Old Age Psychiatry

 

 

NO

SPECIALITY

AREA/HOSPITAL

TRAINER

01

Old Age – community and inpatient (organic)

Bath

Dr Ros Ward

02

Old Age – inpatient

 

Bristol

Dr Jonathan Hewitt

03

Liaison psychiatry (Old age and General Adult)(non-core) - endorsement

Bristol

Dr Anish Patel

04

Liaison Psychiatry - Old Age (but opportunity to achieve endorsement)

Bristol

Dr Alison Lerant

05

Old Age – core

Community and inpatient

Gloucestershire

Dr Nick Ardagh-Walter

06

Old Age - community

Gloucestershire

Dr Martin Ansell

07

Old Age - community

Gloucestershire

Dr Joe Stratford

08

Old Age – community/memory/ research

Gloucestershire

Dr Tarun Kuruvilla

09

Old Age – community and inpatient

Gloucestershire

Dr Katie Kelly

10

Old Age – community/memory

North Somerset

Dr Niall Moore

11

Old Age – community

 

Somerset

Dr Antony Christopher

 

 

12

Old Age – core community and inpatient

Somerset

Dr Mark Upton

13

Old Age – core community and inpatient

Somerset

Dr Stephen de Souza

14

Old Age - community

South Gloucestershire

Dr Sarah Price

 

15

Old Age –

community

South Gloucestershire

Dr Geoff van der Linden

 

DETAILED DESCRIPTIONS

01

Old Age Psychiatry –community and dementia inpatient

Bath/Midsomer Norton

Dr Ros Ward

This is a community post in Old Age Psychiatry (non core), offering  organic inpatient and community experience in the Bath locality. The Advanced Trainee will be a member of the integrated multidisciplinary Complex Intervention and Treatment Team covering the North East Somerset half of the locality and will be encouraged to work closely with the team. The North East Somerset CITT is based at The Hollies, Midsomer Norton, a modern building on the High Street, whilst the organic inpatient unit is based at St Martin’s Hospital in Bath. At present, older adults with functional illness who require an inpatient admission are cared for in other areas of the Trust, but plans are in progress for a dedicated inpatient facility to be completed in 2018. The team serves a population of approximately 19,000 older adults (65 and over), and the training consultant serves 15 GP practices.

 

All work will be supervised by Dr Ward. There is an hour-long, weekly supervision session with Dr Ward. The post offers a broad range of experience in the assessment and management of organic and functional mental disorder in older adults.The trainee will have a dedicated desk, phone and computer facilities based at the Hollies. Easily accessed hot-desking facilities are available at Bath NHS House and in the Doctor’s Office at Hillview Lodge on the Royal United Hospital site. Secretarial support for all work performed by the trainee, including on call work, is provided by Dr Ward’s medical secretary, based at The Hollies.

 

 In-patient facilities for patients with organic illness are provided at St Martin’s Hospital, and the consultants do regular ward rounds which provide an excellent teaching opportunity.  At present, older adults with functional illness who require an inpatient admission are cared for in other areas of the Trust, but plans are in progress for a dedicated inpatient facility to be completed in 2018.

Clinical Special Interest opportunities within the trust locality are many and varied and would include: Older Adult Hospital Liaison in a well-resourced older adult liaison service in the Royal United Hospital, Bath; psychotherapy experience; neuropsychology expertise development; Intensive Support. Opportunities locally out with the Trust would include:  Memory Service experience with the Research Institute for the Care of Older People (RICE); Attendance at the RUH Geriatric teaching programme; Geriatric Medicine; Parkinson’s disease clinic;  Neuroradiology experience, Specialist Drug and Alcohol experience,  to name but a few.There is also plenty of scope for management experience, participation in research and quality improvement and for teaching at all levels.  There is an active academic programme.  (updated 13.3.17)

 Trainee Timetable example

The timetable below is an example only and would be adapted to meet the needs of the trainee.

Research Interest:

Dementia Diagnosis and Research; BPSD; Medical Education

 

AM

PM

Monday

Administration

Balint Group

Journal Club 

Clinical Special interest

Tuesday

Team meetings

11.00 : Supervision with Consultant

Community visits

Outpatient clinic/ community visits

Wednesday

 

Clinical special interest

 

Postgraduate Education Programme  RUH

Admin

Thursday

Community visits

 

Ward Round (ward 4 St Martin’s)

Friday

Non-clinical Special Interest

 

Non-clinical Special Interest

On-Call:    1:15 (Senior rota covering BANES)

GMC Site Approval : The Hollies (RVN2P); Paulton Memorial hospital(RN3C3);St Martin’s Hospital (NLX01)

 

 

 

 

 

 

 

 

02

Old Age Psychiatry - inpatient

Inpatient unit, Callington Road Hospital

Dr Jonathan Hewitt

The trainee will be a supernumerary member of the inpatient Mental Health Team based at Callington Road Hospital, Bristol.  The two inpatient wards for older adults are based within the Coppice unit (Aspen – functional illness, Laurel – organic illness). The available opportunities include the assessment and treatment of psychiatric and medical conditions which frequently coexist in this patient population at a senior level.  There will be the opportunity to chair MDT meetings, ward rounds and Best Interests meetings and to gain experience of treating patients under both the Mental Health and Mental Capacity Acts. He/she will be encouraged to fulfill whatever duties are likely to be of educational value to him/her.  The trainee will also have the opportunity to gain other experiences if required, including older adult liaison to the District General Hospitals, community work within one of the four community teams admitting to these wards, memory clinics and the teaching of both medical and non-medical staff. 

 A particular feature of this post is the supervisor’s lead role in ECT services at Callington Road Hospital (the Linden unit).  This unit treats around 70 patients a year from the western half of the Trust.  Hence there are opportunities to conduct the yearly audit of services and to be involved in the Royal College’s ECTAS inspections.There exist local special interest attachments in liaison old age psychiatry at the Bristol Royal Infirmary, neuropsychiatry and close links with local Medicine for the Elderly physicians. In addition the Trust is developing opportunities for senior trainees to participate in Management projects.

There are ample opportunities to develop teaching skills – training medical students (2 attached to firm), the local Core Psychiatry Training course, and carers support groups. In addition the firm has a number of junior doctors attached to it, and there will be the opportunity to participate in WPBA for the junior trainees.(updated 13.3.17)

 

Research Interest:

 ECT

 

AM

PM

Monday

Ward round – Laurel ward

Ward round – Aspen ward

 

Tuesday

Clinical Special Interest session/ ECT (optional) 

Ward work

Wednesday

 

Ward work

Academic Meeting, Callington Road

Ward work

Thursday

Non-clinical Special interest

Non-clinical Special interest

 

Friday

Clinical Special Interest session/ECT (optional) 

Supervision with consultant

Ward work

On-Call:    1:15 (Senior Bristol super rota)

GMC Site Approval – Callington Road Hospital (RVNEQ)

 

 

 

 

 

 

03

Liaison Psychiatry (mixed Old Age and General Adult Liaison) (endorsement post)

Southmead Hospital

(GMC site approval  RV301)

Dr. Anish Patel

This post is based at Southmead Hospital, and enables the post holder to gain experience in Consultation-Liaison Psychiatry in both adult and later life populations in a large modern state of the art teaching hospital and receive their Royal College endorsement in Liaison Psychiatry.

 This post holder will be based in the NBT Mental Health Liaison Team.  Clinical work typically falls into three categories : Emergency dept/Acute Medical unit, In-patient and Outpatient.  Non-clinical areas of development that will run in parallel include education, quality, service improvement and management.  The work is busy, but extremely varied and covers full range of psychiatric problems from organic psychosis, to denial of illness, which will enhance and develop your skills in managing complex multiple pathologies relating to body, mind and brain, and encouraging an integrated approach to illness and disease.

 Old Age Liaison Psychiatry: The trainee will gain particular experience in assessment informing diagnosis, treatment and management of existing or suspected new mental / neuropsychiatric disorder in older people admitted to the acute hospital (primarily dementia, delirium, depression and anxiety). You will gain advanced experience in the management of depression in the setting of a physical illness, of behavioural disturbance secondary to dementia in an acute setting and in prescribing safely and recognizing common drug interactions. Additional experience will be gained in the specialist opinion for complex capacity decision for patients with mental disorder,care planning that limits the risk of deprivation of liberty, and risk assessment and management within the hospital.

General Adult Liaison Psychiatry: You will be able to see the full range of psychiatric presentations in a general hospital, including mood, somatoform and anxiety disorders, medically unexplained symptoms, addictive disorders. Specific Liaison Psychiatry experience can also be obtained working with the regional services based in NBT including: Renal Services, Plastic Surgery/Burns and Trauma & Orthopaedics. There are allied mental health services on site that link in with Liaison Psychiatry services including Perinatal Psychiatry, Eating disorders and Neuropsychiatry whereby the postholder will have opportunity to have exposure to out-patient clinics.

Education is a key part of the role and effectiveness of an Acute Hospital Mental Health Liaison service and you will have ample opportunity to develop skills and experience in the delivery or development of bespoke educational packages/training to general hospital staff across a variety of medical specialties. There is plenty of scope for service development and the trainee may want to undertake projects such as developing specialist out-patient liaison clinics, joint audit projects with fellow medical/surgical colleagues. Attendance with senior liaison clinicians to the Mental Health Steering group and Committee of Physicians will also assist developing higher management skills. (updated 13.3.17)

On Call : 1:15 (Senior Bristol Super Rota)

 Depending on the trainees CCT and specific educational requirements the post can be weighted towards OA or GA psychiatry providing the general competencies in attaining the endorsement are met as set out in the RCoPsych Liaison Psychiatry curriculum.If you are considering this post (OA and dual trainees), please contact the TPD for Old Age psychiatry Dr Shan Williams in advance so that your application can be considered with that of the GA trainees. 

Research Interest:

Dr. Anish Patel is a member of the Cochrane Dementia and Cognitive Improvement Group and is also a local sub-investigator in the Prevalence of Pathogenic Antibodies in Psychosis (PPiP) study.

 

AM

PM

Monday

Clinical Special Interest

Clinical Special Interest

Tuesday

9-930am –Team allocation/handover Meeting

Consultation- liaison work

 12-2pm-Joint Psychiatry Academic meeting

2-4pm -  Acute Hospital Mental Health Liaison MDT

 

4-5pm Admin/ ward reviews.

 

Wednesday

9-930am -  Team allocation handover Meeting

Consultation- liaison work

Consultation- liaison work

 4-5pm- Supervision with Consultant

Thursday

Non-Clinical Special Interest

Non-Clinical Special Interest

Friday

9-930am- Team allocation/ handover Meeting

Consultation- liaison work

(optional out-patient clinics)

Consultation- liaison work/ admin

 

 

 

 

 

 

 

04

Liaison Psychiatry - Old Age (with potential to gain additional General Adult Liaison experience and thereby endorsement)

Bristol Royal Infirmary

(GMC site approval

RA701)

Dr. Alison Lerant

This post is based at the Bristol Royal Infirmary with the Older People’s mental health liaison service, and the postholder will work with Dr Alison Lerant and her team.  The Older People’s Mental health Liaison Service forms part of the overall liaison psychiatry service at the BRI with close working with the Adult Liaison service who are collocated.  There is close working with GA liaison team with opportunities to work within this team with clinical supervision provided by experienced liaison trainers. The liaison psychiatry service for older people aims to provide assessment, treatment and follow-up of older people with physical and psychiatric co-morbidity whilst they remain in general hospital wards.  Typical clinical work includes assessment informing diagnosis, treatment and management of existing or suspected new mental/neuropsychiatric disorder in older people admitted to the acute hospital (primarily dementia, delirium, depression and anxiety), specialist opinion for complex capacity decisions for patients with mental disorder, care planning that limits the risk of Deprivation of liberty and risk assessment and management within the hospital and upon discharge.

We also assess all older people admitted following an episode of self harm, older people with physical illness and associated complex psychological or emotional problems and those with physical symptoms of psychological origin.  The clinical role would be working predominantly in a consultation-liaison type of model seeing new patietns referred to the team, as well as having an opportunity to provide teching to general hospital staff in the better management of psychiatric illness in this setting.  Dr Lerant is developing an outpatient service for older adults predomionantly with medically unexplained symptoms.  There are also opportunities to provide assessments as part of the multidisciplinary team working in the GP Rapid Access Clinical at South Bristol Community Hospital.

The Advanced Trainee will work within a multidisciplinary hospital-based mental health team for older people, and with other specialties within the general hospital as well as interfacing with a range of other service including primary care, social services, recovery services, Bristol Dementia services and inpatient teams.Additional specific educational opportunities available include education and training of general hospital staff, the opportunity to attend Grand Round and Journal club for the Care of the Elderly Team, teaching and supervision of 3rd and 4th year medical students, opportunities for audit and Quality Improvement projects within the team and attendance at weekly liaison psychiatry education sessions.(updated 13.3.17)

This post may be suitable for achieving an endorsement in liaison psychiatry providing that the trainee, during the course of this post, is able to meet all the liaison competencies required in the curriculum for both OA and GA, and can demonstrate evidence that these competencies have all been met to their educational supervisor and TPD.

On call : 1:15 (Senior Bristol Super Rota)

 If you are considering this post (OA and dual trainees), please contact the TPD for Old Age psychiatry Dr Shan Williams in advance so that your application can be considered with that of the GA trainees. 

 

AM

PM

Monday

Team Handover/case allocation

10.00 Supervision with Dr Lerant

Ward work

13.00 Team supervision

Monthly later life mental health operational group meeting

Ward work/admin/handover

Tuesday

Team Handover/case allocation

Ward work

13.00 Team supervision

Ward work/admin/handover

Wednesday

MDT Case Review Meeting

Business and management meetings

Liaison academic programme BRI

13.00 Team supervision

Monthly team meeting

Admin/handover

Thursday

Non-Clinical Special Interest

Non-Clinical Special Interest

Friday

Clinical Special Interest

Clinical Special Interest

 

 

 

 

 

 

05

Old Age Psychiatry –community

Gloucestershire

Dr Nick Ardagh-Walter

The post is community based but clnical experience can be adjusted according to training needs with the opportunity to undertake inpatient work if required (with clinical supervision provided by the inpatient consultants).  The trainer, Dr Ardagh-Walter, is based at Fieldview, which is a high quality CMHT base housing a full MDT including a senior psychologist.  

The CMHT serves a compact catchment area, which enables a strong domiciliary focus to much of the work.  The area is predominantly urban and suburban, with cohesive ethnic minority communities.  The medical team comprise senior, SAS and junior colleagues with the opportunity to provide supervision to core trainees if required..  Medical students are attached for blocks of time.  Involvement in teaching and training of students and SHOs is welcomed.  Research activity is currently centred at our Cheltenham base, where participation of trainees is possible.

 In the CMHT, core clinical activities will generally include domiciliary and office-based new patient consultations, consultation activity with MDT and memory clinic work.   In both settings, support for the more junior trainees will be an important part of the role.  Weekly supervision will be with Dr Ardagh-Walter.  He also chairs the Drugs and Therapeutics committee and represents the Trust in countywide prescribing forums, which can be a useful source of management experience for trainees.  He has a particular interest in treatment-resistant depression, and Parkinson’s related dementia.  There is a strong weekly postgraduate programme based in Gloucester, with a monthly Old Age Psychiatry academic session in Cheltenham.

 

Research Interest:

Recurrent depressive disorder

 

AM

PM

Monday

Community visits/assessments

 

Postgraduate Meeting then CLC 

Tuesday

Fieldview CMHT

 

Clinical special interest

Wednesday

Clinical special interest

Community visits/admin

Thursday

Memory Clinic

 

MDT 1.30 Fieldview CMHT

Supervision with Dr Ardagh-Walter

Friday

Non-clinical special interest

 

Non-clinical Special interest

On-Call:    1:15

GMC Site Approval – Fieldview (RTQ53);

 

 

 

 

 

 

 

 

 

 

06

Old Age Psychiatry – community (Stroud)

Gloucestershire – Weavers Croft

(GMC site code RTQ33)

Dr Martin Ansell

 

This is primarily a Community Old Age Psychiatry post based at Weavers Croft in Stroud. The patch covers both rural Communities of the South Cotswolds and the Market Towns of Dursley, Tetbury and Wotton under Edge.There will be opportunity to undertake outpatient clincs and home visits for both functional and organic conditions and to be part of the stand-alone Memory Assessment Service which specialises in Early dementia diagnosis.

The post holder will become an active member of the CMHT and will be able to take part in and chair referral and business meetings, CPA meetings and Best Interest meetings with staff, carers and partner agencies. There will be opportunities for hospital liaison work in our 3 community hospitals working with the specialist older peoples liaison nurses and to assist our local care home in their management of psychiatric illness in their residents alongside our care home support team.

We work closely with the Crisis home based treatment team in managing our acutely unwell patients and this will provide experience of managing risk in the community and the use of the MHA.Inpatient beds are located at Charlton Lane Hospital in Cheltenham and sessions can be undertaken as special interest sessions or can be timetabled in as part of the job with clinical supervision provided by the locality in-patient consultant.

 Dr Ansell is currently associate medical director and clinical director of the organic services within 2gether NHS Foundation Trust.  As such there will be opportunities for the trainee to gain experience of medical management including an understanding of the principles of clinical governance, budget setting, business planning and developing business cases. He also sits on the Gloucestershire STP Dementia Pathway Board and the SW Dementia Clinical Network allowing opportunity to witness Regional and National strategic service planning.

 The Locality has a population of 32,000 over 65s.  The Trainee will join a team which consists of 1.8 consultant old age psychiatrists, a specialty psychiatrist, a CT3 trainee, a part time VTS GP trainee, community nursing staff, OT, physiotherapist, and psychologists.  We also regularly take Medical Students from Bristol University and nursing students from UWE. There is ample scope for teaching, as well as providing teaching for the Medical Student and junior medical staff.   The CMHT is always eager for enlightenment and the team provides regular educational sessions for the local GP practices.  (updated 13.3.2017)

 On call : 1 in 15

Research Interest:

Mental Capacity Act;  ECT,  Care Pathway Development

 

AM

PM

Monday

Stroud OPC

 

In-House Teaching

Tuesday

CMHT & Memory clinic meetings

Supervision and HVs

Wednesday

Dursley OPC

 

Medical Management Experience

Thursday

Clinical Special Interest

Clinical Special Interest

Friday

Nonclinical Special interest

Nonclinical special interest

 

 

 

 

 

 

07

Old Age Psychiatry – community/inpatients

Stroud/Cirencester & Cheltenham (GMC site approval codes : Charlton lane – RTQ01; Weavers Croft – RTQ33)

Dr Joe Stratford

This post can be split between community and inpatient old Age psychiatry depending on the needs of the trainee.

Community placement : This element of the post is based within the Stroud Older person’s Mental health Service.  It is a semi-rural area encompassing Stroud, Cirencester and the neighbouring villages.  The population it services is approximately 21,000(over 65 yrs).The team operates along traditional CMHT lines rather than being split into functional units. Staff include nurses, occupational therapists, psychologists, physiotherapists and a social worker as well as 2 consultant psychiatrists, and 2 trainees (GPVTS).The post is primarily community-based since the inpatient beds at Weavers Croft relocated to Cheltenham and Gloucester in December 2007. However, there is ample opportunity to be involved in the inpatient units and this would be encouraged.The postholder would be expected to assess new and existing patients in community, outpatient and general hospital settings, suffering from a variety of both functional and organic mental health conditions. She/he would also be expected to liaise closely with members of the team, carers, statutory agencies and other healthcare professionals as well as providing a degree of clinical support to junior staff.

Inpatient placement : Out inpatient service is in a new, purpose-designed facility at the Charlton Lane Hospital in Cheltenham.  There has been a substantial investment into improved quality of service there, including regular provision of consultant geriatrician input, and an enhanced multidisciplinary team together with dedicated consultant posts. There are two CT1s and two F2 posts on Mulberry Ward and Willow ward respectively.  The staffing for Charlton Lane also includes regular GP input, specialist SALT, OT, clinical psychologist and physio.  The patient group on Dr Stratford’s ward is usually aged from 55 upwards, with a mix of early and late onset disorder, including some patients with SMI and ageing-related issues, so a wide range of skills is needed.  There is good liaison with our neurological and radiological colleagues locally, and a cutting-edge neuroradiology service which has just been awarded the first UK license for running amyloid scans outside London.  If desired, special interest sessions can be arranged accordingly.  There is also now daily consultant old age psychiatrist membership of the general hospital liaison team and established liaison links with geriatrician colleagues within the general hospital, enabling focussed experience there. 

There is an excellent local academic weekly programme run in Gloucester which the ST4-6 will be encouraged to attend as well as providing support to ST1-3 colleagues with their presentations. There is also regular teaching and examination training provided by the ST4-6’s for those junior colleagues attempting MRCPsych exams. Medical students are also attached to the old age psychiatry teams and so there is the opportunity to help with their training. There are plenty of opportunities for special interest sessions and a popular theme tends to be linking in with the local care of the elderly teams for a variety of learning experiences (eg ward rounds, specialist clinics etc). (updated 13.3.17)

 

AM

PM

Monday

Ward reviews/hospital liaison

Supervision with consultant

Local Academic Programme

Tuesday

MDT and Memory meetings

Clinical Special Interest 

Wednesday

Clinical Special interest

Mulberry Ward MDT 

Thursday

Outpatient clinic (Cirencester)

Cirencester Home visits

Friday

Non-clinical Special Interest

Non-clinical Special Interest 

On-Call:    1:15

 

 

 

 

 

 

 

 

08

Old Age Psychiatry – community/memory /research

Cheltenham (GMC site approval Charlton Lane RTQ01)

Dr Tarun Kuruvilla

This is primarily a memory service post within 2gether NHS Foundation Trust, based at Sherborne House, Charlton Lane Centre, Cheltenham. Dr Kuruvilla does not cover the inpatient wards which are housed in the adjacent Charlton Lane Hospital, but inpatient experience can be provided with supervision by Dr Katie Kelly, depending on the educational and training needs of the trainee. The trainee will primarily work with the highly acclaimed Memory Assessment Service (MAS) for Cheltenham & the North Cotswolds. Our MAS has achieved the third highest rates of dementia diagnosis in the South of England.The team comprises of memory nurses, a young-onset dementia nurse, clinical psychologists, occupational therapists, SALT, a speciality doctor & GP trainees. The trainee will get experience in carrying out initial memory assessments; chairing the MAS MDT meeting; training in neuropsychological assessments; interpreting structural & functional scans; giving diagnosis and commencing treatment in a memory clinic.

The trainee will also get experience in the dementia education programme of managing memory 2gether as well as managing BPSD while working with the care home support team and the community dementia nurses. There is also close working with the late life community mental health team based at Avon house, Tewkesbury. The trainee will also have opportunities, if interested, to work with the general & community hospital liaison teams; and the crisis team who provide home treatment for the functionally ill older adults.

Dr Kuruvilla has an interest in neuroimaging which the trainee will be encouraged to take up as a special interest, getting experience in interpreting CT, MRI, FDG-PET and Amyloid PET scans. Other clinical special interest sessions offered are geriatric medicine including Parkinson’s disease and falls clinics; neurology clinics; and palliative care. Dr Kuruvilla is a NIHR funded researcher and joint clinical lead for Division 4 (DeNDRoN, mental health & neurology) of the West of England Clinical Research Network. The trainee will have the opportunity to take part in NIHR adopted clinical trials and other research studies in dementia. Several advanced trainees have collaborated with us in research projects resulting in conference presentations and publications.

We get third and fourth year medical students from University of Bristol, GP trainees from the Severn Deanery GP school and advanced trainees from different specialities from Severn and Oxford Deaneries for special interest / research sessions. The trainee will attend the weekly postgraduate academic programme in Gloucester and the monthly old age psychiatry meetings at Charlton lane centre.There are several management projects which the trainee can participate in such as the young-onset dementia STP working group; the functional neuroimaging for dementia service, organising conferences etc.(updated 16.3.17)

Research Interests:

Neuroimaging in dementia; early diagnosis and newer treatments for dementia; young onset dementia

 

AM

PM

Monday

Community visits

Postgraduate and old age psychiatry academic programme

Tuesday

MAS MDT feedback meeting

 1 hour supervision with Consultant

Memory out-patient clinic - Cheltenham

 

Wednesday

Clinical special interest

 

Clinical special interest

Thursday

Community visits/clinical admin

 

Memory OP clinic – Tewkesbury on alternate Thursdays/clinical admin

Friday

Non-clinical special interest

Non-clinical special interest

On-Call:    1:15

 

09

Old Age Psychiatry

Cheltenham (GMC site approval : Avon House (RTQ07); Charlton Lane (RTQ01))

Dr Katie Kelly

 

This post offers a traditional model of Old Age Psychiatry – covering both community and inpatient work and offering a range of experience across both domains.  The community team is based at modern offices at Avon House, Tewkesbury whilst the inpatient unit is based at the new purpose designed facility at Charlton Lane Hospital, Cheltenham.  The post offers experience in a wide range of mental health services for older people, including inpatient assessment and management of both organic and functional illness, community assessments, work within a community mental health team and outpatient clinic assessments and management. The trainer Dr Kelly divides her time approximately equally between the CMHT and the ward but the balance of time spent in each by the trainee can be adjusted according to training needs.

 Community experience : The Advanced Trainee is a member of the multidisciplinary community mental health team covering the whole of Cheltenham, Tewkesbury and the North Cotswolds and will be encouraged to work closely with the team.  In the CMHT, core clinical activities will generally include domiciliary and office-based new patient consultations and consultation work with the wider MDT.  Dr Kelly also works closely with the Crisis and Home Treatment Team and provides one session per week to this service for the assessment of older people on the crisis team caseload.

Inpatient experience: Dr Kelly currently looks after Chestnut Ward, one of the three wards at Charlton Lane. Chestnut ward has 14 beds covering patients from age 55 with a mix of early-and late-onset disorder, including some patients with SMI and ageing-related issues including dementia.  There is the opportunity to supervise junior doctors attached to the firm, as well as work closely with geriatricians and GPs who provide regular input and advice on the management of long term medical conditions.  There is good liaison with our neurological, radiological and Care of the Elderly colleagues locally and the trainee would be encouraged to establish close links with medical colleagues at Cheltenham General Hospital particularly with respect to mutual patients. The advanced trainee will have the opportunity to provide specialist psychiatric input in these settings and learning to take decisions at a level appropriate to his or her expertise. There would be the opportunity to write Tribunal reports and attend hearings.

 Additional opportunities exist in elective memory assessments and research (with Dr Kuruvilla), teaching and management ( as Dr Kelly is the lead Consultant for Charlton Lane). There is a very active weekly postgraduate programme based in Gloucester and a monthly Old Age Psychiatry academic session in Cheltenham and for both of these there is protected time (updated 17.2.17).

Research Interest: Palliative care

 

 Trainee Timetable

AM

PM

 

Monday

Ward Round Chestnut Ward

Postgraduate Programme

 

Tuesday

CMHT Team Meeting at Avon House alternate weeks or Community Visits

 

CPA’s and ward work Chestnut Ward

 

Wednesday

Ward work or community visits

12.00 – 13.00 supervision with consultant

Outpatients Clinic/Ward work

 

 

Friday

Clinical Special Interest Session

Clinical Special Interest Session 

 

On-Call:  1:15 (Senior on call 2Gether)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

Old Age Psychiatry –community, memory and potential for inpatient 

North Somerset ( GMC Site Approval – Windmill House (RVN4Q); Long Fox Unit (RVN4B))

Dr Niall Moore

This is a job you’ll enjoy and be changed by. Expertise and enthusiasm combined with a refreshing open minded approach to knowledge and complementary approaches to medicine in an integrated and happy team will challenge and broaden your horizons. Don’t miss out!  Come and discuss and meet the team before you decide.

This is a Community Old Age psychiatry post attached to the North Somerset Complex Intervention and Treatment Team (CITT) providing services to the older adult population of North Somerset.  The community base is at Windmill House Clevedon and the trainee’s office base will be here.  There is the opportunity to work across both community and inpatient areas, as well as within a dedicated memory service with the timetable tailored to the needs of the individual trainee. It is a well-knit and happy team with expertise across a wide spectrum. Higher trainees are encouraged to develop their full potential and be stretched in directions of their choosing.

Dr Moore provides medical input to the CITT, providing assessment and interventions to older people in the community with a full range of mental disorders, both functional and organic.  He also provides specialist diagnostic input to the Memory service and has outpatient clinics in primary care settings, with a particular focus on patients with complex Parkinson’s disorders.  The CITT is integrated with social services and includes AMHPs as well as a range of other professional including psychologists specializing in Family Therapy and Neuropsychiatric assessments. There is the opportunity to follow patients admitted to the inpatient facility if desired, with clinical supervision offered by Dr Moore. Dr Moore has extensive experience in management, physical medicine and psychiatry and is an enthusiastic teacher and mentor.  He has extensive experience in the application of the MHA and in providing MCA reports. There is a newly established and highly successful Dementia Enhanced Support Team which aims to avoid admission to hospital for people with challenging behaviour through timely interventions in situ. This is nurse practitioner led with medical input and is being adopted across a wider area because of its effective impact. The post holder would have opportunities to be involved in further development and audit of this.

 The post covers a mixed urban and rural population defined by GP sector.  There is the opportunity to provide supervision to junior doctors attached to the service.  The memory service provides an exciting opportunity to be involved in assessment of people with a wide variety of memory problems at any age.  There is also the opportunity to link in with the Primary Care Liaison Service, the recently established Enablement and Care Home Liaison teams and the Dementia enhanced Specialist Team. The work includes experience undertaking domiciliary visits, and supporting local nursing and residential homes.  Trainees are encouraged to attend management meetings of senior medical staff and attend local and Trust Old Age consultant meetings which are held on a regular basis.

There are opportunities to become involved in clinical research based at Windmill House. (updated 25.01.2018) 

 

AM

PM

Monday

 

Community visits/ management meetings/

Postgraduate Teaching

Community assessments/ward review (if required)/admin

 3..0 – 4.00 : supervision with Dr Moore

Tuesday

Non-clinical Special Interest

 

Non-Clinical Special interest

Wednesday

Community Team Meeting and MDT clinical supervision

 

Community assessments/Memory Formulation meeting/ Ward round (depending on individual training requirement)

Thursday

Outpatient clinic

Windmill House

Community visits/admin

Friday

Clinical Special Interest

Clinical Special Interest

  On call : 1:15 (senior Bristol super rota)    

           

 

11

Old Age Psychiatry –

Community and Day Hospital 

Somerset ( GMC Site Approval – Bracken House (RH531)

Dr Antony Christopher

 

This post offers a broad experience in community old age psychiatry, including organic and functionally ill patients and those with early memory problems. The post is based in an overwhelmingly rural area of South Somerset and out into the Somerset levels. The patch does include the small country towns of Chard, Crewkerne, Ilminster and Langport and the villages between these. There is a wide socio-economic spread – some villages are very affluent (Hinton St George having the longest life expectancy in the UK), whereas other areas are more deprived. The population of patients over 65 supported from Bracken House is 15,500.

The trainee would be part of an integrated multidisciplinary team covering South Somerset – although this is split into two geographical teams – one based in Yeovil, and the other at Bracken House in Chard. The overall team leader covers both sites, and specialist psychology is also split between the two. Medical, nursing, OT, STAR (enabling) and admin staff are dedicated to each site. The trainee would be based at Bracken House where they have access to their own office, with IT access and full time admin support, which would cover support for all aspects of the trainee’s work, including on-call. The work is outpatient based with clinics running both in Bracken House, and also being accommodated in the patient’s own GP surgeries. Many patients require to be visited at home, and access to independent transport will be essential. Patient’s requiring inpatient admission would either be admitted to Yeovil (organic) or Taunton (functional).  Although the trainee would not normally continue with responsibility once admitted, training and experience with inpatients can be arranged if this is appropriate.

Bracken House also runs a 12- place Day Hospital ( mostly for organic patients) which has its own dedicated nursing staff team. The trainee would be welcome and encouraged to gain experience in this area of work.Dr Christopher has special interests in both education and management, and is the Associate Medical Director for OPMH and LD services across the trust. There are many opportunities for enthusiastic trainees to participate in management activities as a special interest either for ongoing operational or more project based work. There are also many opportunities to be involved with education as the trust has both core and higher trainees, and also undergraduate students. The trust  runs an active PGME and audit programme which the trainee would be able to become involved with. (updated 17.3.17)

 

Research Interest:

Management

 

AM

PM

Monday

Non-Clinical Special Interest

Non-Clinical Special Interest

 

Tuesday

Team Meeting

11.00 – 12.00 Supervision with Dr Christopher

Outpatient clinic Bracken House/home visits

 

Wednesday

Clinical Special Interest

Clinical Special Interest

 

Thursday

Outpatient Clinic

Outpatients/Home visits

Friday

Outpatient Clinic 

Emergency Visits

On-Call:   1:15 (until midnight)

 

12

Old Age Psychiatry – Core

Community and Inpatient 

Somerset ( GMC Site Approval – Pyrland (RH563); Wellington Hospital (RH5F1); Minehead (RH5F5))

Dr Mark Upton

This post is based in Pyrland House, Wellsprings Hospital, Taunton and offers a broad experience in old age psychiatry, including organic and functionally ill patients in both community and inpatient settings and fulfils the requirement for a core post in advanced training in old age psychiatry. This traditional sector post places high regard to continuity of care both in clinics, community settings and when patients are admitted to hospital.  The sector is based on GP practices and covers the rural patch to the south and west of Taunton, as well as Wellington, Wiveliscome,  Minehead and West Somerset including most of Exmoor and covers a population base of around 16000 over 65s.  The advanced trainee can enjoy working in well resourced clinics based in the community hopsitals, as well as being involved in joint and individual visits to patient’s homes and care homes.  Some visits are very remote and may require walking the final mile!There are opportunities to undertake liaison work in Musgrove park if required, as well as opportunities to spend time with physicians e.g. undertaking Parkinson’s disease clinics. Dr Upton also has an interest in neuropsychiatry – both in the South West and a national role (brain injury) with opportunities to work in this area if required.

The trainee can enjoy working on the two wards in Pyrland House which are dedicated to the elderly on the Wellspring Hopsital site – one is functional and the other for patients with organic disorders.  Inpatient training will involve following through admissions that the trainee has been involved with in order to provide continuity and to learn from the patient care pathway.

There are two community mental health teams covering Dr Upton’s sector (one based next to Pyrland House, and the other at the Minehead community hospital) and the CMHT screen and triage all referrals with advice from medical staff.  The CMHTs are well resourced with CPN, psychologists, social work, and occupational therapists.  Apart from the consultant there are ward based SHOs and a Part time Specialty doctor in the team.  Morale in the teams is good.Regular attendance at the local PGME on Monday mornings and audit meetings will be strongly encouraged and you will receive weekly supervision with Dr Upton.

Special Interest

Neuropsychiatry

 

AM                                                                           PM

Monday

Ward/Admin

11.00 – 12.00 Supervision with Dr Upton

Community/liaison work

 

Tuesday

Clinic (Minehead)

 

CMHT meeting (Minehead)

Reviews and community visits 

Wednesday

Clinic (Wellington Hospital)

CMHT meeting (Taunton)

Ward Round and reviews

 

Thursday

Clinical Special Interest

Clinical Special interest

Friday

Non-Clinical Special Interest

 

Non-Clinical Special Interest

On-Call:   1:15 (until midnight)

 

 

 

 

 

 

 

13

Old Age Psychiatry – CORE community, memory and inpatient 

Somerset ( GMC Site Approval – Glanville House (RH5C8); Pyrland Ward (RH563))

Dr Stephen de Souza

 

This is a traditional patch post, based in two sites – Glanville House, Bridgwater (for CMHT work) and Pyrland Ward, Taunton (for inpatient work).  This will offer trainees undertaking their first or second higher training post an excellent grounding in old age psychiatry and in particular provide an excellent start to higher training. For those with more experience the post can be adapted to reflect this seniority, by offering more responsibility as required, supported by close consultant supervision.The post holder will undertake outpatient clinics in Glanville house as well as joint and individual visits to patients homes, care home as well as providing opportunities to undertake visits to various hospital settings as required.  Every effort will be made to provide a good range of clinical experience.

 

This post covers a population of approximately 13,800 older people registered with GP practices in Bridgwater, as well as providing input to patients admitted to the inpatient unit in Taunton (both functional and organic) as well as providing inpatient support to physically frail patients from the wider Mendip area who are admitted to Taunton with functional illness. The post includes working with a full MDT, and the trainee will have designated office space and admin support based at Glanville House with opportunities for agile working in Taunton if required.Participation in the senior on call rota is required (1:15) but is only until 12 midnight, with supportive consultant colleagues always rostered on in addition (who take over first on call after midnight).  This is to encourage trainees who may be domiciled elsewhere to consider this post. 

 

Dr De Souza has a particular interest in medical education and would be happy to support any trainee if they wish to develop this further.  If the postholder’s interests lie elsewhere however, there are multiple opportunities in a range of clinical and nonclinical special interests available, including a highly regarded CAT service delivered locally and which the trainee would be supported to attend. As well as clinical work and teaching, Dr. De Souza has also recently been appointed clinical director for the West division within Somerset Partnership, this covers older adults mental health as well as community hospitals in the West of Somerset. Trainees interested in management can be supported to work with Dr. De Souza in his CD role (updated 17.3.17)

 

AM

PM

Monday

 

Clinical Special interest

Clinical Special Interest

Tuesday

Outpatient clinic/community visits

 

Outpatient clinic/admin

Wednesday

Postgraduate Medical Education (optional)

Clinical visits

 

Ward Reviews/liaison to Musgrove Park Hospital if desired

Thursday

Referrals/supervision meeting with MDT

Emergency reviews (Bridgwater)

13.30 – supervision with Dr De Souza

14.30 Ward round (Taunton)

Friday

 

Non-Clinical Special Interest

Non-Clinical Special Interest

On call: 1:15 (until midnight)

 

 

 

 

 

 

 

 

14

Old Age Psychiatry - community

South Gloucestershire ( GMC Site Approval – Blackberry Hill (RVN3Q)

Dr Sarah Price

This post is based at Cedar House Blackberry Hill Hospital, providing Older Adult services in functional illness and dementia.  The postholder will play an integral part in the community team working alongside other doctors, community psychiatric nurses, OTs physiotherapists and psychologists.  The medical staff consists of 2 part time consultants, 2 full time and one part time SAS doctors and this training post.The post holder will attend weekly team meetings and will assess and treat patients in their own homes in the community both independently with supervision and alongside other members of the team.

There will be plenty of opportunity to have experience in other areas of the Later Life services, attending ward rounds, memory clinics and accompanying the liaison team and the residential liaison team on assessments.  The trainee may wish to take a medical lead role within one of these services during their placement under supervision of the Educational Supervisor.  As Dr Price works part time, clinical work is focused towards the end of the week in order to provide sufficient coincidental supervision opportunities, with special interest sessions timetabled to coincide with Dr Price’s non-working days.

 Full admin support will be provided for this post and all out of hours work.  The trainee will have dedicated office and desk space with a computer and phone.  A mobile phone is also available.There are opportunities for research, teaching medical students, junior doctors, educational meetings, involvement in carers groups, an in-house CPD group and a weekly academic programme and the timetable is flexible and negotiable (updated 20.3.15). 

 

 

AM

PM

Monday

 

Clinical Special Interest

Clinical Special Interest

 

Tuesday

Non-clinical special interest day

 

Non-clinical special interest day

 

Wednesday

9.00 doctors CPD group

10-11.30 CITT Team meeting

12.00 Academic programme 

 

 

13.15 – 2pm PCLS team meeting

Clinical work

Thursday

 

 Community visits/admin

 

 Community visits/admin

Friday

 

Extra experience session e.g. hospital liaison, care home liaison, memory service

2.00 – 3.00 Supervision with Dr Price

Emergency visits/admin

On-Call: 1:15 (Bristol and South Glos super rota)

 

 

 

 

 

 

 

15

Old Age Psychiatry - community

South Gloucestershire (GMC Site Approval – Kingswood Civic Centre BS15 9TR)

Dr Geoff  van der Linden

This post offers wide experience in community old age psychiatry. The post is in the Community Mental Health Team for Later Life based at Kingswood Civic Centre.  The team’s caseload is serves primarily older adults with dementia and other mental disorders who are managed under the Care Program Approach. 

 

The trainee will be part of the CMHT and care home liaison teams and will take part in joint assessments and follow-up appointments, including emergency referrals with other members of the team and alone (depending on level of competence) usually in people’s homes or care homes. The CMHT works closely with the Care Home Liaison Service, Memory Service, Primary Care Liaison Service and Therapies Service and there are opportunities for the trainee to have experience in the memory service, primary care liaison service and hospital liaison services. Patients are usually referred to the CMHT by the Primary Care Liaison Team or Memory Disorders Service when secondary care interventions are required because of the level of risk or complexity. Patients who require inpatient assessment and treatment are admitted to an acute assessment unit at Callington Road Hospital (which also admits from the whole of Bristol).

 

Clinical and Educational supervision will be provided by Dr Geoff van der Linden.  There are opportunities for research, teaching medical students, junior doctors, educational meetings, involvement in carers groups, and a weekly academic programme and the timetable is flexible and negotiable (updated 24/1/18).

 

AM

PM

Monday

 

Clinical work

Supervision with Dr van der Linden

Clinical work

 

Tuesday

Non-clinical special interest

Non-clinical special interest

Wednesday

09.15 CMHT team meeting followed by team clinical case load supervision

12.00 – 13.00 Local Academic programme

13.30 – 14.30 Care Home Liaison team meeting

Clinical work

Thursday

 

 9.30 Memory clinic diagnostic supervision meeting

11.00 Memory Clinic Outpatient Assessment

Clinical Work

Friday

 

Clinical Special Interest

Clinical Special Interest

On call 1:15 (senior Bristol and South Glos super rota)