Consultant in Community Older Persons Mental Health (OPMH) Psychiatry

Job responsibilities

The Clinical Role

The community mental health teams and memory services provide psychiatric community care to patients over the age of 65.

The West Somerset area covers 8 GP practices and equates to approximately 11000 patients over the age of 65 (CCG figures December 2017). The Taunton area relating to this post covers one large GP Practice (Bishops Lydeard) with a population of approx. 1000 patients over 65. There is also a much smaller group of patients under 65 years of age, with primary dementias who are also cared for by the older adults' community mental health team.

There is an emphasis on members of the CMHT seeing the majority of initial assessments with a daytime duty rota dealing with urgent referrals. This helps to minimise consultant emergency work and keeps their individual community caseload at a manageable size. The CMHT will seek advice from the post holder in order to guide management for the patient; this is achieved through formal team meetings, as well as ad hoc discussions with the team when required.

Staff from within the dementia assessment service currently see all initial referrals; these are discussed with the consultant and a decision is made as to who is best placed to see the patient for further assessment and treatment. We are encouraging colleagues in primary care to make memory assessments in less complex cases and the post holder will be expected to work with colleagues in primary care in order to advise and support these diagnoses.

The post holder will hold regular clinics in Minehead and Taunton, as well as undertaking domiciliary visits when required.

The community mental health teams are part of wider integrated teams. Each team is collocated with staff from district nursing and the integrated rehabilitation team (community OT and Physiotherapists). These links are very helpful when managing a patient from a holistic viewpoint. The links will also allow the post holder to work towards closer integration between physical and mental health care, as well as primary and secondary care. Being collocated with this team allows for a free flow of advice and ideas between the services.

Transfers from general adult services to older adults are made in discussion between the teams, and with the patient and their carer. Our aim is that the right treatment is delivered by the right people at all times.

OUT-OF-HOURS ON-CALL DUTIES:

There are no compulsory Out of Hours duties as part of this role.

The post holder can opt to join the senior out-of-hours on-call rota subject to availability. Duties include senior medical and RC cover for the inpatient wards and S12 MHA work both in Trust premises and in the community.

This is a 1 in 12 rota operating 5pm to 9am on weekdays; at weekends the rota operates from 9am on Saturday morning to 9am on Monday morning.

This rota provides senior medical cover including Responsible Clinician duties to all the inpatient wards in the Trust except the child and adolescent ward (Wessex House). It therefore covers inpatient services for adults of working age (Rydon 1 and 2 Wards in Taunton, Rowan Ward in Yeovil and St Andrews Ward in Wells), older people (Pyrland Ward in Taunton), the PICU (Holford Ward in Taunton), and the rehabilitation and low secure wards (Willow and Ash Wards respectively in Bridgwater). Hence it includes duties for patients within the following specialties: adult general, old age, rehabilitation and learning disability.

The senior on-call rota also involves MHA assessments in inpatient wards, the two Hospital Place of Safety suites (located in Yeovil and Taunton), the district general and community hospitals, police custody centres and also in the community.

The rota attracts a payment of 1 PA (for the S12 component) and a 3% salary enhancement for the RC / senior medical cover for inpatient wards. Section fees are also paid and retained for assessments (excluding current Trust inpatients).

The rota is occasionally supported by senior trainees who undertake the Consultant Role under supervision until midnight.

The trust is currently piloting an all age rota ( as above but including CAMHS Inpatient and community ) and if successful the trust will plan to move towards this for provision of cover out of hours.

Person Specification

Qualifications

Essential

• Medial Degree
• Mental Health Act Approved Clinician / Section 12 approval -- or eligible and willing to apply for these.
• Entry on GMC Specialist Register or eligible for entry on Register within 6 months of interview via Specialist Training (CCT) or CESR

Desirable

• MRCPsych.
• Accredited for the training of Higher trainees / junior doctors.
• Further professional qualifications such as MRCP/DGM
• A Higher degree such as a Masters Degree.

Experience

Essential

• Significant experience of assessment and management of patients in Older People's community psychiatry.
• Ability to offer expert clinical care of patients.
• A particular understanding of the care and treatment of frail older adults in the community.
• A clear understanding of mental health and mental capacity legislation and the application of these areas of legislation as they relate to community care.

Desirable

• 3 years supervised training in an appropriate ST4-6 equivalent ...