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NHS Grampian (Grampian Teaching Hospitals) CONSULTANT ADOLESCENT PSYCHIATRY JOB REFERENCE DK5403 Young People’s Department Royal Cornhill Hospital Aberdeen Description of Post Based at the Young People’s Department, Royal Cornhill Hospital, these permanent posts are available due to retirements.. The department offers a service to young people in Aberdeen City and Aberdeenshire, a beautiful and generally prosperous and thriving area. The posts offer the opportunity to work in a well established and organised multidisciplinary team, able to offer a wide range of evidence based treatments. There are excellent links with primary care and the establishment of Community Health Partnerships (joint NHS Grampian and local authorities) are now offering increased opportunities for integrated planning for CAMHs services, and improved links with local authority and voluntary sector services. Recent developments have included the establishment of care packages for a wide range of clinical problems, and ongoing work to develop local intensive services for adolescents within the recently established North of Scotland adolescent CAMHS Tier 4 network.. This is therefore an exciting opportunity to be part of further developments in an integrated CAMHS service. Current team composition Vacancy Consultant Psychiatrist (full-time) Dr. Anne Gilchrist, Consultant Psychiatrist (0.9) (clinical lead) Dr Kandarp Joshi, Consultant Psychiatrist (1.1) Dr Lynn Brown, Consultant Psychiatrist (0.9) Dr. Catherine Cougan, Staff Grade Community Child Health (0.2) Specialty Doctor (full-time) – vacant Dr David Huxtable Clinical psychologist (full time) Dr Jenny Makinson Clinical psychologist (0.9) Dr Danielle Skene, Clinical psychologist (0.5) – maternity leave Dr. Rachael Smith, Senior Clinical Psychologist (full time) Dr. Lynne Taylor, Consultant Clinical Psychologist (0.5) Ms Lynne Connell, Nurse Specialist in Adolescent Mental Health (0.6) Mr. Alan Davidson, Nurse Specialist in Adolescent Mental Health (full time) Mrs. Gail Duncan, Nurse Specialist in Adolescent Mental Health (0.6) Mr Peter Hammond, Nurse Specialist in Adolescent Mental Health (full time) Mr. Kenny McLeod, Nurse Specialist in Adolescent Mental Health (full time) Ms Jakki Mathers, band 6 nurse Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 1 of 12 Mrs. Sheila Reid, Nurse Specialist in Adolescent Mental Health (0.6) Mrs. Raeleen Thomson, Nurse Specialist in Adolescent Mental Health (0.6) Ms. Linda Stewart, Nurse Specialist in Adolescent Mental Health (full time) Mrs. Lizzie Dixon, Occupational Therapist (0.8) Mrs Claire Inverarity Health Care assistant Mrs Mandy Farman, Secretary (part time) Mrs. Ivy Hutcheon, Secretary (part-time) Mrs Helen Paterson, Secretary (part time ) Ms. Nikki Sharma, Receptionist (full-time) Ms Natalie Bain, secretary (full time) Clinical service The Young People’s Department provides assessment and treatment for young people with all types of moderate to severe mental health and developmental difficulty. Referrals are accepted from Aberdeen City, Aberdeenshire (excluding Banff) and Orkney. The age range is between 13th and 18th birthdays, and there are around 900 referrals each year, from a total population of around 450,000. Clinical work is undertaken on a multidisciplinary basis, using a whole team CHOICE and PARTNERSHIP model. Referrals are accepted from GPs, community child health, paediatrics or medical services, social work or educational psychology. Most young people referred are invited to book an initial CHOICE appointment, and will subsequently be booked into an appropriate PARTNERSHIP appointment if required. Other care pathways for specific types of referrals are in place. During later clinical contact other care may be arranged using specific skills of team members There is a multidisciplinary on call rota for enquiries or clinical issues. Urgent CHOICE appointments are reserved to be booked for cases which meet specified criteria. Tier 4 intensive care can be organised on an out patient or day patient basis, and uses an integrated care pathway designed for the North of Scotland network. Immediate local in patient treatment can be organised through a protocol for admission to Crathes ward, Royal Cornhill Hospital, and the network arrangements will support further care planning including access to a regional young peoples unit (a new expanded 12 bed unit in Tayside will open in 2014).. When required YPD Consultants act as RMO for in patients in Crathes ward and undertake duties as an Approved Medical Practitioner with regard to the Mental Health (Care & Treatment) (Scotland) Act 2003. Consultants otherwise are medically responsible for cases seen by them or medical staff, but other members of the multidisciplinary team carry clinical responsibility for their own cases. Young people with identified learning disability and mental health problems are seen by a separate service based at the Royal Aberdeen Children’s hospital. Urgent liaison psychiatry referrals (including assessments following deliberate self harm) are dealt with by the liaison psychiatry team (if 14 or older), and by the Department of Child and Family Mental Health (if under 14 and admitted to the Children’s Hospital). Referrals with a primary problem of substance misuse are dealt with by a specialist worker in the substance misuse team if aged 16 or over, and jointly with a YPD team member if under 16. There are multidisciplinary supervision and educational meetings at fixed times during the week, which all team members are expected to attend, and quarterly clinical governance case reviews. Individual team members are encouraged to develop areas of special interest. Current interests within the team include, for example, autism spectrum disorders, eating disorders, and schema focused therapies. We hope soon to Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 2 of 12 extend the team’s approach to multiagency consultative work, and to develop evidence based approaches for emerging personality disorder. Team members are actively involved in research and particular interests include neurodevelopmental disorders, schema based approaches with adolescents, and intensive services. It is expected that the appointee will take part in ongoing programmes of undergraduate and postgraduate teaching. It is also expected that the appointee will be involved in clinical and service audit and other clinical governance activities, for which support is available within the team and from full-time audit staff. The department provides training placements for core trainees (CT1-3) and Specialty Registrars (ST4-6) on the N/NE Scotland training scheme in child and adolescent psychiatry. Consultants are encouraged to become educational supervisors and to be actively involved in teaching and training. Management arrangements for NHS Grampian CAMHS are integrated with a dedicated full time CAMHs manager and a clinical lead. The CAMHs service is a separate entity within the adult mental health (AMH) and CAMHS directorate. Programmed activities will currently be allocated by arrangement with the appointee, through job planning, which is to be undertaken with Dr Anne Gilchrist, clinical lead for CAMHS. The posts are available for ten Programmed Activities, and up to two Extra Programmed Activities may be available by separate negotiation. An indicative timetable is attached. The Indicative Timetable is prepared in line with NHS Grampian’s policy of advertising new Consultant posts with nine Direct Clinical Care PAs and one session of Supporting Professional Activity (SPA). The detailed job plan will be agreed with the successful candidate at the time of appointment, taking account of the experience, skills and interests of the candidate and how they can best be used within the consultant team. The job plan will be reviewed on an annual basis in line with nationally agreed policy and there will be an interim review six months after commencement of post. There is currently no out of hours commitment. It is possible, subject to changes in management arrangements, that a joint child and adolescent duty rota may be considered, with appropriate remuneration and job planning negotiations. The Department was refurbished in 2010 using funding from the Archie charitable foundation in order to provide a young person-friendly environment. The appointee will have their own office for clinical and non clinical work within the Young People’s Department. All consultants have access to a computer with e-mail facility and Internet access. Secretarial support will be provided by a named secretary within the administrative team, supported by other members of the team as needed. All secretarial staff work for a small group of team members, and provide cross cover when required. The appointee should hold a valid driving licence. expected to live within ten miles of the base hospital. A Consultant will normally be Professional development, study and training The post holder will be expected to participate in annual Consultant Appraisal. Local training opportunities available to all NHS Grampian staff include teaching, clinical supervision, research, management and leadership skills. All consultants become members of the Psychiatric Medical Advisory Committee. Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 3 of 12 The appointee will be expected to maintain his/her standards of knowledge and clinical practice including undertaking training as an Approved Medical Practitioner with regard to Mental Health (Care & Treatment) (Scotland) Act 2003. It is expected that the appointee will register with the Continuing Professional Development Programme of the Royal College of Psychiatrists, for which funding will be provided, and that he/she will prepare a Personal Development Plan in consultation with colleagues. There is an active local programme for continuing professional development, and the appointee will be encouraged to attend and contribute. Funding is made available for other approved study leave. Clinical research is encouraged by NHS Grampian and is supported by the University Departments of Mental Health and Child Health, and the Clinical Research Centre. All staff have access to an on site library and the NHS e-Library. The hospital is a short distance from Aberdeen University Medical School on the Foresterhill site, which has a full medical library and other research facilities. Other Child and Adolescent Mental Health Services in NHS Grampian CAMHS The Rowan centre, Elgin provides a child and adolescent service for young people from Elgin (up to 16) and Banff (up to 18) areas. There are currently 1.5 Consultants based in Elgin and a small multidisciplinary team. The team works with out patients and uses local in patient facilities in Elgin when required. There is collaboration with colleagues in the adult services. (Six Consultants are based at Dr Gray’s Hospital, Elgin) The Department of Child and Family Mental Health is located at the Royal Aberdeen Children’s Hospital, and Rosehill House, both on the Aberdeen Royal Infirmary, Foresterhill site. It has out patient facilities and a day hospital for children and adolescents up to school leaving age (the Lowit Unit). There are 3.5 WTE Consultant Psychiatrists in the general out patient services in the Department of Child and Family Mental Health, and there is an identified team for children and adolescents with learning disability with a further 1 WTE CAMHS LD consultant. Dr Justin Williams, Honorary Consultant/Senior Lecturer in the Department of Child Health (Aberdeen University) acts as consultant (0.5WTE) to the Lowit unit. GENERAL INFORMATION ABOUT NHS GRAMPIAN MENTAL HEALTH SERVICES Health services are provided in close co-operation with local authority services, through community health partnerships for each local authority area (Aberdeen City, Aberdeenshire and Moray), which are responsible for the provision of most health services for the area. NHS Grampian embraces the acute services, mental health, primary care and other services across Grampian. Mental Health Services are managed as a single entity, divided into Clinical Directorates, Adult Mental Health and CAMHS,, Old Age Psychiatry, Specialisms, Learning Disability, and Elgin based services. There are well established multidisciplinary Mental Health Services for Adults (16 Consultants), the Elderly (8 Consultants), and in a number of specialty areas – Learning Disabilities (4 Consultants), Forensic (3 Consultants), Psychotherapy (1.5 Consultants), Substance Misuse (2 Consultants), Liaison (1 Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 4 of 12 Consultant), Eating Disorders (0.5 Consultant) and Rehabilitation (1 Consultant). There are three Honorary Consultants. The Mental Health Services Clinical Management Board of NHS Grampian is responsible for the provision of psychiatric services to Aberdeen City, Aberdeenshire, Moray and to Orkney. In-patient psychiatric care is provided for the Shetland population. The Royal Cornhill Hospital is located close to the centre of Aberdeen. The Young People’s Department and the Psychotherapy Department are located in separate older premises on the Royal Cornhill site. The main hospital has a bed complement of 416 and includes acute and continuing care wards, central treatment complex (Physiotherapy, Occupational Therapy and ECT suite) and forensic and intensive psychiatric care units. Adult learning disability services are provided from a newly developed purpose built inpatient facility at Elmwood (also on the Royal Cornhill Hospital site). There are excellent library facilities and designated seminar rooms with full audio-visual and video teleconferencing facilities. These are supported by a part-time audio-visual technician. A new Day Nursery for staff use is located on the Royal Cornhill Hospital site. There are two Associate Specialists, eleven full-time and seven part-time Specialty Doctors in Aberdeen. There are two Associate Specialists (one full time and one part-time) and two Specialty Doctors (one full time and one part-time) in Elgin. There is an establishment of 34 Specialist/Specialty Registrars, four GP Specialist Registrar slots and six Foundation House Officer 2s in Aberdeen. There is one Specialist Registrar, one GP Specialty Registrar and one Foundation House Officer 2 in Elgin. Department of Mental Health, University of Aberdeen The department occupies re-furbished accommodation on the Royal Cornhill site. The current staff complement comprises Professor Ian Reid (Head of Department); Professor David St. Clair and Professor Claude Wischik. Dr. Andrew Moskovitch is a senior lecturer in Clinical Psychology. Further appointments are anticipated. Administrative staff includes Ms. Angela Thomson (senior secretary) and Ms. Kirsty Sykes. At the moment there are 9 graduate research students and research fellows. NHS consultants. Dr Ross Hamilton (Honorary Senior Lecturer); and Dr. John Callender (Honorary Senior Lecturer and Research Fellow) each have research dedicated sessions. Honorary University appointments can be negotiated when appropriate for new NHS staff. The Department has a wide-ranging research portfolio, including neuroimaging studies in affective disorder; investigation of the genetics of schizophrenia; observation of the impact of early trauma on adult psychiatric disorder; and a variety of cognition related studies, focusing on the effects of mood disorder and ageing. Dr Justin Williams, senior lecturer in child and adolescent psychiatry, has an interest in autism spectrum disorders and functional neuroimaging. The University staff contributes to the NHS general adult and CAMHS psychiatry, psychotherapy and old age clinical services. Undergraduate teaching is jointly developed and administered with NHS colleagues via the local Committee for Undergraduate Training and Education. Further information is available at www.abdn.ac.uk/mental health Good links exist with the academic department of Child Health. Within the Department of Child Health is the Developmental Cognitive Neuroscience Unit (DevCoN-U) and the Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 5 of 12 Scottish Evidence Based Child Health Unit (SEBCHU). DevCoN-U supports a range of studies, largely involving funded research into the imitative deficit associated with autism. In particular Aberdeen’s excellent neuroimaging facilities are utilised to do MRI studies. SEBCHU is funded by the Scottish Office and has a remit to carry out systematic reviews of the literature, to advise the Scottish Office on public health interventions that might improve child health. Mental Health is considered an important component and a current topic of interest is the effect of interventions for postnatal depression on child health. Input from clinical advisors is sought and welcomed. Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 6 of 12 NHS GRAMPIAN (Grampian Teaching Hospitals) Consultant in Adolescent Psychiatry TERMS AND CONDITIONS OF SERVICE (a) The appointment will be made by NHS Grampian, on the recommendation of an Advisory Appointments Committee, constituted in terms of the National Health Service (Appointment of Consultants) (Scotland) Regulations 1993, which will include University Representatives. (b) The person appointed will be expected to take part in Continuing Medical Education, which includes regular case conferences, journal clubs, and other meetings. In addition there will be undergraduate teaching responsibilities. It is anticipated that the University of Aberdeen will invite new NHS staff to apply for honorary status. (c) NHS Grampian encourages Consultants to undertake appropriate research work and it is expected that University facilities will be made available to assist in such work. (d) Day to day arrangements for undertaking the specified duties of the post will be made in consultation with other Consultants in the Department and with NHS Grampian and University of Aberdeen. (e) The person appointed will have continuing responsibility for the care of patients in his or her charge and will undertake the administrative duties associated with the care of his or her patients and an appropriate share in the running of the clinical departments. (f) The person appointed may act as an adviser to NHS Grampian in Adolescent Psychiatry. (g) The person appointed will be expected to undertake domiciliary consultations as may be required by NHS Grampian. (h) The person appointed will be expected to undertake advisory visits to hospital/clinics in the area. (i) The full time salary, exclusive of any distinction award, will be on the scale £74,504 to £100,446 per annum, with appropriate scale placing according to experience and previous service. The appointee will be appointed on the terms and conditions of service in the new consultant contract and a job plan will be agreed with his/her Clinical Director and/or nominated representative. Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 7 of 12 The salary will be adjusted pro-rata to reflect any appointment that is not wholetime. Any private practice that the appointee may undertake will be governed by the Code of Conduct set out in Appendix 8 of the Terms and Conditions of Service in the New Consultant Contract. (j) The appointment will be superannuable should the person appointed choose. He or she will be subject to the regulations of the NHS Superannuation Scheme and the remuneration will be subject to deduction of contributions accordingly, unless he or she opts out of the scheme. (k) The private residence of the person appointed which shall be maintained in contact with the public telephone service, shall not be more than ten miles by road from the agreed base unless specific approval is given by NHS Grampian to a greater distance. (l) NHS Grampian is legally responsible for the negligent acts or omissions of 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 Board Indemnity. (m) NHS Boards are liable for work carried out by their own employees and also by University Medical Staff and their Research Workers under their Honorary Contracts in the course of their NHS duties. (n) Where a clinical trial is authorised, the Board is liable in respect of a claim against a Doctor involving his or her NHS Patients. All trials must have the required approval of the local Ethical Committee and the formal approval of the Board. In this connection, the Medical Director of the Board must be informed of all clinical trials in which staff are taking part in the course of their NHS Board employment. (o) Boards are not responsible for a consultant’s private practice, even in an NHS hospital. However, where Junior Medical Staff are involved in the care of private patients in an NHS Hospital, under the terms of their contract with the Board, they would be the responsibility of the Board. It should be noted where a patient is on an inclusive contract with the Board for private care, the Board would be regarded as liable for the actions of their staff. (p) The officer appointed will be required to be registered with the General Medical Council and should hold or be within six months of obtaining the Certificate of Completion of Training (CCT) or be on the Specialist Register, or eligible for inclusion on the Specialist Register. (Please note that while an appointment can be made with an applicant being within six months of obtaining the CCT, the date of taking up substantive consultant duties must post date completing training for a CCT or appearance on the Specialist Register). Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 8 of 12 (q) The appointment is subject to satisfactory fitness for employment. Therefore preemployment health screening will be required prior to appointment. (r) The Board is required to instigate a check to be made with Disclosure Scotland for any convictions recorded before an offer of appointment can be made (rehabilitation of Offenders Act 1974 amended 1985 and 1986) and (Disclosure of Criminal Convictions of NHS staff with Substantial Access to Children 1989). (s) The Board has established Joint Negotiating machinery for Medical and Dental staff. Any agreement reached in that forum will form part of your contract of employment. Where such agreement has not been reached on particular aspects of terms and conditions of service, the Trust will apply the terms and conditions of service agreed nationally for medical and dental staff under the Hospital Medical and Dental Staff and Doctors in Public Health and the Community Health Service (Scotland), Consultant Grade, Terms and Conditions of Service, April 2004 and the General Whitley Council Handbooks as amended from time to time. Your appointment will therefore initially be subject to these nationally agreed terms and conditions. (t) Three months notice of intention to relinquish the appointment is required. A similar period is also required on both sides in respect of any proposed modifications of the terms of the contract. (u) The appointee should hold a valid driving licence. Informal enquiries are welcome by telephoning the following: Dr Anne Gilchrist, Consultant in Adolescent Psychiatry on (01224) 557366. Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 9 of 12 Appendix 1 Indicative Weekly Timetable Monday AM Referrals meeting Out patients PM Out patients or Higher Training Scheme meetings when scheduled 0.5 SPA Tuesday AM Outpatient or inpatient work Clinical work PM Wednesday Thursday AM Out patients and patient related administration PM Out patients and patient related administration AM Team CPD Multidisciplinary team supervision meeting PM SPA/Clinical work Friday AM Outpatients Out patients PM Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 10 of 12 POST CONSULTANT IN CHILD & ADOLESCENT PSYCHIATRY REQUIREMENTS ESSENTIAL A Qualifications Basic MBChB or equivalent. MRCPsych or equivalent. Postgraduate . Continuing participation in approved CPD. REF: DESIRABLE Additional relevant qualifications. CCT or CESR in Child & Adolescent Psychiatry, or within 6 months of obtaining this. On Specialist Register or eligible for inclusion Eligible for recognition (if required, following standard training) as Approved Medical Practitioner with regard to Mental Health (Care and Treatment) (Scotland) Act 2003. B C Clinical Experience Ability Knowledge Clinical Skills and Technical Skills D Motivation E Interpersonal Skills F Audit G Research Experience and evidence of 1) high level of competence in all aspects of child & adolescent psychiatry across the age range 0-18 2) competence in multidisciplinary and multiagency work in child and adolescent mental health services 3) competence in teaching and supervision. Attended Training as Approved Medical Practitioner with regard to Mental Health (Care & Treatment) (Scotland) Act 2003 Experience of relevant other specialties (psychiatric & non psychiatric). Wide knowledge of child & adolescent psychiatry, range of diagnostic & assessment/clinical management skills, ability to use evidence base in clinical work. Ability to take a leadership role in services, including audit, clinical governance and service planning Specialist clinical skills in diagnosis, assessment or treatment. Interest in consulting and involving children, young people, and families. Clinical focus on recovery and resilience Willingness to be adaptable and flexible. Good time management skills. Effective interpersonal skills. Excellent verbal and written communication. Demonstrates ability to provide clinical leadership and work within a multidisciplinary child and adolescent mental health team. Knowledge and experience of principles and implementation of clinical governance processes, including clinical audit Previous experience of consulting and involving young people in service development. Experience of research; understands use and limitations of research. Relevant publications. Job Description – Adolescent Psychiatry_June09(rev Aug09) Experience with specific clinical groups eg looked after children, substance misuse, severely ill young people Experience of leading clinical audit. Page 11 of 12 H Management Ability I Other requirements Prepared by Understanding of current issues in the NHS and CAMHS policies in Scotland. Willingness to collaborate in clinical governance and service improvement Ability to adapt to unpredictable clinical demands Full registration with the GMC. Satisfactory fitness for employment. Ability and willingness to travel when necessary Dr Anne Gilchrist Previous management experience and evidence of ability to plan services. Previous involvement in developing and organising teaching. Date 050313 ` Job Description – Adolescent Psychiatry_June09(rev Aug09) Page 12 of 12