Trust Associate Specialist South Gloucestershire Kingswood Civic Centre 7 PAs 342-TAS791-AS Page 1 of 25 Avon and Wiltshire Mental Health Partnership Trust CONTENTS Page 3 1. Introduction to The Post Page 4 2. Service Details Page 6 3. Clinical Duties Page 9 4. Suggested timetable Page 10 5. Remuneration and Benefits Page 14 6. Person Specification Page 16 7. Geography/Attractions in Area Page 17 8. The Local Health Community and Local Services Page 20 9. The Trust Page 25 10. Apply for the post Page 2 of 25 Avon and Wiltshire Mental Health Partnership Trust 1. Introduction to the Post Post and specialty: Trust Associate Specialist in Early Intervention in Psychosis Psychiatry Base: Kingswood Civic Centre Number of programmed activities: 7 PAs Accountable professionally to: Medical Director Supervisor: Dr Andrew Brindley Context for the role This is an exciting opportunity for an Associate Specialist with an interest in Early Intervention in Psychosis to join the team. This post has become available due to the current post holder moving to another team within the South Glos locality and additional finance being available to provide increased sessions to the Early Intervention Team. The service requires increased medical time to ensure the duration of untreated psychosis is reduced by prescribing in a timely manner, as well as supporting care coordinators with assessments of complex mental states and ongoing medical reviews; providing specialist input from the Speciality Doctor. Key working relationships and lines of responsibility Medical Director: Dr Sarah Constantine Deputy Medical Director: Dr Pete Wood Medical Lead: Dr Avneet Sharma Clinical Director: Dr Eva Dietrich Clinical Lead: Jenny MacDonald Operational Manager: Suzanne Howell Responsible Officer: Dr Sarah Constantine Page 3 of 25 Avon and Wiltshire Mental Health Partnership Trust 2. Service Details The post holder will provide medical input in to the Early Intervention in Psychosis Team within the Clinical Commissioning Group area. Summary Of Post In October 2014, NHS England and the Department of Health jointly published Achieving better access to mental health services by 2020. This document outlined a first set of mental health access and waiting time standards for introduction during 2015/16. The access and waiting time standard for early intervention in psychosis (EIP) services requires that, from 1 April 2016 more than 50% of people experiencing first episode psychosis will be treated with a NICE-approved care package within two weeks of referral. The service increased its age group to include those aged 36 – 65 and also started to work with service users who have an at risk mental state for up to 9 months. The service works with 14 – 18 year old service users and families in conjunction with CAMHS. A local protocol enables flexible joint working. Following the implementation of these standards, the team received financial input from NHS England to increase the staff levels to meet the increased demand on the service and to also offer training for staff within the team to provide specialist interventions such as family intervention, Cognitive Behavioural Therapy for psychosis and Individual Placement Support. The service currently has a caseload of 90 service users. A full time (1 WTE) care coordinator will hold a caseload of 15 service users. In the last year the team received 95 referrals of which 63 service users were taken onto the team case load. The maximum commissioned caseload is 90 service users at any one time. The Early Intervention team receives the majority of referrals through the Primary Care Liaison Team; however, service users are able to self-refer direct over the phone. More than 63% of referrals should be assessed and engaged with a care coordinator within two weeks of psychosis being suspected. Care coordinators are rostered to provide assessments with three assessments per week being offered. The post holder will be involved in offering informal supervision for new patient assessments and to assess individual clients who require medical expertise. In line with new Ways of Working, the post holder will provide a mixture of supervision, case review and clinical input across the caseload of service users. This will include involvement with families and carers care programme approach meetings. The role would involve approximately 10 outpatient appointments per week as well as a Multidisciplinary Clinical Team Meeting on Tuesday Mornings. There is a role for the involvement of the Associate Specialist in assessment; particularly of complex cases where there is a large measure of diagnostic uncertainty and or organic complicating factors. In terms of where service users are seen, the EI Team offers flexibility to maximise the chances of engaging young people. Appointments maybe at the Team base, at other Page 4 of 25 Avon and Wiltshire Mental Health Partnership Trust team bases in the city, in service user’s homes, in GP premises or other community facilities. Therefore the post holder will need to be able to drive and have access to a car for work purposes. The majority of contacts will be done jointly with other EI team members. However, due to the covid pandemic, many appointments are now facilitated through online platforms with some service users continuing to be seen face to face. The South Gloucestershire Early Intervention Service has been shown to be providing consistently high care with either good or outstanding performance against the NICE guidelines. South Gloucestershire Early Intervention service also had a comparatively low admission rate with 13% of the caseload having been admitted; this was low when compared against other Early Intervention Services in the South of England. There is also a comparatively high rate of the caseload in employment with 58% of the caseload having an occupation; this is high when compared against other Early Intervention Services in the South. The early intervention teams within AWP meet on a regular basis to provide CPD and support to develop services to help achieve the access and waiting time standards. The service is also part of the South West Regional Network which meets every two months. The Early intervention service works closely with the Intensive Support team who provide out of hours support to service users in crisis as well as the AMHP service. The team also work closely with the local inpatient ward. The South Gloucestershire Early Intervention Team works as an MDT and currently includes the following: Consultant Psychiatrist 0.2 WTE Team Manager, Band 7, 1 WTE Senior Practitioner, Band 7, 0.8 WTE CBT Therapists, Band 7, 1.5 WTE Community Mental Health Nurse / Care coordinator, Band 6, 4.5 WTE Occupational Therapists / Care Coordinator, Band 6, .25 WTE Social Worker / Care Coordinator, Band 6, 1 WTE RMN / Care Coordinator, Band 5, 1 WTE Recovery Worker, Band 4, 0.8 WTE Health and Wellbeing Practitioner, Band 4, 0.5 WTE Employment and Vocational Specialist, Band 4, 1 WTE Administrator, Band 3, 1 WTE Page 5 of 25 Avon and Wiltshire Mental Health Partnership Trust 3. Clinical Duties To assess and treat service users in the community and in a clinic. To attend weekly Early Intervention MDT meeting and to support the team with medical input as required. To arrange and participate in CPA meetings for service users. Undertake urgent psychiatric assessments when necessary. To liaise with other parts of the service and GPs and non NHS organisations wherever applicable. Write up all their notes using the Trusts Electronic Record system RIO which also records time and date of entry. The post holder is personally responsible for entering their notes onto the system themselves. Ensure effective and timely documentation and communication of clinical decision making and management plans The post holder is expected to seek Section 12 approval, but this is not a requirement of the post. General Duties To undertake the administrative duties associated with the care of patients. To record clinical activity accurately and comprehensively, and submit this promptly to the Information Department. To participate in service and business planning activity for the locality and, as appropriate, for the whole mental health service. To participate in annual appraisal. To attend and participate in the academic programme of the Trust, including lectures and seminars as part of the internal CPD programme. To maintain professional registration with the General Medical Council and to abide by professional codes of conduct. To participate annually in a job plan review with the clinical manager, which will include consultation with a relevant manager in order to ensure that the post is developed to take into account changes in service configuration and delivery associated with modernisation. To work with local managers and professional colleagues in ensuring the efficient running of services, and share with consultant colleagues in the medical contribution to management. To comply with all Trust policies including Equal Opportunities policies and to promote equality of access to healthcare at all times. Page 6 of 25 Avon and Wiltshire Mental Health Partnership Trust Participation in the Trustwide Medical Advisory Group TMAG. To participate in continuing medical education and maintain good standing for Royal College of Psychiatrists CPD or equivalent. Associate Specialists are expected to become members of a peer group and will be signposted to the appropriate group on appointment.