Job description

HIGHER SPECIALIST TRAINEE

GENERAL ADULT PSYCHIATRY – REHABILITATION

EAST KENT 

This is a Rehabilitation General Adult Psychiatry training post where the trainee works as a member of the multi-professional team under consultant supervision. The trainer is Dr Margaret Nolan, consultant psychiatrist to the rehabilitation service covering East Kent.

Kent & Medway NHS & Social Care Partnership Trust (KMPT) covers the whole of Kent, which has a population of 1.8 million. The services provided by the Trust are acute mental health, community and recovery (including learning difficulties), forensic, and mental health care of older adults.  Further information about the trust can be found at www.kmpt.nhs.uk.

The rehabilitation service is within the Community and Recovery Care Group. It is divided into services for East and West Kent. There is a consultant psychiatrist based in each of the two localities.

The East Kent Rehabilitation Service provides inpatient rehabilitation in three units:

11 Ethelbert Road, Canterbury has 10 beds;
Rivendell, Eastry 10 beds; -All Male
The Grove, Ramsgate has 8 beds.

The units have nursing, occupational therapy, psychology professionals and peer support staff as well as access to Vocational Rehabilitation services.

Medical input is 0.5 WTE specialty doctor on The Grove,  0.5 LTFT Core Trainee on 11 Ethelbert Road and 1.0 GP CT1 Trainee doctor on Rivendell. Dr Nolan works full time.

Clinical duties include working within this team on the units, conducting joint assessments of referrals (from acute ward, community teams or external specialist services) and supervising the specialty doctors and trainees in their work. We embrace meaningful application of the recovery model, facilitating patients to reach their goals, to prepare for their next steps after rehabilitation, to foster contacts outside the unit, to involve their family and carers in their recovery as appropriate, and to accept responsibility for self-management.

Each unit has a weekly clinical review meeting including CPA meetings. Teaching opportunities exist in the team in relation to the specialty doctors and other team members, and in the trust’s education systems.

The East Rehabilitation service will be piloting the electronic prescribing system (eMeds) in the Trust and the post holder is most welcome to contribute to and learn from the development system.

The post-holder will be supported in developing in all areas of Good Medical Practice, as published by the GMC. As well as the areas mentioned above there are opportunities for audit or quality improvement, and leadership and management experience.

The post-holder is expected to attend CPD activities. This training time will be ring-fenced in their timetable.

The post-holder will be part of a tier of out-of-hours on-call doctors between the duty junior doctors and the duty consultant. This is approximately on a 1 in 10 basis.

Two sessions per week are allocated for research and special interest experience. These may be pursued locally and/or outside the service/trust, as agreed with the TPD, in pursuit of meeting training needs.

A year in this post attracts an endorsement in rehabilitation psychiatry. Skills and competencies likely to be enhanced during the training include those described in the RCPsych curriculum entitled ‘Specialists in General Psychiatry with Endorsement in Rehabilitation Psychiatry’. These can be summarised as follows:

• Complete and document assessments of patients from diverse demographic groups.
• Formulate patients’ situations.
• Investigate appropriately, including biological, psychological and social aspects.
• Assess and manage risk.
• Interview therapeutically, applying a variety of modalities of therapy.
• Assess and manage patients suffering from serious and complex mental illness.
• Work in a multi-professional team.
• Develop leadership skills.
• Develop as a trainer – capability to teach, assess and appraise.

These learning outcomes will be offered through day to day clinical work and duties, which include:

• Mental Health Act work
• Application of the Mental Capacity Act
• Assessment of referrals
• Use of the recovery model and personalised care plans.
• Participating in weekly clinical review meetings on each unit.
• Supervision of doctors.
• Working in a team, including developing leadership skills.
• Involvement of family and carers.
• Contributing to the service meeting national and trust requirements.
• Helping ensure we meet the requirements of the CQIN relating to physical healthcare.
• Using NICE guidance and prescribing guidelines.
• Attendance at unit Business Meetings.

The post holder will have opportunities to gain experience of:

• Teaching and supervision.
• Audit and quality improvement projects.
• Group work.
• Involvement in service development.
• Medical Leadership in teams.

Dr Nolan has a wide range of consultant experience having worked in community mental health, acute  inpatient ward and Psychiatric Intensive Care settings.

She has extensive experience of supervising trainees form Foundation Year to Specialist Trainee 6 levels and has remained up to date with training courses relevant to the developing research and educational approaches.

A possible timetable appears below. This would be negotiated prior to starting in post.

Time	Monday	Tuesday	Wednesday	Thursday	Friday
AM	9.30 - Clinical review meeting Rivendell	Research or special interest	9.30 - Clinical review meeting. 11 Ethelbert Road	Teaching programme CPD	Working with carers and or families
PM	Assessments	Research or special interest	Supervision - junior doctor. Supervision by Dr Nolan to HST	Rehabilitation East. Referrals and business meeting	Assessments

Current timetable for Dr Nolan

Monday

• AM - Rivendell MDT client review, inc CPA
• PM - Supervision trainee

Tuesday

• AM - The Grove MDT client review, inc CPA
• PM - Supervision trainee

Wednesday

• AM - 11 Ethelbert Road client review, inc CPA
• PM - HST supervision

Thursday

• AM - Local CPD programme
• PM - East referrals and business meeting

Friday

• AM - referrals
• PM - CPD

There is flexibility within the time Table to address any urgent issues in the service.

There is a monthly Joint East /West Service  meeting(1^st  Tuesday Mornings).

MHRT meetings are generally held on Thursdays and Fridays.

There is time to engage with service users doing activities in the afternoons ad for ad hoc activities such as fishing, outings, walks.