Consultant in Eating Disorders Team: STEPs Eating Disorders Unit Based: Blackberry Hill Hospital 10 PAs RVN010-SSC-SR Pending on behalf of the Royal College Page 1 of 30 Avon and Wiltshire Mental Health Partnership Trust CONTENTS Page 3 1. Introduction to The Post Page 4 2. Service Details Page 7 3. Clinical Duties Page 13 4. Suggested timetable Page 14 5. Remuneration and Benefits Page 18 6. Person Specification Page 20 7. Geography/Attractions in Area Page 21 8. The Local Health Community and Local Services Page 24 9. The Trust Page 30 10. Apply for the post Page 2 of 30 Avon and Wiltshire Mental Health Partnership Trust 1. Introduction to the Post Post and specialty: Consultant Psychiatrist in Eating Disorders Base: Blackberry Hill Hospital Number of programmed activities: 10 PA per week Accountable professionally to: Medical Director Accountable operationally to: Medical Lead Context for the role The Trust is seeking a Consultant Psychiatrist to join provide Consultant clinical input and leadership to STEPs the Specialist Eating Disorders Unit, alongside the Community Consultant Psychiatrist for the STEPs Eating Disorders Service, based in Bristol, with a wider geographical remit. This Consultant post will ensure the stability and sustainability of the service. Key working relationships and lines of responsibility Medical Director: Dr Sarah Constantine Deputy Medical Director: Dr Pete Wood Medical Lead: Dr Salim Razak Clinical Director: Sarah Jones Clinical Lead: Rachel Heron Operational Manager: Martin Mclean Responsible Officer: Dr Sarah Constantine Page 3 of 30 Avon and Wiltshire Mental Health Partnership Trust 2. Service Details The Eating Disorders team was formed in 1999, initially operating a 4 bed EDU within a general psychiatry ward, and a day programme. In April 2012 the service moved to a stand-alone unit in Clifton Building on the Southmead Hospital site, bringing inpatient and community services under one roof, increasing inpatient capacity to 10, and establishing a dedicated inpatient care team. The STEPs service is for people with Anorexia Nervosa, Bulimia Nervosa and atypical and partial ED presentations (EDNOS). At present there are no commissioning arrangements to treat people with Binge Eating Disorder. We treat people from (or approaching) 18 years of age. 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. The EDU works in close liaison with Gastroenterology services in acute hospital sites in the area, and occasionally patients may be transferred for intensive medical treatments. The unit is commissioned through NHS England, is mostly at full capacity and admits patients mostly from within the STEPs catchment area and surrounding regions, such as Somerset, Gloucestershire and Devon. The STEPs EDU is accredited by the Royal College AIMS QED inspectorate. We also have junior doctor cover within our establishment. The EDU is staffed by its own team of Band 7 ward manager, 2 Band 6 charge nurses, Band 5 nurses, and HCAs, clinical psychologist, dietician, OT and physio. Consultant activity on the ward includes: leading the once weekly all day multidisciplinary ward review meeting in which each patient is interviewed; attending or chairing CPA review meetings for current inpatients, meeting with prospective inpatients prior to their admission to clarify aims; chairing the weekly bed planning meeting; liaising with referrers from out of area; reviewing current inpatients in between ward rounds if required; leading a therapeutic group on the ward; acting as RC for detained patients; leading on liaison with medical wards. STEPs Community Team is an MDT comprising psychiatrist (including ST and CT trainees), psychologists, nurses, OT, dietitian, administrators. Student health care professionals have placements in the team. The service receives about 350 referrals yearly and runs a caseload of approximately 350 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, 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. Page 4 of 30 Avon and Wiltshire Mental Health Partnership Trust Consultant activity in the community team includes: carrying out 1 new patient assessment weekly; sometimes in addition doing urgent or medically complex assessments; providing periods of regular outpatient contact with patients with complex needs (around 5-10 appointments per week) though not usually care-coordinating; attending or chairing CPA reviews for community patients; 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. The Eating Disorders services are proud of the relationships we have built with our stakeholders, service users, carers and work hard to maintain and develop a partnership approach to the development of services and care pathways. The STEPs service has close and effective working relationships with other ED services in the region that enhance patient care across providers: Gloucestershire EDS (2gether Trust), Cotswold House Marlborough, Somerset EDS (Sompar Trust), Priory Bristol, Haldon Unit Exeter. STEPs takes a leading role in the South West EDS network (SWED), and liaises with ED charities including Beat, and more locally SWEDA and ABC. In 2015 STEPs lead a recent application to Bristol Health Partners to establish a Health Integration Team for Eating Disorders, bringing together service providers, commissioners, researchers, public health and third sector organisations. The application was successful and ED HIT was launched in 2016. 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. The purpose and aim of the service is to provide the following: Assessment and treatment of referred adults with Eating Disorders, which may comprise joint working with GPs and MH teams, individual and group treatments, psychoeducational and psychological treatments, motivational and change-based treatments, and sessions with dietitian, OT and physiotherapist. Provide assessments and treatments near to patients’ homes. Specialist out-patient provision of intensive community treatment for patients at very low weight. This may avoid the need for in-patient admission and ensures locally based care. Specialist in-patient provision. We aim that people requiring in-patient treatment should be admitted to a setting that can provide physical monitoring and interventions in combination with psychological and psychosocial interventions, within reach of home. Involvement of relatives and carers in treatment, to maintain social and occupational links and to avoid difficulty in transition between primary, secondary and tertiary care services. There is an existing experienced Consultant Psychiatrist (0.9 WTE) in the STEPs service, whom this post holder will work alongside. The Consultant Psychiatrists may carry small individual caseloads of complex patients. Page 5 of 30 Avon and Wiltshire Mental Health Partnership Trust The STEPs Service is currently temporarily based on the Blackberry hill Site, a move which came about in response to the covid pandemic. The unit was previously located on the Southmead Hospital in Bristol. Bristol has a population of 428,100 making it the largest city in the South West of England and the 7th largest city in England. It is one of England’s eight ‘Core cities’, meaning it is one of the eight largest city economies outside of London. It is the Capital of the South West and also one of the UK’s leading green cities. Bristol has a unique population, which brings with it a diverse range of challenges. Some wards of Bristol are amongst the most deprived in the country. A few are among the most affluent. 16% of Bristol’s population belongs to a Black & Minority Ethnic (BME) group, including a large immigrant Somali population. The Office of National Statistics (ONS) estimate that around 7,500 people per year access NHS specialist mental health services in Bristol. Bristol’s 57,200 older people make up 13% of the total population suggesting 1 in 7 people living in Bristol are aged 65 or over. Avon and Wiltshire Partnership Mental Health Trust deliver integrated Health and Social Care services in Bristol, in an area coterminous with the Bristol Clinical Commissioning Group and the Bristol Council boundary. The city of Bristol is lively yet laid back, mixing its rich maritime heritage with an innovative dynamic culture making it the most interesting outside of London. It has a creative and independent spirit which can be experienced throughout the city, from its colourful street art and huge selection of independent traders, to its very own currency, the Bristol Pound. Bristol is also one of the most family friendly cities in the UK, packed with activities and award-wining attractions such as the Harbourside with Bristol Aquarium, At-Bristol and Brunel’s SS Great Britain. Bristol Airport has direct flights to many European destinations. The STEPs Service serves 3 other CCG/local authority areas: BANES; North Somerset; and South Gloucestershire. Most of this area can be reached within an hour by car from the base at Southmead Hospital. These areas comprise a mix of urban, suburban and rural localities. North Somerset includes the Mendip Hills and coastline along the Severn Estuary, South Glos includes the Southern Cotswolds, and BANES is centred on the beautiful and historic city of Bath, which is home to 2 large universities.