lothian

Consultant Psychiatrist General Adult Psychiatry

Attributes Essential Desirable MRCPsych qualification (or Additional post-graduate equivalent) qualifications, e.g. MD/ PhD/MSc Qualifications Full Registration with the GMC and a licence to practice

Completion of Higher Training in General Adult Psychiatry and inclusion on the GMC Specialist Register or within six months of CCT or CESR (General Adult Psychiatry) at Training interview

Eligible for (or in receipt of) approval under Section 22 of the Mental Health (Care and Treatment) (Scotland) Act 2003

Experience in general adult Evidence of leading team psychiatry including meetings, CPA meetings, working in a community family meetings etc setting Experience of undertaking Mental Health act assessments in the Experience community

Experience of giving evidence at Mental Health Tribunals

Ability to take full Evidence of complex case responsibility for independent management management of patients.

Ability Ability to communicate effectively and clearly with patients and team members

Supportive of research activity Evidence of research and Academic publications in peer Achievements reviewed journals

Evidence of commitment to: Experience of designing Clinical audit / quality audits improvement Formal and informal teaching and training Evidence of training in of trainee doctors, medical clinical and / or educational Teaching students and other clinical supervision and Audit staff. Completed audit leading to Learning and continuing change in practice professional development

Evidence of commitment to: Experience of involvement in Patient-focused care service development projects

Continuous professional Clear commitment to development and life-long developing role in relation to Motivation learning community services

Effective and efficient use of resources

Ability to work in a team Ability to motivate with colleagues in own colleagues and other disciplines Leadership training Ability to organise time efficiently and effectively Good liaison and negotiation Team Working skills Reliability

Excellent communication skills

May be required to work at Circumstances any of NHS Edinburgh and of Job the Lothian’s sites

TERMS AND CONDITIONS OF SERVICE

NHS Lothian

Consultant Psychiatrist General Adult Psychiatry

Type of contract Permanent

Grade and salary Consultant: £80,653 to £107,170 per annum (GBP) New Entrants to the NHS will normally commence on the minimum point of the salary scale, (dependent on qualifications and experience). Salary is paid monthly by Bank Credit Transfer.

Hours of duty 40 hours per week (10 sessions per week)

Superannuation New entrants to NHS Lothian who are aged sixteen but under seventy five will be enrolled automatically into membership of the NHS Pension Scheme. Should you choose to "opt out" arrangements can be made to do this via: www.sppa.gov.uk.

General Provisions You will be expected to work with local managers and professional colleagues in the efficient running of services and will share with Consultant colleagues in the medical contribution to management. Subject to the provision of the Terms and Conditions, you are expected to observe the organisation’s agreed policies and procedures and to follow the standing orders and financial instruction of NHS Lothian, in particular, where you manage employees of the organisation, you will be expected to follow the local and national employment and personnel policies and procedures. You will be expected to make sure that there are adequate arrangements for hospital staff involved in the care of your patients to be able to contact you when necessary.

Removal expenses Assistance with removal and associated expenses may be awarded (up to 10% of salary).

Expenses of candidates for appointment Candidates who are requested to attend an interview will be given assistance with appropriate travelling expenses. Re-imbursement shall not normally be made to employees who withdraw their application, refuse an offer of appointment. Non NHS employees are not normally awarded travel expenses.

Tobacco policy NHS Lothian operates a No Smoking Policy in all premises and grounds.

Disclosure Scotland This post is considered to be in the category of “Regulated Work” and therefore requires a Disclosure Scotland Protection of Vulnerable Groups Scheme (PVG) Membership.

Confirmation of eligibility to work in the UK NHS Lothian has a legal obligation to ensure that it’s employees, both EEA and non EEA nationals are legally entitled to work in the United Kingdom. Before any person can commence employment within NHS Lothian they will need to provide documentation to prove that they are eligible to work in the UK. Non EEA nationals will be required to show evidence that either Entry Clearance or Leave to Remain in the UK has been granted for the work which they are applying to do. Where an individual is subject to immigration control under no circumstances will they be allowed to commence until right to work in the UK has been verified.

Rehabilitation of Offenders Act 1974 The rehabilitation of Offenders act 1974 allows people who have been convicted of certain criminal offences to regard their convictions as “spent” after the lapse of a period of years. However, due to the nature of work for which you are applying this post is exempt from the provisions of Section 4 of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions Orders 1975 and 1986). Therefore, applicants are required to disclose information about convictions which for other purposes are “spent” under the provision of the act in the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action by NHS Lothian. Any information given will be completely confidential.

Social Media policy You are required to adhere to NHS Lothian’s Social Media policy, which highlights the importance of confidentiality, professionalism and acceptable behaviours when using social media. It sets out the organisation’s expectations to safeguard staff in their use of social media.

Principle base of work You may be required to work at any of NHS Lothian’s sites as part of your role.

Notice Employment is subject to three months’ notice on either side, subject to appeal against dismissal.

Medical negligence In terms of NHS Circular 1989 (PCS) 32 dealing with Medical Negligence the Health Board indemnity will cover only Health Board responsibilities. Paragraph 63 of the General Medical Council's Good Medical Practice requires you to have adequate insurance or indemnity cover. You may wish to consider taking out additional medical indemnity e.g. with a Medical Defence Organisation to ensure that you have indemnity for the whole of your practice.