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Locum Community Consultant in Eating Disorders Psychiatry Team Locality: Specialised 10 PA’S Per Week LORVN780-SR

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Locum Community Consultant in Eating Disorders Psychiatry Team Locality: Specialised 10 PA’S Per Week LORVN780-SR Locum Community Consultant in Eating Disorders Psychiatry Team Locality: Specialised 10 PA’s per week LORVN780-SR Page 1 of 26 Avon and Wiltshire Mental Health Partnership Trust CONTENTS Page 1. Introduction to The Post Page 2. Service Details Page 3. Clinical Duties Page 4. Suggested timetable Page 5. Remuneration and Benefits Page 6. Person Specification Page 7. Geography/Attractions in Area Page 8. The Local Health Community and Local Services Page 9. The Trust Page 10. Apply for the post 1. Introduction to the Post Post and specialty: Consultant Psychiatrist Eating Disorders Community Base: Blackberry Hill Hospital, Bristol Number of programmed activities: 10 Page 2 of 26 Avon and Wiltshire Mental Health Partnership Trust Accountable professionally to: Medical Director Accountable operationally to: Medical Lead Context for the role The Trust is seeking a locum Consultant Psychiatrist for the Community STEPS Eating Disorder Service in Bristol. A locum is required to cover the period of maternity leave - February 2021 until October 2021. The post holder will join an existing experienced Consultant Psychiatrist on the inpatient eating disorder unit (EDU). Key working relationships and lines of responsibility Medical Director Dr Sarah Constantine Deputy Medical Director Dr Pete Wood Responsible Officer Dr Sarah Constantine Medical Lead Dr Salim Razak Clinical Director Sarah Jones Associate Director of Operations Mark Arruda-Bunker Operational Manager Martin Mclean Clinical Lead Rachel Heron Service Manager Paul Rice Matron Cynthia Mhungu Community Team Manager Out to advert Inpatient Ward Manager Julie Stott Consultant Psychiatrist Inpatient Dr Lauren Gavaghan Consultant Psychiatrist Community Dr Fran Burton (who cover is required for) 2. Service Details Page 3 of 26 Avon and Wiltshire Mental Health Partnership Trust The STEPs service is commissioned to treat patients who have Anorexia Nervosa, Bulimia Nervosa and OSFED. At present there are no commissioning arrangements to treat people with Binge Eating Disorder. We treat people from (or approaching) 18 years of age. We have an established CAMHS transition lead who works with patients from 17.5 years if age who are currently under the local CAMHS services. Our inpatient unit is a 10 adult bed facility for both males and females. We aim to treat people collaboratively and the majority of patients are informal, though detained patients are also treated. We are able to nasogastric tube feed on the EDU. There are four local acute trusts, where patients may be transferred for medical treatments not available on the EDU. We hold regular MARSIPAN meetings with the acute clinicians. The EDU is commissioned through NHS England, and is always full. We admit patients mostly from within the STEPs catchment. We are currently in the process of forming a Provider Collaborative Network for the South West with Devon, Cornwall and Somerset MH trusts. AWP will hold Clinical Lead responsibility for this Network. When this is up and running we will be able to admit patients more freely within the EDU network. The STEPs community team receives about 350 referrals yearly and runs a caseload of 300 or so, from the 4 CCG areas it serves: Bristol; Bath and North East Somerset (BANES); South Gloucestershire; North Somerset. This area has a total population of 1.1 million and includes high proportions of students and young adults, 4 universities and 4 FE colleges (40 000 university students in Bristol alone). The service provides clinical assessments, group and individual treatments (CBT-E and MANTRA therapies), family and carer support, GP and MH team liaison and joint working, and liaison with 4 acute medical hospitals to deliver care to critically ill patients in accordance with MARSIPAN guidance. The Community Team has a highly skilled and experienced MDT consisting of band 6 & 7 nurses (including a nurse who is duel trained), two psychologists (one of which is currently out to advert), a drama therapist, a dietitian and an occupational therapist. The team manager post is currently out to advert. The Administration resource for the service (EDU, Community and Primary Care) is currently 1 Band 4 Lead Administrator, 2 Band 3 Administrators and a Band 3 ward clerk. Consultant activity in the community team includes: carrying out new patient assessments; providing a weekly “high risk clinic” for patients potentially heading towards an EDU admission; providing “stabilisation” work over six sessions to stabilise a urgent patients physical health needs; providing acute hospital liaison for patients admitted to medical wards; doing the occasional MHA assessment; providing periods of regular outpatient contact with patients with complex needs; doing medication reviews; liaising with GPs on the medical care of community patients; supporting the MDT in the medical care and monitoring of patients on their case load; undertaking patients Page 4 of 26 Avon and Wiltshire Mental Health Partnership Trust for CBT-E or MANTRA therapy if there was sufficient time to do so. This would be agreed subject to number of sessions offered by candidate. We train and support staff to work safely and competently and recognise the specific skills, commitment, and expertise that is needed in this role. We believe that work in Specialised Services provides great challenges and opportunities to make a real difference to a diverse and often complex client group. There is an existing experienced Consultant Psychiatrist (1.0 WTE) on the Inpatient EDU, whom this post holder will work alongside. 3. Clinical Duties Develop an active leadership role in Eating Disorders services in conjunction with the team manager, consultant psychiatrist, and senior psychologist. The assessment, diagnosis, management and treatment of patients with eating disorders and non-eating disorder psychopathology, clinical leadership to safely manage medical risk, and contributing to the triaging and prioritisation of referrals. The Consultant Psychiatrist is expected to provide clinical advice and direction within the multidisciplinary team, and collaborate in systems of supervision and care management. Formulation of complex cases with medical and psychiatric needs. Risk assessment and management for the medical and psychiatric components of the disorder. The Consultant Psychiatrist is expected to take a leading role in the monitoring and treatment of physical complications of eating disorders in collaboration with other health care professionals (dieticians, physicians, paediatricians, general practitioners, etc). Implementation of guidelines e.g., MARSIPAN guidelines. The Consultant Psychiatrist will have responsibility for treating and monitoring of psychiatric aspects of eating disorders, including core psychopathology and psychiatric co-morbidities, such as depression, obsessive compulsive disorders, borderline personality disorder, and autistic spectrum disorders. Prescribing, which extends beyond the usual psychiatric formulary, and appropriate monitoring medications (according to relevant NICE guidelines). Using the Mental Health Act as appropriate in the management of eating disorders and general psychiatry. Page 5 of 26 Avon and Wiltshire Mental Health Partnership Trust Report writing for patients in education, training, work and accessing benefits. The Consultant Psychiatrist will decide on most appropriate treatment setting (in or out patient). The Consultant Psychiatrist and team will work with acute medical hospitals, mental health teams and primary care to further develop joint working and effective care pathways for patients. Emergencies in eating disorder patients usually relate to physical risk and are likely to involve the Consultant Psychiatrist to ensure the patient is referred to and receives urgent medical care. Psychiatric emergencies in the community can be managed by CMHT/Rapid Response Teams. If patients are deteriorating there is usually time to discuss in the team and plan the appropriate response. Occasionally this may require a home visit or community MHA assessment in which the Consultant Psychiatrist would be involved. True emergencies occur rarely if effective joint working with hospitals, community teams and primary care is in place. The Consultant will contribute to the provision of the appropriate training and eating disorders awareness for the health community in the region. The Consultant Psychiatrist will work in partnership with the multidisciplinary teams for the clinical management of patients in relation to the care programme approach (CPA). This will include risk assessment, the assessment of the needs of carers, and the development of services to meet the needs of patients and families for which the teams are responsible. The Consultant Psychiatrist will liaise with general hospital physicians, Adult Mental Health, GPs and other agencies involved in the lives of our patients, including higher education, employers, housing and social care organisations. The Consultant will contribute to joint working with CAMHS teams to promote effective clinical liaison and care transitions. The Consultant Psychiatrist will support and develop Community ED services for patients and their carers in the catchment area. The Consultant Psychiatrist will contribute actively to a culture of continuous improvement and innovation across the service. The Consultant Psychiatrist will be a champion for the service and work alongside senior colleagues to ensure appropriate governance and quality assurance. The Consultant
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