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Nhs borders – Job Information Pack position: Consultant Psychiatrist – Older Adults Service


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NHS Borders – Job Information Pack
POSITION: Consultant Psychiatrist – Older Adults Service












Scott’s View, Scottish Borders

Job Description and particulars for the post:


Consultant Psychiatrist – Older Adults Service, NHS Borders


Reference

MED583

Please quote on all correspondence

Grade

Consultant

Location

Melburn Lodge, Borders General Hospital

Hours / PA’s

Full-time basis available – 10 P.A.s. Applications welcome from candidates interested in part-time or job share.

Salary Scale

Consultant scale - £74,504 – £100,446 with 3% availability supplement

Closing Date

Friday 14 June 2013




Your Application


Thank you for expressing an interest in the above post within NHS Borders. Please find all the relevant information attached to begin the application process.


Should you require further information regarding this post you can contact the Medical Staffing team or make informal enquiries with the department using the contact details below.
To ensure we can process your application as easily as possible please complete all the information required within the Application Pack and return with your full C.V.





Contact Details


Telephone

01896 826167

Email

Medical.staffing@borders.scot.nhs.uk




Application Process

To apply please submit a copy of your Curriculum Vitae along with the completed Application Pack (below), together with a daytime telephone number where you can be contacted, to Medical Staffing, Borders General Hospital, Melrose TD6 9BS. Tel: 01896 826167. Fax: 01896 826159 or e-mail to: HUmedical.staffing@borders.scot.nhs.ukUH.



If emailing your CV please telephone 01896 826167 to confirm safe receipt.

Interview Date: 5 July 2013








Visits and Enquiries

Informal visits can be arranged and informal enquiries regarding this post will be welcomed by:-




Dr Cliff Sharp

Associate Medical Director – Mental Health & Learning Disability Service

01896 827155 (secretary)

Date post is vacant

The post is vacant immediately and a start date will be agreed with the successful candidate.




NHS Borders

Website

For further information regarding NHS Borders, please visit our website:- HUwww.nhsborders.org.ukU







The Department



Mental Health Service

With approximately 350 staff and an annual operational budget of £13 million, the NHS Borders Mental Health Service provides treatment in a variety of community and inpatient settings, with Clinical Leadership provided by the consultant working alongside the Team and Service Managers.

The shared philosophy is that of a personal service based on respect for the individual. It builds on the foundations of the Therapeutic Community principles of Dingleton Hospital and the solidly established community psychiatry approach commenced in the early 1970s. Thus we expect people to respond to their maximum potential when given the maximum appropriate involvement and responsibility. Through our community approach and home based treatment, we are able to intervene early to provide assertive outreach and deliver a variety of treatment approaches, seeking to use the most effective combination of the medical model (in the broadest sense), cognitive behavioural, psychodynamic, occupational, social and family support.

There is a clear value base within the service that front line clinicians must be involved in the key decisions that affect their everyday working practice and there is a range of opportunities for medical staff to get involved through active clinical governance systems, Medical Staff Committee and a range of project steering groups. The Mental Health Clinical Board oversees the delivery of services, and this group includes a wide range clinical staff including a number of consultant psychiatrists.



Adult Mental Health Services

These have undergone a decade of development following the closure of Dingleton Hospital. The Adult Mental Health Services consist of 3 Community Mental Health Teams (CMHTs) based geographically throughout the Borders (Hawick, Duns and Melrose). There is also access to day services and voluntary organisations throughout the Borders area.


The CMHTs accept referrals of adults aged 18 to 69 years who present with a range of acute psychiatric disorders, including major mental illness, severe adjustment disorders and emotional and behavioural disturbances requiring psychiatric assessment, and with more specialist patient groups such as dual diagnosis, alcohol misuse and eating disorders. Borders CMHTs provide an assessment and treatment service, either in team base clinics, their own homes, or a community venue of their choice.

A dedicated Liaison Psychiatry service for the Borders General Hospital was started early in 2005, with emergency/same day referrals dealt with by a rota of team members. In addition, there is a Crisis Team which assesses emergency referrals and provides safe and effective community based assessment, treatment and social interventions as an alternative to in-patient care.


The Inpatient Service offers 19 acute admission beds in the newly refurbished Huntlyburn House, Melrose, in a unit originally opened in 2001 for individuals requiring 24-hour specialist nursing care. All bedrooms are single, with en-suite facilities. There are 2 sitting rooms with dining areas, additional sitting areas and one outdoor smoking area on the unit. Bed occupancy averages 85%.
Borders Addictions Service (BAS)
BAS provides assessment and care planning for Borders adults with mental health problems related to alcohol or substances misuse. The Team work closely with primary care services, with agreed shared care detoxification and stabilisation programmes. The team work within a broad philosophy of harm reduction, which recognises the right of clients to make informed choices regarding their lifestyles and changes they wish to make within this.
Child and Adolescent Mental Health Services
The Child and Adolescent Mental Health Team is based at the Andrew Lang Unit in Selkirk. It provides assessment and treatment of mental health problems relating to children and young people under the age of 18 years, and promotes the understanding of issues affecting the mental health of this age group. In-patient provision is available at the Young People’s Unit in Edinburgh.
Learning Disability Service
The Community Learning Disability Service, based in Melrose, provides a service to adults (16+ years) with a learning disability and complex mental health needs.
There are no learning disability beds in the Borders, with inpatient assessment and treatment beds accessed out-of-area. The Learning Disability Service is part of the regional planning network for South East Scotland and Tayside regions, and has now developed into a fully integrated (Health and Social Work) Borders-wide service.
Rehabilitation Service
The Community Rehabilitation Team provides a Borders-wide service for around 120 patients Borders-wide. It accepts referrals of adults from community mental health teams, the child and adolescent service and other psychiatric services where patients are returning to live within Borders. The referral criteria are:

  • adults with severe and enduring mental health problems: usually with a diagnosis of schizophrenia, schizo-affective disorder or severe bi-polar affective disorder

  • with complex needs involving the combination of health, social, occupational, employment and educational difficulties

  • who are likely to benefit from active rehabilitation, or

  • require a level of community input and consistency that cannot be provided by the acute community mental health teams.

An increasing number of referrals have co-morbid diagnoses of psychosis and alcohol/substance misuse. The Team delivers individual care packages to adults across Borders, with a key worker model of service delivery is used with a strong emphasis on multi-disciplinary and multi-agency joint working. The specialist nature of the team allows investment in specific rehabilitation skills. Multi-agency care plans ensure consistent delivery of care and continuity is ensured by community team's active involvement with the inpatient units which are adjacent to the community team base.


Inpatient Beds are provided in East and West Brig - 16 beds for patients in relapse, requiring active rehabilitation and for relapse prevention. The community team also has access to a “core and cluster” of supported accommodation in Galashiels for those patients who cannot manage in their own independent tenancies.
Borders Alcohol and Drugs Partnership (ADP)

The Borders Alcohol and Drug Partnership is responsible for implementing national drug and alcohol strategies1,2 at a local level. The ADP membership encompasses key organisations at a senior level to enable a partnership approach in tackling a broad range of issues. The Commissioning Group and four subgroups, formed to reflect national priorities, support the delivery of local action plans:




  • Practitioner’s Forum

  • Young People’s subgroup

  • Communities subgroup

  • Employability subgroup

The Commissioning Group has recently been formed to take forward the Joint Future agenda. As such it will take on responsibility for identification of funding, joint commissioning/contracting of services, and monitoring and evaluation processes.


Scottish Borders Council

Good working relationships exist between NHS Borders and the Local Authority, who are working together to implement joint strategies for mental health. A shadow Pathfinder Health and Social Care Partnership Committee will be established in 2013 and considerable work is underway to progress the Integration of Health & Social Care agenda in a way that will result in genuine improvements in the delivery of joint services.



Social Services

There is specialist Mental Health Social Work input into most CMHTs, fostering excellent working relationships. The MHO service can be contacted 24 hours per day, seven days per week.



POST INFORMATION

The Post

Mental Health Services for Older Adults

The Mental Health for Older Adults Service (MHOAS) is a Borders-wide multi-disciplinary service, which operates around two team bases: The West Team in Melburn Lodge, adjacent to our continuing complex care unit (Melburn) and opposite the dementia acute care unit (Cauldshiels); and the East Team based at Poynder View in Kelso. Lindean, the inpatient facility for functionally ill older adults, is adjacent to Cauldshiels, and has six beds. The community teams operate during the hours of 9am to 5pm, Monday to Friday, at present.


There is also a team of senior nurses who form an Older Adults Mental Health Liaison Service covering the Borders General Hospital, Community Hospitals and Care homes.
Referral
MHOAS provides a Borders-wide specialist Mental Health Service for all people aged over 70, and for those of any age with progressive dementia. MHOAS provides community assessment, usually in the patient’s own home, with treatment and ongoing support for those with complex needs. Approximately two thirds of referrals are for dementia assessment, and a third for functional psychiatric illness, mainly depression. The teams work closely with Primary Care Services, and with Social Work and the voluntary sector. In 2011 the teams received around 570 referrals.
Inpatient facilities include: A 14 bed dementia acute care ward (Cauldshiels); a 16-bed continuing complex needs ward for dementia patients requiring 24-hour NHS care (Melburn); 6 beds for functionally ill older people (Lindean). There are also four NHS Dementia Resource Centres, which include non traditional Day Care, in Galashiels, Peebles, Hawick and Kelso.


Reporting Arrangements

The Consultant will be a member of the Medical Staff Committee within the Mental Health Service and a member of the NHS Borders Senior Medical Staff Committee. There is a Joint Mental Health Clinical Management Team which is chaired by the Associate Medical Director (Dr Cliff Sharp) accountable to the Clinical Executive.




Health and Safety

You are required to comply with NHS Borders Health and Safety Policies.




Training Grade Medical Staff

You will be responsible for the training and supervision of the Training Grade Medical staff (Foundation Trainees, GPSTs, Core Psychiatry Trainees and Specialty Registrars) who work with you, and you will be expected to devote time to this on a regular basis. In addition, you will be expected to ensure that staff have access to advice and counseling.




Medical Staffing within Unit

MHOAS Staffing:
Medical Staff: 10 PA Full time Consultant (this post,West Team)

7 PA Part time Consultant (East Team)

5 PA Part-time Consultant (East Team)

8 PA Specialty Doctor


Clinical Psychology 1 Consultant Clinical Psychologist

Clinical Service Manger 1 Band 8b

Operational Manger 1 Band 8a

Team Managers: 2.0 wte Band 7

Community Psychiatric Nursing: 3.9 wte Band 6

3 wte Older Adult Mental Health Liaison Nurses

18 wte Band 5


Community Support Workers: 18 wte Band 3
Occupational Therapy: 1 wte Senior OT

1 wte Band 5 as part of Melburn Lodge staff

complement

1 wte Band 5 (MHA Monies)

0.5 OT Helper

Administrative Staff: 2.0 wte Team Secretary

2.0 wte Secretary

An office with PC, e-mail and internet access is available in the MHOAS Office. Patients are seen in the community and in local day services, health centres and residential nursing homes. There is dedicated secretarial time for clinical work and additional administrative time available within Medical Administration to assist with rotas, education programmes, etc.

The Consultant staff establishment within the Mental Health and Learning Disability Network is as follows:

Dr Cliff Sharp Associate Medical Director/Consultant

Psychiatrist - South Community Mental

Health Team

Dr Amanda Cotton South Community Mental Health Team

Dr Basel Switzer East Community Mental Health Team

Dr Derek Dickson West Community Mental Health Team

Dr Ruth Solomon (p/t) Rehabilitation Team

Vacant (this post) Mental Health for Older Adults

Dr Gill Yellowlees (p/t) Mental Health for Older Adults

Dr Ingrid Swan (p/t) Mental Health for Older Adults

Dr Mark Hughes Learning Disability Service

Dr Sarah Glen (p/t) Child & Adolescent Mental Health Service

Dr Theresa McArdle Child & Adolescent Mental Health Service

Dr Joanna Smith Liaison & Crisis Team Psychiatry

Dr Jason Luty Borders Addictions Service

Other permanent medical staff supporting the Service:

Dr Kate Bisset (p/t) Specialty Doctor, East Community Mental

Health Team

Dr Flora Sinclair (p/t) Associate Specialist, Rehabilitation Team

Dr Eimear O’Kane (p/t) Specialty Doctor, West Community Mental

Health Team

Dr Anne-Marie McGhee (p/t) Associate Specialist, Child and Adolescent

Service

Dr Muriel Foreman (p/t) Associate Specialist, Child and Adolescent



Service

Dr Chammy Sirisena (p/t) Associate Specialist, Learning Disability

Team

Dr Lucy Calvert (p/t) Specialty Doctor, Mental Health for Older



Adults

Dr Jenny Forbes (p/t) GP with Special Interest, Addictions Service

Dr Rowena Murray-Park Specialty Doctor (inpatient unit)

Dr Karen Andrews (p/t) Specialty Doctor, Rehabilitation Service






DUTIES AND RESPONSIBILITIES

Main Duties



Clinical

  • To take a clinical lead in conjunction with the two part-time consultants currently in post in the provision of Old Age Psychiatry, and to have medical responsibility for outpatients and inpatients from the West (Peebles/Galashiels) areas. (this is currently under review)




  • To undertake psychiatric and risk assessments, and treatment planning in conjunction with the multi-disciplinary team within both community and inpatient services.




  • To promote a multi-disciplinary/multi-agency approach and provide consultancy support to Primary Care staff, Mental Health Nurses and the Resource Centres within the catchment area.




  • To be an Approved Medical Practitioner in terms of the Mental Health (Care and Treatment) (Scotland) Act 2003 and undertake the required duties in relation to this.




  • To provide psychiatric court reports as requested by the local legal authorities.




  • To take a special interest lead, the nature of which is to be agreed between the post holder and Associate Medical Director.




  • To participate in the psychiatric on-call rota.




  • To participate in cross cover arrangements for other colleagues during periods of annual leave, study leave and short term sick leave.


Liaison With Other Agencies

  • To provide expert advice and forge working links with other stakeholder agencies and groups, including out of area services for Borders clients and primary care


Management

  • To contribute to the continuing strategic development and evolution of mental health services overall and old age psychiatric services in particular, working closely with the Clinical Service Manger for the area, in line with national and local guidance, including the proposals for integration of Older Adult services with the relevant Local Authority.




  • To participate actively in the NHS Borders Clinical Governance programme, including active involvement in clinical audit, critical incident reviews and complaints management.


Education, Training & Research

  • To provide supervision to the Core Trainees in Psychiatry or Foundation doctors who may rotate into a training slot from time to time. In addition, there may be a Specialist Trainee in Psychiatry attached to the Team for whom appropriate supervision will also be required, depending on the incumbent obtaining approval as a trainer.




  • To initiate or participate in relevant research, as appropriate and if interested. There are excellent library facilities available at the Education Centre based in the grounds of the nearby Borders General Hospital, access to the NHS eLibrary from your PC, and a comprehensive patient information system.




  • To participate in Continuing Professional Development, annual appraisal and Revalidation.




  • To participate in the training and development of staff, including medical students on attachments, nursing staff and AHPs.




  • To participate in the local post-graduate education and training programme. There is also an opportunity to become involved in the MRCPsych Teaching Course and the General Practice Psychiatry Course for Vocational Trainees in Edinburgh with which the Borders has close links.







WORK PROGRAMME AND OUTLINE JOB PLANS



As required under Section 3 of the Terms and Conditions of Service, the duties and responsibilities are supported by a job plan and work programme. On taking up post, the formal plan will be agreed by the Head of Service and the successful applicant and subject to an annual cycle of review.


The job plan will include specific responsibilities as well as on-call commitment and sub specialty sessions. Therefore the content of the job plan will be dependent on the successful candidate’s subspecialty training and interests and may also be modified for part-time or job share postholders.
The default position in the job plan for a new appointment is 1 Supporting Professional Activity (SPA). On appointment, or at any time thereafter, SPA time will be negotiated for specific, clearly identified duties and these activities would be reflected in the job plan.





Days

Timing

Type of Work

Location

Monday


AM

Team Meeting / Admin




Melburn Lodge

PM


Education Meeting

Melburn Lodge

Tuesday

AM


Clinical Work

Melburn Lodge

PM


Clinical Work

Melburn Lodge

Wednesday


AM


Clinical Work

Melburn Lodge

PM


Clinical Work

Melburn Lodge

Thursday

AM


Clinical Work

Melburn Lodge

PM


SPA

Melburn Lodge

Friday

AM


Clinical Work

Melburn Lodge

PM


Clinical Admin

Melburn Lodge

Out of Hours on-call




1 in 10 commitment to non resident On-call



NHS Borders




Notes on Job Plan

  • This is a draft job plan – a final job plan will be agreed with the successful candidate.

  • This is a full time contract which includes the consultant on call. The job plan would be amended if the successful candidate is part-time.

  • 1 in 10 commitment to Consultant non resident On-call










NHS Borders Board


NHS Borders has an entirely integrated structure for management of health services. Decision-making is firmly embedded within an integrated Clinical Executive, part of a natural evolution towards more integrated care, which has seen health and social services within the Borders develop nationally recognised joint initiatives. From January 2013, the SGHD announced a consultation for legislation on integration of adult health and social care services, with a particular focus, via performance management, on improving outcomes for older people.

The Clinical Executive (CE) is the body responsible for ensuring the overall management of services, operational service planning and service redesign. The CE is chaired by the Chief Operating Officer and includes the Medical Director, Director of Nursing, Clinical Chairs and General Managers from each of the Clinical Boards across NHS Borders (including the Mental Health Clinical Board)

The Clinical Executive therefore has the authority to manage resources across the area and to design care from a “whole system” perspective.

Clinical Governance is well established, forming part of the Risk Management of the whole organisation. Clinical Governance is seen as a positive support to all clinicians with active participation by all professions. There is a wide range of opportunities for the post-holder to be involved in this area of work.





Educational Facilities

There is an excellent library within the Borders General Hospital grounds run by Napier University with good Internet access. Post graduate and continuing medical education is actively encouraged and supported.




The Scottish Borders

Scottish Borders covers a large and scenically beautiful area of the Southern Uplands of Scotland. Predominately rural, it is historically a unique part of the country, the home of the Border Reivers, where annually each town in the Borders maintain its links with the past during the season of Common Ridings. Seven-a-side rugby originated in Melrose, and the Melrose event in particular draws large crowds each year. The Borders has tremendous facilities for sport and leisure. Glentress and Innerleithen mountain bike parks are world renowned for both cross country and down hill biking. The beautiful Berwickshire coast provides options for sea kayaking, surfing, diving and sea fishing. In addition there are facilities for fishing, golf, swimming, horse riding, cricket, football, hiking and many other activities. The Borders has excellent cultural opportunities in terms of music and art societies, drama, and small theatres in Melrose and Selkirk as well as amateur opera. There are excellent restaurants, cinemas and shops. The Hospital also has corporate membership of an excellent Fitness Centre in Galashiels. There is a purpose built nursery in the grounds of the hospital for hospital employees’ children.


The Scottish Borders offers all the benefits of rural life with very easy access to major cities such as Edinburgh (37 miles) Glasgow (75 miles) Newcastle (75 miles). Edinburgh is renowned for its cultural activities in music, including opera and ballet, theatre, cinemas (including a film theatre) and visual arts, and of course every year there is the world famous Edinburgh International Festival and Fringe Festival. Glasgow also runs an annual festival in the early summer.
There are rail links to the rest of the country at Berwick Upon Tweed, and Carlisle and there is easy access to Edinburgh Airport (approximately 1 hour 15 minutes) and Newcastle Airport (approximately 1 hour 30 minutes). The reopening of the Waverly line, Edinburgh Waverly Station – Tweedbank Station terminus (1 mile from BGH) railway line is expected by the end of 2014.
House prices in the Borders Region are significantly less than in major cities and also less than many other rural parts of the country, particularly in the south. There is assistance with temporary housing costs and relocation allowances up to full inland revenue limits for the successful applicant.
Please see Websites:
Scottish Borders Tourist Board - www.scot-borders.co.uk

Southern Reporter - www.borderstoday.co.uk

NHS Borders – www.nhsborders.co.uk





PERSON SPECIFICATION

Attributes


Essential

Desirable


Qualifications


MRC Psych (or equivalent)

Full GMC Registration

Included on the General Medical Council (GMC) Specialist Register, or Specialist Registrars within 3 months of completing their CCST.

Applicants should hold Section 22 of the Mental Health (Scotland) Act approval or be willing to gain the approval once in post.



Qualifications in psychiatry of old age. (sub-specialty endorsement).

Qualifications or training in geriatric medicine.




Training and

Experience

Relevant experience in old age psychiatry, including both dementia and functional illness.

Clinical expertise in community psychiatry and knowledge of modern treatment options.

Experience of and skills in multi-disciplinary working.
Training record culminating in

award of CCST or equivalent


Experience in motivating and training junior medical and other healthcare staff.


Working in a CMHT.

Experience of prescribing and monitoring acetyl cholinesterase inhibitors






Skills, abilities and knowledge
Managerial

Experience in day-to-day organisation of Mental Health for Older Adults services.


A commitment to developing services and working in partnership with service users and carers.
Basic management skills
Thorough understanding of healthcare governance.

Familiar with structure of Scottish Health Service and recent initiatives.


Developing multi-disciplinary clinical service.


Skills, abilities and knowledge
Audit



Thorough understanding of principles of clinical audit and healthcare governance.


Experience in undertaking and completing audit projects





Skills, abilities and knowledge
Research and

Publications

Knowledge of the principles of

medical research
Thorough understanding of recent Psychiatry literature.

Research experience


Publication of research and /or review article(s)



Personal Attributes

Effective communicator with patients, relatives, colleagues across primary and secondary care.


Able to work in a small inter-disciplinary team and co-operate with medical, nursing and other healthcare staff.
Reliable.
Professional approach to work.






Other


Car driver with full driving



license





TERMS AND CONDITIONS



Main Conditions of Service





  • The Terms and Conditions of Service will be drawn from the New Consultant Contract (2004)




  • The appointment will be made by NHS Borders on the recommendation of an Advisory Appointment Committee, constituted in terms of the National Health Service (Appointment of Consultants) (Scotland) Regulations 2009 - NHS Circular CEL 25 (2009). Any person suitably qualified and experienced who is unable for personal reasons to work full-time, will be eligible to be considered for the post on a part-time basis.




  • Possession of MRCPsych or equivalent certificate is essential. You must also be fully registered with the General Medical Council with a licence to practice and your name should appear in the Specialist Registrar for Psychiatry. Alternatively you may be within six months of the expected date of obtaining your CCST or equivalent.




  • The full-time salary, exclusive of any discretionary points or distinction award, will be on the scale £74,504 – £100,446 per annum with scale placing as appropriate to experience and qualifications. There is a 3% availability supplement for participation on the on-call rota.




  • Annual leave allowances and public holidays are combined 8 weeks per annum for a full time appointment.



  • The appointment will be superannuable if the person appointed chooses. He or she will be subject to the regulations of the National Health Service Superannuation Scheme and the remuneration will be subject to deduction of contributions accordingly, unless he or she opts out of the Scheme.




  • The NHS Board is legally liable for the negligent acts or omissions of the employees in the course of their NHS employment. Medical staff are however advised to ensure that they have defence cover for activities not covered by the NHS indemnity.



  • All entrants to the Borders General Hospital must be certified medically fit and the appointment is conditional on such certification. Arrangements for medical screening are the responsibility of the Occupational Health Service. Candidates must show evidence of immune status to HEPATITIS B, or agree to undergo the necessary procedures. The Occupational Health Service will check this.




  • The normal notice period in the Terms and Conditions of Employment is 3 months notice from either side to terminate the appointment.




  • Assistance with removal expenses / temporary accommodation etc. may be provided in accordance with the Relocation Benefits Policy.




  • NHS Borders operates a No Smoking Policy. It is a condition of your employment that you must not smoke whilst you are on duty. Failure to observe this rule could result in disciplinary action. When selecting new staff, NHS Borders does not discriminate against applicants who smoke but applicants who accept an offer of employment will, in doing so, agree to observe the policy and the legal requirements on smoking in public places.




  • The Equal Opportunities Policy affirms that all employees should be offered equal opportunities in employment, irrespective of their age, gender, marital status, race, religion, creed, sexual orientation, colour or disability.






1 Tackling Drugs in Scotland: Action in Partnership, Scottish Office 1999

2 Plan for Action on Alcohol Problems, Scottish Executive 2001


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