CORE TRAINEE JOB DESCRIPTION

CORE TRAINEE - GENERAL ADULT PSYCHIATRY Job Title: INPATIENT/ OUTPATIENT National Post Number: Educational / Clinical Dr Hilary Foster, Consultant Psychiatrist Supervisor: Rehab/ Liaison, Margaret Laurie House Inpatient Rehabilitation Unit, 1 Base: Church Road, , RH2 8HY & East Liaison, East Surrey Hospital, Canada Avenue, Redhill, Surrey, RH1 5RH 40 hours with full shift pattern comprising 12.5 hour long days and 12.5 hour Hours of Work: night shifts – each area rota will advise of additional / enhanced hours of work 09:00 – 09:30 handover with junior doctor (following night shift) and 21:00 – Handover: 21:30 handover to junior doctor (following long day duty).

Job Outline: This is a Core Trainee post based at Margaret Laurie House, a 12 place inpatient rehabilitation unit for Surrey & Borders’ Partnership NHS Foundation Trust. You will also work in a liaison service at East Surrey Hospital one day per week, assessing patients as requested by the liaison team manager, who are on medical / surgical wards or in A and E department and requiring mental health assessment.

Objectives of Core Skills: Placement:  Detailed history taking, examinations and initiation of all necessary investigations for patients, keeping full clinical notes and ensuring the medical records information is updated according to local guidelines.  Mental State examination.  Extended Cognitive Examination.  Physical Health examination.  Inpatient risk assessment / observations decisions.  Interviewing relatives and carers of patients.  Arranging appropriate referrals to other disciplines.  Admission and Discharge Summaries.  Communication and team-working skills.  Engagement with multi-disciplinary team.  Liaison with Community Team for post-discharge follow-up.  Regular presentation of full psychiatric cases either in the ward round or to Clinical Supervisor.  Participation in out-of-hours assessments with Psychiatric Liaison Nurses while on-call.

Educational Objectives for Grade  Learn the basic skills in assessment, diagnosis and management of common psychiatric disorders.  Learn about risk assessment for staff and clients in the Community.  Learn basic psychopharmacology and gain experience in using common psychotropic drugs.  Gain experience in working with a multi-disciplinary team and in time management.  Learn the basics of risk assessment and keeping proper medical

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documentation for outpatients.  Gain experience in drafting reports, summaries and letters.  Gain experience in managing acute psychiatric emergencies.  Develop basic competence in the use of the Mental Health Act.  Understand the range of psychological and social treatments in psychiatry.

Education and  Individual supervision will be provided by the approved Clinical Training: Supervisor who will provide clinical supervision for one hour every week.  The teaching programme is mandatory and runs on Friday mornings. Trainees will be expected to attend each week and at times present at Journal Clubs and Case Conferences.  Study Leave is available within HEKSS Guidelines

Research and Trainees are encouraged to undertake a Quality Improvement Project Quality during their post. Opportunities for research may be available and will be Improvement: tailored to individual trainees needs.

Emergencies: The junior doctor accepts that he / she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate consultant in consultation, where practicable, with his colleagues, both senior and junior. Additional commitments are exceptions and juniors should not be required to undertake work of this kind for prolonged periods on a regular basis. The job description includes cover of normal annual and study leave of colleagues for whom the practitioner is expected to deputise during the normal run of his/her duties.

INDICATIVE TIMETABLE

Monday Tuesday Wednesday Thursday Friday

a.m. East Surrey Margaret Laurie St George’s Margaret Laurie Burnham Hospital House, Reigate London House, Reigate ACADEMIC MEETING PROGRAMME Liaison Psychiatry New patient MRCPsych course Ward Round 09:15–10:15 assessments OR Educational Presentation 10:30–11:30 East Surrey Supervision with Balint Group Hospital Dr Foster 11:30–12:00 Simulation Practice Liaison Psychiatry 12:30-13:30 12:00–13:00 Journal Club Term Time Only

p.m. East Surrey Margaret Laurie SABP (site Margeret Laurie East Surrey Hospital, Hospital, House, Reigate depending on House Reigate Liaison Psychiatry Liaison Psychiatry Patient reviews trainee) Group activity Psychotherapy and porgramme supervision

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Supervisors’ Roles A named clinical supervisor oversees the trainee’s clinical work and throughout a placement. He or she gives feedback during the placement Responsibilities: and leads in providing a review of the trainee’s performance which contributes to the educational supervisor's report on determining if the trainee progresses to the next stage of their training.

A named educational supervisor is responsible for the overall supervision and management of a trainee’s development during a placement or series of placements. He or she helps the trainee to plan their training, achieve agreed learning outcomes and brings together all relevant evidence to determine if the trainee progresses to the next stage of their training.

Although these two roles are distinct they may be the same person, Core Trainees and HSTs usually have an educational supervisor who is also the clinical supervisor. GP trainees and foundation trainees usually have a separate educational supervisor.

Expectations for supervision: This job description briefly describes the training placement and outlines a timetable which includes an identified time for supervision. This should be one hour per week and is protected teaching time. This should be one-to-one with your supervisor but may be delivered in a group with other trainees that your supervisor is responsible for. Ad hoc supervision about clinical matters will happen outside of this, for instance discussing a patient, but is not a substitute for protected teaching time.

Please contact your locality tutor if supervision is not happening as per the guidelines above.

Core Training (CT1-3) Curriculum 2016 - Placement Matrix

The following table provides an indication as to what extent the Core syllabus areas may be met during a specific placement.

None of the syllabus areas should be expected to be met in this placement To some extent/limited opportunity (please note that this may be positive or negative e.g. positive in that you may be able to experience this outcome) To a great extent/ample opportunities

Good Medical Intended Learning outcomes Specific opportunities Expect Practice Domain to achieve Domain 1: ILO1: Be able to perform Out patient clinics Knowledge, specialist assessment of patients On call assessments including Inpatient skills and and document relevant history admissions performance and examination on culturally Inpatient reviews diverse patients to include: Mental Health Act assessments • Presenting or main complaint • History of present illness Reviewed in supervision and assessed by • Past medical and psychiatric WPBA including CBD history • Systemic review • Family history • Socio-cultural history • Developmental history a. Clinical history b. Patient examination ILO2: Demonstrate the ability to Out patient clinics construct formulations of On call assessments including Inpatient Page 3 August 2017 patients’ problems that include admissions appropriate differential Inpatient reviews diagnoses Mental Health Act assessments a. Diagnosis b. Formulation Reviewed in supervision and assessed by WPBA including CBD ILO3: Demonstrate the ability to Out patient clinics recommend relevant On call assessments including Inpatient investigation and treatment in admissions the context of the clinical Inpatient reviews management plan. This will Mental Health Act assessments include the ability to develop and document an investigation plan Reviewed in supervision and assessed by including appropriate medical, WPBA including CBD laboratory, radiological and psychological investigations and then to construct a comprehensive treatment plan addressing biological, psychological and socio-cultural domains a. Individual consideration b. Investigation c. Treatment planning d. Substance misuse ILO4: Based on a comprehensive Out patient clinics psychiatric assessment, On call assessments including Inpatient demonstrate the ability to admissions comprehensively assess and Inpatient reviews document patient’s potential for Mental Health Act assessments self-harm or harm to others. This will be displayed whenever Reviewed in supervision and assessed by appropriate, including in WPBA including CBD emergencies a. All clinical situations Discussed at team meetings, academic b. Psychiatric emergencies for all meetings and Balint Group. specialties c. Mental health legislation d. Broader legal framework ILO5: Based on the full Out patient clinics psychiatric assessment, On call assessments including Inpatient demonstrate the ability to admissions conduct therapeutic interviews; Inpatient reviews that is to collect and use Mental Health Act assessments clinically relevant material. The doctor will also demonstrate the Reviewed in supervision and assessed by ability to conduct a range of WPBA including CBD individual, group and family therapies using standard Interaction with the team psychologists at accepted models and to integrate team meeting and for ad hoc discussions. these psychotherapies into everyday treatment, including Observing senior clinician interviews in biological and socio-cultural clinics or ward rounds interventions ILO6: Demonstrate the ability to Clinical recording keeping in the form of concisely, accurately and legibly system one entries record appropriate aspects of the Letters/ Communications to GPs and other clinical assessment and agencies management plan Reviewed in supervision and assessed by WPBA including CBD

ILO7: Develop the ability to carry Out patient clinics out specialist assessment and On call assessments including Inpatient treatment of patients with admissions chronic and severe mental Inpatient reviews Page 4 August 2017

disorders and to demonstrate Mental Health Act assessments effective management of these disease states Reviewed in supervision and assessed by WPBA including CBD ILO8: To develop an Opportunity to engage in weekly journal club understanding of research methodology and critical Attend MRCPsych course (if applicable) appraisal of the research h literature Research opportunities available through a. Research techniques supervisor or research department b. Evaluation and critical appraisal of research Attend Annual Trust Research Day

ILO9: To develop the habits of Register for NHS Athens lifelong learning a. Maintaining good medical Make use of Library services (in person or practice online) b. Lifelong learning c. Relevance of outside bodies Read journals, attend academic programme and use CPD appropriately (e.g attend conferences)

Domain 2: Safety ILO10: Develop the ability to Opportunity to complete an audit facilitated and Quality conduct and complete audit in by supervisor clinical practice ILO11: To develop an Attend governance meetings such as QAG, understanding of the MAC, acute care forum, LFG, IEB implementation of clinical governance ILO12: To develop reflective Active engagement in portfolio practice including self reflection as an essential element of safe Reflecting on complaints or Sis and effective psychiatric clinical practice Declaring any health issues a. Reflective practice b. Complaints Reviewed in supervision c. Personal health

Domain 3: ILO13: Use effective Out patient clinics Communication, communication with patients, On call assessments including Inpatient partnership and relatives and colleagues. This admissions teamwork includes the ability to conduct Inpatient reviews interviews in a manner that Mental Health Act assessments facilitates information gathering and the formation of therapeutic Supervisor observed assessments alliances Reviewed in supervision

ILO14: Demonstrate the ability to Reviewed in supervision and through Multi work effectively with colleagues, Source Feedback including team working ILO15: Develop appropriate Opportunity to take on leadership project leadership skills and complete LEADER form

Reviewed in supervision ILO16: Demonstrate the Agree schedule with supervisor at start of knowledge, skills and behaviours placement to manage time and problems Maintain a diary effectively Prioritise workload a. Time management Report working in excess of hours through b. Communication with colleagues exit reporting c. Decision making d. Continuity of care Reviewed in supervision

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ILO17: To develop the ability to Opportunities to teach medical students, teach, assess and appraise junior trainees and multi-disciplinary a. The skills, attitudes, behaviours teaching within team. Participation at the and practices of a competent weekly academic meetings teacher b. Assessment Assessed through Assessment of Teaching c. Appraisal WPBA

Domain 4: ILO18: To ensure that the doctor Out patient clinics Maintaining trust is able to inform and educate Inpatient reviews patients effectively a. Educating patients about illness Supervisor observed assessments and its treatment b. Environmental and lifestyle Reviewed in supervision factors

ILO19: To ensure that the doctor All clinical activity acts in a professional manner at all times Reviewed in supervision a. Doctor patient relationship b. Valuing diversity Assessment through multi-source feedback c. Confidentiality and supervision d. Consent e. Recognise own limitations f. Probity

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