NHS

CONSULTANT PSYCHIATRIST Old Age Psychiatry VACANCY

Consultant in Old Age Psychiatry Post 1: East and Mid Ross-Shire/ Post 2: Central Sector 40 hours per week £80,653 (GBP) to £107,170 (GBP) per annum Tenure: Permanent

We are currently seeking two Consultants in Older Age Psychiatry to join the team within NHS Highland.

The posts will provide an opportunity for motivated individuals who enjoy teamwork, to be part of a modern service for Older Adult Psychiatry. The postholder will have the opportunity to provide leadership to strong, cohesive inpatient and community teams.

NHS Highland is committed to providing high quality care and a dementia ICP has been developed. In addition, memory clinics have been piloted in Highland and are being rolled out to the locality settings.

Postholders will be encouraged to develop a special interest in keeping with the needs of the service, and be encouraged to participate in CPD and peer supervision. Consultant peer groups meet regularly and there are regular educational events organised as part of our in-house programme.

Applicants must have full GMC registration, a licence to practise and be eligible for inclusion in the GMC Specialist Register. Those trained in the UK should have evidence of higher specialist training leading to a CCT in Old Age Psychiatry or eligibility for specialist registration (CESR) or be within 6 months of confirmed entry from the date of interview.

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

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

GLOSSARY

AHP Allied Health Profession BPSD Behavioural and Psychological Symptoms of Dementia 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 CPN Community Psychiatric Nurse 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 IP Inpatient(s) IPCU Intensive Psychiatric Care Unit LD Learning Disabilities MRCPsych Member of the Royal College of Psychiatry NHS OOH Out of Hours OP Outpatient(s) 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 Highland

Consultant Psychiatrist Old Age Psychiatry

Mental health services in Highland provide a range of health services over some 10,000 square miles ranging from in the North, in the south, to Skye in the west and Strathspey in the east.

New Craigs Site The Mental Health service in Highland employs 19 wte Consultant staff supported by Associate Specialists, Staff Grades, Clinical Assistants, Specialist Registrars, Psychiatric trainees, GP trainees and FY2 doctors. There are 216 registered nursing staff, 134 nursing assistants, a range of Allied Health Professionals and a team of Clinical Psychologists. There is emphasis on supporting multidisciplinary working and staff governance approaches to corporate decision making are well established.

The service is based at New Craigs Hospital in . This has been a substantial PFI project for the redevelopment of Psychiatric and Learning Disability inpatient facilities across Highland and originally opened in July 2000. The current inpatient provision on the New Craigs site is as follows:  43 general adult acute psychiatric beds  10 IPCU beds  5 addictions/ detox/ dual diagnosis beds  16 dementia assessment beds  12 continuing care dementia beds  12 functional elderly beds  9 rehabilitation beds in a community setting  8 rehabilitation beds in a secure setting  6 learning disability assessment and treatment beds

Specific Older Adult in-patient facilities Clava Ward is the Acute Dementia Assessment ward in the hospital. There is soon to be a re-organisation, whereby acute dementia assessment beds will increase from 14 to 24 and the ward will be within the main building. Ward staff participate in regular team/staff support meetings, and the post-holder will be invited to join these as appropriate.

In addition, Ruthven Ward has 12 beds for older adult patients with functional illnesses.

Wider service organisation and additional community facilities Psychotherapy Department This department currently provides the Eating Disorder Service and Personality Disorder Service for Highland and provides DBT, CBT and IPT. It is based at Greenfields House on the New Craigs campus.

Personality Disorder Service Along with Consultant input, this service is includes a Dialectical Behavioural Therapy team which assesses referrals of patients with borderline personality disorder with a view to inclusion in a DBT treatment programme. In addition, it has recently opened a Personality Disorder Service Day Hospital, which operates one day a week providing practical help and training to patients.

The treatment of Personality Disorder in NHS Highland follows the phased approach to treatment, and the majority of all in-patient and out-patient clinical staff have now been trained in The Decider, which is a life skills based stabilisation programme of therapy.

Clinical Psychology The aim of the department is to improve the mental and physical health of the population of the Highlands through efficient delivery of psychology services and through the dissemination for psychological knowledge. The clinical psychology department is a central organisational structure with responsibility for delivering all applications of psychological principles to health care (clinical, health and counselling psychology) as per the MATRIX. The service also provides support, consultancy and training to other professional colleagues who are engaged in psychological therapy or who use psychological principles in their work. The department is a Training Department for the East and South of Scotland Doctoral course in Clinical Psychology.

Liaison Psychiatry Services At Hospital there is a well-established liaison psychiatry team. The team provides specialist psycho-social assessment for all patients referred from the wards at , and those seen in the A & E Department.

Mental Health Assessment Team This team of senior psychiatric nurses is based in New Craigs Hospital but has a Highland-wide remit for the assessment, in liaison with the on call doctor, of unplanned referrals to the hospital and decision making regarding urgent treatment.

The post-holder will have the opportunity to liaise as appropriate with the team regarding patient care plans.

Braeside Crisis Service To complement other community services, a multidisciplinary crisis service (Braeside), provides a range of psychological therapies for patients from Inverness and surrounding areas. This has been shown to cope with complex cases which would otherwise be admitted to hospital.

Rehabilitation Service The Highland Mental Health Rehabilitation Service has recently been redesigned and now includes an 8 bed secure rehabilitation unit (Bruar) and a 9 bed community based rehabilitation unit (Aonach Mor). A full multidisciplinary team (including input from nursing, OT, social work, psychology, psychiatry and pharmacy) supports both units.

Dual Diagnosis/Alcohol and Substance Misuse The addiction services are structured to include a specialist centre, Osprey House (see below) which is situated near the Raigmore Hospital campus and there are well established community teams. A Dual Diagnosis post has been developed for inpatients at New Craigs.

Osprey House In addition to locality based provision, there is a purpose-build centre, Osprey House, near Raigmore Hospital. There are four CPNs for Addictions in Inverness, along with one nurse who acts as the dual diagnosis worker for Highland-wide.

There is also a nurse who works Highland-wide, but mainly in Inverness, for the Drug Treatment and Testing Order scheme, this being a joint Health/Social Work initiative.

Forensic Psychiatry There are currently two part time Forensic Psychiatrists who are responsible for the care and treatment of patients with significant forensic issues: undertaking regular visits to the prison and co-ordinating the management of forensic cases through liaison with the courts, The State Hospital and the criminal justice system.

Learning Disability Services – The Orchard Services for children and adolescents with Learning Disabilities are provided in a community setting managed by the Social Services Department of Highland Council with NHS input. NHS Highland collaborated in the establishment of The Orchard in Inverness, a residential and respite unit and provides trained nurses for the facility.

Local demographics and services Overview The population in the Highlands is dispersed and at only 7 people per square kilometre, is almost the lowest population density in the European Union. Apart from the city of Inverness and towns such as Fort William, Nairn, Thurso and Wick, most people live in small rural communities. The region has variations in infrastructure in terms of public services, transport, employment, amenity and retail. Although much of the area has a buoyant economy, there is evidence of rural deprivation and pockets of urban deprivation can be found within Inverness and some of the larger towns.

Aging Population The percentage of the population aged 65 plus is likely to increase very considerably over the next few years. This has implications not only for Learning Disabilities Services, Glenview Unit and the local hospitals, but also for psychiatric inpatient and community provision. The organisation is very aware of these impending pressures, and the Older Adult Psychiatric Service is undergoing re-design in order that it might meet these challenges.

Suicide and Alcohol/Drug Use The Highland suicide rate has been shown to be the highest in Scotland and this has been the subject of extensive research. A number of “Choose Life” initiatives have been taken forward in Highland and there is an extensive training programme for staff and the general community around suicide prevention. Alcohol use in the

region is significant and impacts on the demand for services. There is an increased use of drugs by younger people including those under sixteen. There are well developed addiction services and a liaison psychiatry team to focus on this vulnerable group.

Out of Area Patients The population of the Highlands increases during the tourist season with a consequential impact on drug/alcohol and psychiatric services. As with permanent residents, a primary requirement is prompt access to services when required. There is a designated Consultant who holds responsibility for out of area patients.

JOB DESCRIPTION

Post 1: East & Mid Ross/Sutherland

The post holder provides outpatient and inpatient care for the over 65 population of Mid Ross (Dingwall, Strathpeffer), East Ross (Alness, Invergordon, Tain) and Sutherland. In keeping with the practice of the other Older Adult teams in Highland, the post holder will manage both organic and functional conditions, and may be asked from time to time to provide clinical care to patients younger than 65 years with progressive cognitive decline.

The Older Adult psychiatric services in Highland are currently provided by five Consultant teams in North, South, East (this post), West and Central sectors. The Older Adult service continues to develop taking into account the requirements of the Scottish Mental Health Delivery Plan to provide high quality services within local communities and early intervention for dementia in terms of diagnosis and treatment.

The base hospital is New Craigs in Inverness, a modern purpose-built hospital which provides a high standard of care and accommodation for patients in Highland who require psychiatric inpatient services. At present, Older Adult patients with functional illness are admitted to Ruthven ward in the main hospital.

Patients with dementia may be admitted to Strathy ward in the (Bonar Bridge) or Clava Ward in the Glenview unit (on the New Craigs Hospital site in Inverness).

Torvean ward on the New Craigs Hospital site provides care for longer stay patients with dementia.

The hospital wards have close working links with the CMHTs, and videolink facilities are used to strengthen communication and discussions about patient care. The need for increased inpatient beds for the older adult population has been recognised and we are currently in the implementation phase of a hospital redesign that will deliver increased capacity.

Duties and Responsibilities of the Post This post includes the provision of community psychiatric care to the designated sector of East & Mid Ross / Sutherland with outpatient clinics, home and nursing home or other care facility visits as appropriate, liaison with GPs, team working with colleagues from the CMHTs and the hospital sector team, and liaison-consultation work in general / community hospitals. The postholder will be expected to lead in the inpatient care for sector patients admitted to New Craigs Hospital, and lead the care of patients admitted to Stathy ward in the Migdale Hospital.

The postholder will be required to undergo training to become an Approved Medical Practitioner under the Mental Health (Scotland) Act 2003 when eligible to do so. AMP work will be incorporated into the role of the postholder. The post includes work under the Adults with Incapacity (Scotland) Act 2000 and participation in CPA.

On call frequency is approximately 1 in 19. On call is non-residential. Consultants have to stay within 30 minutes travel time of the hospital.

Further professional and career development will be supported. Peer group support will be encouraged in New Craigs, and the post holder will be expected to participate in the weekly internal teaching session which covers all specialities. There is also ample opportunity to learn more about managerial and service development issues, in discussion with colleagues and at the Consultant’s Meeting and Mental Health Advisory Group Meeting, each of which are held monthly.

Regular audit of clinical effectiveness in relation to working protocols or treatments will be encouraged. Responsibilities for carrying out teaching include tuition to medical students, departmental trainees and other staff as appropriate. The postholder will be subject to annual appraisal and participation in revalidation. Full admin/secretarial support is offered.

JOB DESCRIPTION

Post 2: Central Sector

The role includes the provision of Older Adult Psychiatry services to the population of parts of Inverness, Mid Ross and Beauly. The post-holder will work with well established teams, both within the hospital setting and the community.

The post involves participation in multi-disciplinary team meetings, out-patient work and management of sector patients admitted to New Craigs Hospital. Included in the job description is one session of Liaison. This is a service that Psychiatry of Old Age in conjunction with the Health Board is keen to develop further. The post-holder will be based at New Craigs and will join an enthusiastic team of consultant colleagues and multi-disciplinary staff.

Duties and Responsibilities of the Post Duties include the provision of consultant psychiatric services to the designated sector, including psychiatric assessment and overview of the development of treatment plans in liaison with GPs and multi-disciplinary colleagues. It is anticipated that the Consultant will work to a modernised consultative role within the team retaining a caseload of more complex cases and providing supervision to junior doctors within the team.

A special interest appropriate to the needs of the population would be supported and can be discussed at interview.

The post-holder will be expected to liaise with local authority, general hospital colleagues, hospital and community staff and other agencies, including voluntary bodies, as appropriate to the role.

The post-holder will be encouraged to play a role in the planning and development of future services within the sector. The post-holder will be invited to join in regular management meetings, including monthly Mental Health Clinical Standards Group, monthly formal Consultant meetings, and yearly Consultant away-day. Involvement of clinicians in service provision is encouraged by our mental health service manager, via the Acute In-Patients’ Forum (In-Patient Services), and Mental Health Operational Groups. Consultants are represented at both meetings by the Clinical Director for Mental Health. Projects from the Scottish Mental Health Delivery Plan have included the development of generic and condition-specific ICPs, and a focus on preventing unnecessary admission to hospital by development of appropriate community resources and modern treatment options. The Personality Disorder Service is a relatively recent successful project.

Duties include the training of junior medical staff and medical students from Aberdeen University when attached to the team. There is also the opportunity to participate in weekly Case Conference/Journal Club meetings to which the post- holder will be invited to present cases from time to time.

A Mental Health Research Strategy is currently being developed in Highland and we have strong links with Aberdeen University, Stirling University and the University of the Highlands and Islands. Research educational meetings occur on a regular basis.

The Clinical Governance Committee participates in the Acute In-Patients Forum on a bi-monthly basis and reviews appropriate matters such audit outcomes, ICP development, etc.

Along with other consultants, the post-holder will provide specialist reports as required, e.g. to the Court, local authority and other agencies, including working as an Approved Medical Practitioner under the Mental Health (Scotland) (Care and Treatment) Act 2003 and the Adults with Incapacity (Scotland) 2000.

On call frequency is approximately 1 in 19. On call is non-residential. Consultants have to stay within 30 minutes travel time of the hospital.

Cross cover arrangements with appropriate medical colleagues for holidays and study leave will be included on a reciprocal arrangement.

NHS Highland supports CPD and attending appropriate internal and external educational events is encouraged. We have departmental peer groups to support college CPD certification and an in-house teaching programme. We also link with consultant psychiatry colleagues in Aberdeen for regular CPD events.

Regular supervision of doctors in training and team medical staff as appropriate is included in the job plan. The postholder will be supported to access appropriate professional supervision to maintain skills and accreditation with professional bodies.

Telelinking has existed in Highland for some time and will provide a means of link-up with Consultants, Sector Ward and New Craigs colleagues when necessary and also with the community teams when working at New Craigs.

The post holder will be expected to hold Section 22 Approval, or undergo the appropriate training to carry out work of this kind when eligible, including Mental Health Act and AW Incapacity Act duties.

PERSON SPECIFICATION

NHS Highland

Consultant Psychiatrist Old Age Psychiatry

Attributes Essential Desirable Education and MB, ChB or equivalent. Qualifications MRCPsych qualification (or equivalent)

Full Registration with the GMC and a licence to practice

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

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

Clinical Clinical experience of working Experience in OA Liaison Experience in OA Psychiatry Psychiatry

Ability to work independently at Consultant level

Knowledge of and willingness to undergo training in MHA and AWI Act

Teaching & In date Appraisal and Training Revalidation.

Registration for CPD with Royal College of Psychiatrists

Commitment to maintaining and developing skills

Research & Ability to work in and lead a

Audit clinical team Experience Excellent communication skills across a number of different agencies

Staff Understands principles of audit Evidence of participation in Management and experience of using audit audit projects in practice Participation in research or Research skills and evidence ideas regarding future based training participation

Team Working Experience of management & Interpersonal training at SpR level Skills

TERMS AND CONDITIONS OF SERVICE

NHS Highland

Consultant Psychiatrist Old Age 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)