ADDITIONAL INFO FOR VACANCY LOCATION: MEDICAL CENTRE, REDFORD BARRACKS, EDINBURGH
Redford Barracks is an early 20th century-built Army establishment originally designed to house both infantry and cavalry regiments. Whilst the horses are long gone, the imposing architecture remains – elements of which are now listed for their importance. The substantial parade squares now play host each year to the dress-rehearsals for the world- famous Edinburgh Military Tattoo. Facilities for staff include onsite parking, a cafeteria and separate coffee shop, use of the gymnasium and learning centre. Swimming pool facilities are offered at the nearby Dreghorn Barracks. Civilian staff have the option to become Mess members and enjoy the social activities that offers. Within the Medical Centre itself, staff can take part in Pilates classes. Located in the family-friendly Edinburgh suburb of Colinton, the barracks are within easy reach of all that Edinburgh has to offer. The city centre is a short bus journey and the international airport no more than 5 miles away. Less than a mile away is the Edinburgh bypass providing an easy gateway to the countryside of the Pentland Hills as well as the rest of Scotland or south to England.
JOB DESCRIPTION AND POST HRMS Position Number: SKILLS PROFILE
Position Title: CONSULTANT PSYCHIATRIST Branch: PSYCHIATRY
Location: Scotland/North Region Grade/Rank: CONSULTANT Clearance: Security Check, Disclosure barring Service Faslane DCMH (Enhanced)
HRMS Job Family: DOCTOR HRMS Job Code:
Minimum Tour Length: 2 years Maximum Tour Length:
Working Hours/Pattern: 40 hours 30 days leave (increases to max. 32 days after 7 years employed as a consultant)
10.5 days public and privilege holidays
Professional or study leave will normally be granted to the maximum extent consistent with maintaining essential services in accordance with the recommended standards, or may exceptionally be granted under the provisions of paragraphs 14 and 16. The recommended standard for consultants is leave with pay and expenses within a maximum of thirty days (including off-duty days falling within the period of leave) in any period of three years for professional purposes within the United Kingdom.
Is the Post identified as Critical to the YES Business: Reason: This position is the senior clinical decision maker within the department. Without this post being filled there would be a significant reduction in the ability of the DCMH to provide clinical and advisory support or supervise other Mental Health activites.
Allowances Associated with the Post: Type: NA
Title:
Value:
Line Manager Position Title: Regional Clinical Director Line Manager HRMS Position Number:
Introduction
1. Mental health services within the Armed Forces are provided by Defence Primary Health Care (DPHC) via Defence Mental Health Services (DMHS) whose aim is to –
a. Provide effective care, with an approach based on recovery and rehabilitation, for Service personnel and entitled civilians with speedy access to skilled and effective assessment, treatment and occupational recommendations that is flexible and based around individual needs.
b. Provide psychological education to primary care staff to enhance their capability to manage mental healthcare issues and to support their responsibilities in addressing the mental health of all personnel.
c. Undertake research in mental health and mental wellbeing.
d. Act in a command liaison role to support both case management and organisational initiatives including health promotion aimed at mental wellbeing and welfare.
2. In terms of the overall process of delivering mental health services there are clearly some parallels between the NHS and the Armed Forces, however in terms of morbidity there are differences between what is required of NHS mental health services and that required on a day to day basis by the Armed Forces.
3. The range of psychopathology tends to be less severe within the Armed Forces than is the routine for NHS work, and this allows time for the Services mental health teams to respond to the occupational needs of service life, which require early intervention and a highly rehabilitative approach to the care that is provided. Unique to service psychiatry is the ability to greatly influence the occupational factors which impact upon the individuals’ mental health.
4. This Job Description and Post Skills Profile form part of a comprehensive job plan that is to be ratified by both the incumbent and line manager and follows the general principles laid down in RCPsych guidance CR1741
Defence Primary Healthcare (DPHC)
1 CR174- Safe patients and high-quality services: a guide to job descriptions and job plans for consultant psychiatrists, Nov 2012
5. DPHC provides primary healthcare services to all Armed Forces personnel, and this includes musculosceletal rehabilitation, primare care, occupational medicine, mental health and dentistry. The Defence Mental Health Services are imbedded in DPHC and delivers care across the UK from 11 Departments of
Community Mental Health (DCMHs), acting as “hubs”, and 6 Mental Health Teams (MHTs) acting as “spokes”.
6. The vast majority of the morbidity are from common mental health disorders, with serious and enduring mental illness and personality disorder being uncommon. Therefore, the vast amount of work is done in the community with a low risk population who are employed and functioning relatively well. However, they work in a complex system where occupational requirements differ significantly from the civilian population, wherein lies the challenge of military psychiatry. In-patient facilities are provided through an independent contract.
Local working arrangments
7. DPHC is seeking a 1 WTE consultant psychiatrist to join DCMH Faslane. The vacancy has arisen as the result of a staff move, and the Trust regards this as an opportune moment to develop the functioning of the team. The service covers personnel stationed or sick at home in the local area, and each WTE consultant psychiatrist covers a population at risk of ~7500 service persons.
8. The DCMH team consists of:
• 3 WTE Consultant Psychiatrists • 1.6 WTE Clinical Psychologists • 7 WTE Community Mental Health Practitioners • 2 WTE Social Workers • 1 WTE Practice Manager • 2 WTE Administrative Staff
9. The associated MHT at Kinloss team consist of: • 1 WTE Clinical Psychologists • 3 WTE Community Mental Health Practitioners • 0.5 WTE Social Workers • 1 WTE Administrative Staff
10. The team expects to receive on average 11 new referrals a week and will see urgent cases by the next working day and routine cases within 15 working days. It is expected that all team members carry roughly equivalent numbers of cases as care co-ordinators. The consultant psychiatrist is expected to carry a compact caseload of the most complex and unstable cases, but will also be available at short
notice to provide consultation and advice to other team members.It must be stressed that the caseload contains far lower levels of morbidity and risk than a NHS general adult population and there is not a high emergency burden.
11. Inpatient services are provided by an independent contractor with ready access to inpatient beds, arranged through the local Service Liaison Officer. The job holder will not be responsible for inpatient care.
12. The DCMH provides care in hours only, and after hours crisis care is manged as per usual by the NHS. The post has no on-call commitment. There is a voluntary rota for clinics in Cyprus, Northern Ireland or elsewhere in the UK which the post holder can join if they so wish.
13. While primarily responsible for delivering a quality clinical service, the consultant psychiatrist is also expected to be actively involved in the strategic development of the team and broader services, being involved with the team manager and locality manager in helping to steer the development of the service in line with the strategic direction of the organisation.
MAIN JOB OBJECTIVES:
Direct Clinical Care (DCC) (7.5 PAs)
14. To provide a high quality, evidence based interventions as part of a multi-disciplinary team to provide a safe, effective and professional mental health service to maximise the number of personnel fit for role.
15. Offer advice and support to commanders and entitled Service Personnel.
16. Receive and appraise referrals from MO/GP within the Area of Responsibility (AoR) and advising on the most appropriate care pathway and carry out thorough clinical risk assessments of patients.
17. Provide safe and effective mental health services, including consultations for urgent referrals, and have clinical responsibility for their patient case-load.
18. Maintain responsibility for the patient during the process of care including referral to other regional services e.g. the Regional Occupational Health Team.
19. Provide mental health care that complies with the GMC’s ‘Good Medical Practice’ and the RCPsych’s Good Psychiatric Practice.
20. Provide recognised and clinically recommended interventions and managerial guidance for an identified, varied and somtimes complex caseload.
21. Prescribe medication in a safe and effective manner in accordance with the tri-Service Formulary and if prescribing off-licence products ensure compliance with current Service guidance.
22. Provide initial Consultant specialist occupational mental health assessments and formulation of mental health needs for referred patients, which will include planning, implementing and evaluating care.
23. Produce clinical reports to MO/GP and other relevant professional agencies after initial assessment, on discharge from caseload and where otherwise indicated/appropriate.
24. Provide advice and recommendations to MO/GP on all matters of mental health, care and treatment which will include occupational advice on the individual’s ability to be employed in their operational role. At times this will include communicating, where appropriate, on occupational information directly with service person’s Chain of Command (CoC) whilst respecting the principles of patient confidentiality.
25. Assist in the supervision, development, training and education of the multi-disciplinary team and assist with the managerial support of clinical staff if required.
26. Maintain accurate, comprehensive and contemporaneous records and clinical notes of all patient contact.
27. Initiate and participate in clinical case conferences/care meetings where consultant clinical input is required.
28. Work collaboratively with the patient and include family members and significant others in the patient’s treatment when appropriate.
29. Liaise with the in-patient Consultant Psychiatrist at the Inpatient Service Provider (ISP) and attend ward rounds at the ISP as required.
30. Maintain ethical and legal standards in carrying out therapeutic interventions.
31. Ensure the safety of the patient and others is maintained at all times.
32. To exercise autonomous professional responsibility for the assessment and treatment of clients in line with the service.
33. As part of the comprehensive job plan, adhere to agreed activity relating to direct clinical care through clinical sessions carried out per week specifically aimed at contributing to ensuring diagnosis and treatment delivery remains accessible and responsive in line with key performance indicators.
34. Work closely with other members of the team ensuring appropriate step-up and step-down arrangements are in place to maintain a stepped care approach.
35. Liaise with other health and social care staff from a range of agencies in the care provided to clients where appropriate.
36. Use highly developed communication skills in working with people to understand their personal and often very sensitive difficulties.
37. You are accountable for the standard of Mental Health care and delivery, advice and support that you provide to a patient and the MO/GP and CoC, in line with the code of conduct and standards of the General Medical Council (GMC).
38. You are to be cognisant of your limits of competence and seek clinical supervision and /or advice as appropriate, e.g. liaising with other colleagues when required.
39. Provide cover for the department’s other Consultant Psychiatrist during periods of absence.
40. You are to maintain the confidentiality of patient information and clinical notes within the constraints of an occupational mental health service. All such clinical records are to be managed with regards to the Data Protection Act 1998.
Supporting Professional Avtivities (SPA) (2.5 PAs)
41. Maintain professional standards in line with GMC, Royal College of Psychiatrists and DMS policy.
42. Complete all requirements relating to data collection within the service.
43. Support clinical effectiveness, quality improvement and the continuous development of healthcare governance within the facility by the use of HG tools eg audit, CAF and the completion and actioning of PSIRs.
44. To adhere to agreed protocols pertaining to Governance including implementation of standards, risk management strategies and audit processes.
45. To ensure that all significant events are recorded, reported, reviewed and action taken within the context of the culture of continuous improvement.
46. Take part in Continuous Professional Development in line with the recommendations of the Royal College of Psychiatrists.
47. Take part in the GMC Annual Appraisal process in accordance with DMS policy.
48. You are to maintain your professional knowledge and registration/revalidation.
49. You are to engage in regular clinical supervision in line with current practice guidelines with an appropriate supervisor and provide clinical supervision for other colleagues and peers.
50. Receive managerial, clinical and caseload supervision in line with relevant policy.
51. Participate and contribute to the Annual Appraisal process and for those working within the department.
52. Complete all mandatory training.
53. Act as an educator in areas relating to mental health and in the promotion of psychological and physical wellbeing to patients, professional colleagues, commanders and where appropriate unit personnel.
54. Provide and contribute to clinical leadership both within the team and to primary care professionals on mental health care, advice, support and legislation.
55. Maintain own professional training and development needs as identified for the purposes of registration and revalidation.
56. To contribute to the identification of the education and training needs for personnel within the post holders’ sphere of responsibility.
57. Advise and lead on research initiatives.
58. Participate in clinical audit projects, lead on Quality Improvement Programs (QIPs) initiatives and advise on how to improve the service.
59. Evaluate the outcomes of wider mental health research and lead on introducing and evaluating evidence based improvements.
60. In the temporary absence of the Department Manager (DM) or other senior military personnel, provide Leadership and Management to the nursing team in order to maintain and assure the service.
61. Have the ability to effectively communicate using a variety of mediums, to a varied audience.
62. Participate in the formulation and implementation of local QIPs and national mental health policies and procedures.
63. Contribute to and lead on all aspects of Clinical Governance and associated risk management, to monitor and improve the quality of service delivery.
64. Promote the safety and welfare of self, patients, visitors and staff, by observing the regulations of local and national laws, regulations and policies and disseminating relevant information to the team.
65. Sample job plan at Annex A.
Post Skills Profile:
Success Profiles Behaviours
Communicating and Influencing Building Capacity for All Making Effective Decisions Leading and Communicating Managing a Quality Service Changing and Improving
Specific Competency
Personal Attributes Able to plan, organise and delegate effectively.
Able to work in a team and under pressure at times, with excellent communication and organisational skills and the ability to be firm but tactful with patients and staff.
Able to create and grasp opportunities for improvement and anticipate and resolve problems.
A solid clinician with mentoring skills and an eye to quality assurance.
To maintain own professional development and undertake training as necessary.
You have an obligation under law to safeguard the confidentiality of Personal/Medical information you may have access to during the course of your duties which must not be communicated to other persons except per current legislation. Any breach of confidentiality could be a matter of Disciplinary Action being invoked and provide grounds for a complaint against you.
This Job Description and its associated Job Plan is a working document and the duties stated within may evolve and change in line with the development of both the post and the individual. They should be reviewed and agreed annually in line with the yearly appraisal process.
Essential/Desirable Level Professional/external qualifications/Professional Registrations required:
(As appropriate)
Full GMC registration with licence to practise. Essential
Listing on GMC Specialist Register (e.g. MRCPsych or Essential
FRCPsych)
Certificate of Completion of Training (CCT) Essential Current/recent clinical experience (e.g. as evidenced by Essential current appraisal)
Current certificate of Hepatitis B immunity Essential (note some locations Full driving licence may be difficult to access via public Desirable Disclosure barring Service (Enhanced) transport) Essential MSc relevant to mental health Desirable Experience in occupational mental health, ideally in a military setting Desirable
Experience in operation of DMICP
Experience in Armed Forces medical documentation Desirable
Desirable
Post Mandatory Training (Add as appropriate for the role: Health & Safety, Fraud Awareness, Security Briefings, Protecting Information, Fire Awareness,) Defence Writing Guide, Equality & Diversity, Government Security Classifications, Environmental Awareness
Equality and Diversity Awareness Unconcious Bias Caldicott Defence Information Management Passport Health and Safety Awareness for Managers Safeguarding Children Level 3
Display screen Equipment Fire Safety Awareness Office Safety Well-Being, Resilience and Stress Environmental Awareness Manual Handling Security - General Threat Brief – Local Training DMICP BLS AED IPC – Clinical Staff Business Continuity Selection Interviewing (if in a clinical lead role)
Current Post Holder: Name: Signature:
Current Line Manager: Name: Signature:
Date Agreed:
Date for Review:
Health & Safety: Post holder must be fully acquainted with the Establishment’s Health & Safety and Environmental Protection Regulations and Procedures at HMS Nelson and complete all mandatory training. Equality & Diversity: Post holder must adhere to Departmental Equality & Diversity Policies and complete all appropriate mandatory training requirements. Confidentiality: The post holder will have access to confidential information of both a clinical and commercial nature. The post holder may access to information only on a need to know basis in the direct discharge of duties and divulge information only in the proper course of duties. Disclosure to any unauthorised person(s) will be regarded as a breach of contract and may lead to termination of employment.
The Post holder must adhere to policy guidance on confidentiality of information, including Electronic Medical Records Data, at all times in accordance with the Data Protection Act
Annex A: Example Job Plan
EXAMPLE JOB PLAN FOR CONSULTANT PSYCHIATRISTS (28h DCC/9.5h SPA – 7.5 PAs DCC and 2.5 PAs SPA)i
(
Monday Tuesday Wednesday Thursday
0830 to 1100 (2.5h) 0830 to 1230 Clinic (4h) 0830 to 1230 Clinic (4h) 0830 to 1230 Clinic
Supervision 2 Fresh cases (2 hours each) 2 Fresh cases (2 hours each) 1 Emergency slot, to or other Patient reports and note reviews cases if not before (2h)
2 reviews 1100 to 1200 (1h) (45 min ea
GP liaison session 30min clinical admin
1200 to 1230 Lunch 1230 to 1300 Lunch 1230 to 1300 Lunch 1230 to 1300 Lunch
1230 to 1330 (1h) 1300 to 1630 Clinic (3.5h) 1300 to 1630 Clinic (3.5h) 1300 to 1430 Clinic
Department CPD program and 4 reviews (45 min each) 4 reviews (45 min each) 1 review (45 min) business meeting
30min clinical admin “catch-up” 30min clinical admin “catch-up” 45min clinical admin
1430 to 1630 (2h)
1330 to 1630 (3h)
MDT Health governance d
Total SPA 1h Total SPA 0h Total SPA 0h Total SPA 2h
Total DCC 6.5h Total DCC 7.5h Total DCC 7.5h Total DCC 5.5h
(
i 4-6 fresh cases a week and 8-12 reviews. The minimum is, therefore, 12 per week and we expect consultants to see 504 contacts over a working year of 42 weeks.