Post and Timetables

No

Specialty

Area/Hospital

Trust that employs trainee

Trainer

01

Learning Disability

Bristol Central

AWP

Dr Manash Chattopadhyay

02

Learning Disability

Bristol South

AWP

Dr Charlotte Boyer-Millar

03

CAMHS / LD

Swindon

AWP (seconded into Oxford Health)

Dr Kindy Mahal

04

Learning Disability

South Gloucestershire

AWP (Seconded into Sirona)

Dr Salim Razak

05

Learning Disability

Stroud

Gloucestershire Health and Care NHS Foundation Trust

Dr Joanna Kingston (currently not a training post)

06

Learning Disability

Gloucester

Gloucestershire Health and Care NHS Foundation Trust

Dr Heena Hargovan

07

Learning Disability

Cheltenham/ South Cotswolds and Cirencester

Gloucestershire Health and Care NHS Foundation Trust

Dr Karen Poon

08

Learning Disability

North Cotswolds, Gloucestershire

Gloucestershire Health and Care NHS Foundation Trust

Dr Mark Scheepers

(Not currently offering a training post)

09

Learning Disability

Forest of Dean, Gloucestershire

Gloucestershire Health and Care NHS Foundation Trust

Dr Paul Winterbottom and Dr Helen Sharrard

10

Learning Disability

Bristol North

AWP

Dr Suraj Perera

11

Forensic Neurodevelopmental Psychiatry

FIND Team

Fromeside Medium Secure Unit, Bristol

AWP

Dr Hannah Toogood

12

CAMHS/LD

South Gloucestershire

AWP

Dr Sue Crimlisk

13

CAMHS / LD

Bristol

AWP

Dr Toni Hovey

(Not currently offering training beyond Aug 2019)

14

Learning Disability

Marlborough and Chippenham, Wiltshire

AWP

Dr Fran Ward

15

Neurodevelopmental Disorders

Petherton Resource Centre Bristol

AWP

Dr Dietmar Hank

If you wish to read about the services in further details please visit our 'Services in Bristol' and 'Services in Gloucester' webpages. These can be found in the Learning Disability section of the website. 

01

Learning Disability

Bristol Central

Dr Manash Chattopadhyay

This is an excellent post offering plenty of opportunities to advanced trainees keen on gaining a wide range of experience in Learning Disability psychiatry.

  • The trainee will be a member of the multidisciplinary team based at New Friends Hall in Stapleton. The patch is Central and East Bristol, a culturally and ethnically diverse population with a population of approximately 130,000. A core trainee is regularly attached to the team
  • The job is mainly outpatient based through outpatient clinics, visits to residential homes and supported living accommodations and day centres. The tradition of joint working with members of the CTPLD, social workers and IMCA service is well established.
  • There are regular opportunities to work with mainstream crisis teams. A+T admissions are to a variety of units.
  • There is a significant level of mental illness as well as dementia and epilepsy in the local population.
  • Fortnightly CTPLD meeting for allocation of new referrals and case discussion.
  • Trainees are encouraged to develop their own audit projects as part of the monthly clinical governance programme.
  • Management opportunities-involvement in local project eg. Dementia Group, Epilepsy Group, Autism Diagnosis Group etc.
  • The trainee will be encouraged to develop a teaching portfolio with supervision for undergraduate and postgraduate trainees

Dr Chattopadhyay has interests in teaching, examination, post graduate training and NHS management. At present he is the Medical Lead of the Learning Disabilities service of the Avon and Wiltshire Mental Health Partnership NHS Trust. He is the Deputy Regional Advisor (North), South West Division, Royal College of Psychiatrists.

Trainee Timetable

 

 

AM

PM

Monday

Research / Special Interest / Clinical Work

Clinical Work / CLDT Meeting / Supervision (1 hour) / Admin

Tuesday

Out Patient Clinic

Out Patient Clinic

Wednesday

Peer support group / Clinical governance / Medical Advisory Group

Academic meeting / Clinical governance

Thursday

Home Visit / Admin

Research / Special Interest

Friday

Research / Special Interest / Clinical Work

Research / Special Interest

 

02

Learning Disability

Bristol South

Dr Charlotte Boyer-Millar

This post offers an opportunity to work in a well established team offering a community service to individuals with a learning disability in the South Bristol area. The Bristol South Community Learning Disability Team is based at the Withywood Centre covering a population of over 167 000. As an area it is culturally and ethnically diverse and has several economically deprived areas.

For an Advanced Trainee this would include case management and comprehensive initial assessments of a heterogeneous patient group with a variety of complexities. Given the local population, this team has a higher prevalence of the mild- moderate end of LD and with this, greater issues with the criminal justice system, drug and alcohol issues and safeguarding concerns. This leads to opportunities for multi-agency working particularly with Social Services and close working alongside the Avon Forensic Community Learning Disability Team, the Forensic Intellectual Neurodevelopmental Team and General Adult Services. Alongside this there is still plenty of opportunity to look after individuals with moderate to severe LD and associated mental and physical health problems including Epilepsy. The Team care for adults from Transition (18yr +) to death so also is responsible for dementia care pathways. The medical team deliver their care in a variety of settings including patient’s homes, clinic appointments at the base, day centres, GP practices, hospitals (secure and non secure), Prison and custody suites.

The Team are a full multidisciplinary health team (Social Services are now separate) and includes: Community Nurses, Mental Health Nurse, Psychologists, SALT, OT, Physio, Creative Therapists and Behavioural Nurses (within a intensive Bristol wide team). The Consultant works 8 sessions but there is an on call system, which means there is clinical supervision available seven days a week.

ADMIN SUPPORT: There is excellent  administrative support with a dedicated Medical Secretary available for all aspects of trainees work, including on call and special interest work.

The trainee will share an office with the other members of the multi-disciplinary team. Every desk has a telephone, computer with Internet and e-mail access. There is a lockable filing cabinet for trainees.

 

Trainee Timetable 

AM

PM

Monday

Non-Clinical/Clinical Special Interest Session

Non-Clinical/Clinical Special Interest Session

Tuesday

9.30-10.30 Supervision

Clinical work (assessments/Clinical Meetings)

Clinical work (assessments/ Clinical Meetings)

Wednesday

9-11 Clinical work

11-13.00 Trainee Support Group/Clinical Governance/CGM

Clinical Admin/ Academic Meetings

Thursday

(9-11 CLDT meeting)

Clinical Work

Clinical Work

Friday

Non-Clinical/Clinical Special Interest Session

Non-Clinical/Clinical Special Interest Session

 

03

Learning Disability

Swindon (CAMHS/LD)

Dr Kindy Mahal

This post offers experience in Learning Disability CAMHS in the Salt Way Centre in West Swindon.

The team of approximately 5 WTE consists of 0.6 Psychiatry, 0.8 Psychology and 3.4 Community Learning Disability Nurses one of which is the Team Manager.

Dr Mahal’s role consists of 0.5 sessions in the Swindon Team and 0.1 sessions in the Marlborough CAMHS Integrated Learning Disability Team. The local Special School Nurse also joins the team on a regular basis.

The team provides a community based service for psychiatric assessment, treatment and continuing care of children and young people aged 0-18 with mild to profound learning disability in Swindon and Marlborough. This includes joint working with Tier 2 and 3 services and other agencies and supporting transition to adult services.The team also offers consultation to other agencies including social services and education.

Clinical work is undertaken in the community, home, special schools and in clinic settings with MDT colleagues when appropriate.

Neurodevelopmental diagnostic assessments for ASD and ADHD are undertaken in conjunction with Psychology colleagues.

There is the opportunity to join two monthly Wiltshire LD service development meetings.

There are opportunities to attend monthly LD CAMHS Clinics at the Marlborough CAMHS base. This involves patient assessment and offering consultation or joint working if appropriate to CAMHS colleagues. The Marlborough LD CAMHS service is delivered through an integrated model for children with moderate to profound Learning Disability.

Trainees can also be involved in delivering a training programme to multidisciplinary colleagues on mental health topics alongside Dr Mahal and the Psychologist in the team.

There is close working with Community Paediatric Colleagues and there would be opportunities to join specialist clinics if this supported clinical learning needs.

This is an opportunity for trainees to develop skills in assessing managing and treating children and young people with mild to profound learning disabilities presenting with Mental Health difficulties eg challenging behaviour, anxiety etc

As a Learning Disability CAMHS service the team are currently developing Positive Based Support (PBS) interventions as this is the evidence based intervention for Challenging Behaviour in children and young people with Learning Disabilities. Trainees would have opportunities to support this development and improve their understanding of PBS and how to use it as an intervention

Clinical and Non-Clinical special interest time is fully supported

Trainee Timetable:

AM

PM

Monday

Clinical time

Trainees Supervision 11.00 - 12.00

Clinical Special Interest session

Tuesday

Clinical time

Clinical Special Interest session

Wednesday

Team Meeting alternate weeks / Referrals/ clinical time

LD Psychiatry Academic Meeting

Thursday

Clinical time

Clinical time

Friday

Non-Clinical Special Interest

Non-Clinical Special Interest

 

04

Learning Disability

South Gloucestershire

Dr Salim Razak

This is a well established post offering a wide range of experience in learning disability psychiatry including:

  • Out-patient assessment, management and follow up of adult service users with mental illness across the learning disability range (average 4 new referrals per month)
  • Multidisciplinary work with other members of the health team and close working with social services

The post can be tailored to the individual needs of the trainee, who will be a member of the multidisciplinary team covering Kingswood (covering a population of 110,000, approx) based in Soundwell, Bristol. A significant number of people with moderate or severe learning disability live in the area & there are a number of residential homes for challenging behaviour. Approximately half of service users suffer from epilepsy & the trainee will gain confidence & expertise the management of complex epilepsy. There is a close working relationship with the Burden neuropsychiatric unit and also with general neurologists at Southmead Hospital.

There are ample opportunities for special interest sessions- Neuropsychiatry at the Burden centre, Southmead Hospital, the Bristol Autism Spectrum Service, ADHD service and Child and Adolescent LD based at Southmead Hospital amongst others. There is also close links with the Bristol University, reputed for high quality research. The trainee would be encouraged to develop their own teaching portfolio with supervision, with respect to undergraduate and postgraduate trainees; professions allied to medicine and carers groups. Dr Razak is the lead for clinical governance within the learning disabilities directorate and has a long standing interest in medical leadership. The trainee will also be encouraged to carry out local audits and to develop their management skills.

Medical Staff

One consultant: full time

Multidisciplinary Team

The South Gloucestershire Community Learning Difficulties Team is based in Soundwell, Bristol and the team comprises:

  • Occupational therapist 
  • Clinical Psychologist (and trainee)
  • Community Nurses (and trainee)
  • Intensive Community Support Team 
  • Speech and language Therapist
  • Physiotherapist 
  • Art therapist
  • Team Manager

Trainer

Dr Razak is trained in WBA, supervision, appraisal skills and equal opportunities and has completed all the educational supervisor required training for Severn Deanery.
Dr Razak is up to date with appraisal & mandatory training & is registered with the College for CPD and is in good professional standing for CPD.
Dr Razak has an audit and research portfolio and can offer support to trainees in audit and research projects.

Office and Admin support

There is a dedicated Medical secretary and excellent administrative support is available for all aspects of trainees work, including oncall and special interest work.
The trainee will share an office with the other members of the multi-disciplinary team. There is a desk for each member of the team. Every desk has a telephone, computer with Internet and e-mail access and a satellite library. There is a lockable filing cabinet for trainees.

On call duties:

The trainee is expected to participate in the LD on call rota - frequency of 1 in 10 with prospective cover. This commitment is non residential covering Bristol, South Gloucestershire, BANES and North Somerset. This will attract pay banding 1C.

Trainee Timetable:

AM

PM

Monday

10.00 - 11.00 Trainee supervision with consultant/clinical admin 

Clinical special interest session

Tuesday

Outpatient work 

Outpatient work 

Wednesday

Trainee support group/ medical advisory group/ outpatient work 

Academic programme/ ST4-6 business meetings

Thursday

Team meeting/ clinical admin 

Clinical special interest session

Friday

Non clinical special interest session

Non clinical special interest session

 

05

Learning Disability

Stroud

(Not currently available as a training post)

Dr Joanna Kingston (currently not a trainer)

When a consultant trainer is appointed, this post will offer a senior trainee an opportunity to develop their clinical skills as well as an opportunity to support management experience

  • Community assessments and work within an Integrated Community Mental Health Team
  • Inpatient assessment and management (separately supervised)
  • Outpatient clinic assessments and management
  • Management meetings associated with Clinical Director work

The post can be tailored to the educational needs of the trainee. The advanced trainee is a member of the community learning disability team (CLDT) based in Stroud, a rural setting with a catchment area population of 175 000,  but an above average LD population due to the presence of some old independent sector homes.  The post is based at Weavers Croft, where an office, a computer, a lockable filing cabinet and secretarial support are provided.  The team are co-located in the same building.

The trainee will be expected to contribute to the teaching of medical students, staff and independent sector carers.  There will be many opportunities for audit and research in the post.

 Trainee Timetable

AM

PM

Monday

Clinical Admin/1hrSupervision

Research/Special interest

Tuesday

Team meeting

Community visits

Wednesday

Research/Special interest

Teaching

Thursday

Outpatients

Outpatients

Friday

Research/Special Interest

Research/Special Interest

 

06

Learning Disability

Gloucester

Dr Heena Hargovan

 

This post provides prospective trainees the opportunity to work within a very experienced multidisciplinary team of professionals committed to improving and investing in the lives of people with learning disabilities. The team covers the Gloucester area, with a catchment area population of 175,000, but with an above average LD population. The team is based at Field View in Gloucester, which is well located within the catchment area.

The team are well trained in the assessment and diagnosis of Autistic Spectrum Disorder and nurse specialists trained in the management of epilepsy in people with learning disabilities. There are opportunities for a trainee to become involved in group work with psychology and nursing in helping young offenders with learning disabilities to gain thinking skills and strategies to make them less vulnerable in social situations.

The team has an excellent track record for being open and available to deal with clinical emergencies and managing complex and difficult to place individuals. Past trainees have enjoyed their time with the team feeling confident on leaving that their time with us has been well spent. There has been excellent feedback from psychiatric, nursing and psychology trainees placed with the team over the years.

The post is based at Pullman Place, Great Western Road, Gloucester with Dr Hargovan and the team. The trainee will have an allocated desk area and will be provided with a lockable cabinet, and computer and full secretarial support.

Dr Hargovan and her team work very closely with CCG and the Local authority and there is a local initiative at trying to return patients back into county.  As a result, the trainee will work closely with Social Services and the Commissioners when it comes to seeking out placements for patients returning. The trainee will have the opportunity to chair CPA meetings, case conferences, and put together tribunal reports for detained patients. The trainee will also have the opportunity to attend tribunals for detained patients. The use of the MCA will also be highlighted as part of training in the in-patient services.

Dr Hargovan is an approved CASC examiner at the Royal College of Psychiatrists. Her clinical interests are: autism, challenging behaviour, children with LD and psychotherapy.  Apart from the clinical experience offered above, there is also an opportunity to attend management meetings and to get first-hand experience of senior NHS management.

The trainee will be expected to contribute to the teaching of medical students, staff and independent sector carers.  There will be many opportunities for audit and research in the post.

Trainee Timetable

AM

PM

Monday

Special Interest/Research

Special Interest/Research

Tuesday

Outpatients/community reviews

Outpatients / community visits/clinics.

Wednesday

Team meeting in Gloucester. 1hr supervision

Academic meeting Bristol and/ or admin.

Thursday

Outpatients/community reviews

Outpatients/community reviews

Friday

Special Interest/Research

Special Interest/Research

 

07

Learning Disability

Cheltenham/S Cotswolds/Cirencester

Dr Karen Poon

This post will offer a senior trainee an opportunity to develop their clinical skills as well as an opportunity to support management experience

  • Community assessments and work within an Integrated Community Mental Health Team
  • Inpatient assessment and management
  • Inpatient outreach assessment and management (Learning Disability Intensive Support Services and Intensive Health and Outreach Team)
  • Outpatient clinic assessments and management
  • Meetings associated with management roles such as Drugs and Therapeutics, End of Life Care
  • Teaching experience – Medical Students

The post can be tailored to the educational needs of the trainee. The advanced trainee is a member of the  community learning disability teams (CLDTs) based in Cheltenham and Stroud, covering two Cotswold towns and surrounding rural areas.  The catchment area population is 90,000 (South Cotswolds).

The post is based at Leckhampton Lodge, Cheltenham where an office, a computer, a lockable filing cabinet and secretarial support are provided.  The teams, however, are based at Leckhampton Lodge in Cheltenham, plus Weavers Croft in Stroud.

Dr Poon's clinical interests are: health inequalities, autism and end of life care.  Apart from the clinical experience offered in the above, there is also an opportunity to organise and teach medical students, as Dr Poon is responsible for the Learning Disability component of the Psychiatric placement in Gloucestershire, as well as attending the relevant management meetings associated with Dr Poon’s management roles.

The trainee will be expected to contribute to the teaching of medical students, staff and independent sector carers.  There will be opportunities for audit and research in the post.

 Trainee Timetable

AM

PM

Monday

Community Visits and Clinics

Academic meeting Gloucestershire or Clinics 

Tuesday

Team meeting

Clinical Admin/1 hr supervision

Wednesday

Research/Special Interest Session

Teaching/ Academic meetings Bristol

Thursday

Community Visits and Clinics

Research/Special Interest Session

Friday

Research/Special Interest Session

Research/Special Interest Session

 

08

Learning Disability

North Cotswolds

Dr Mark Scheepers

(NOT CURRENTLY OFFERING A TRAINING POST)

This post will offer a senior trainee an opportunity to develop their clinical skills as well as an opportunity to support management experience

  • Community assessments and work within an Integrated Community Mental Health Team
  • Inpatient assessment and management
  • Inpatient outreach assessment and management (Learning Disability Intensive Support Services and Intensive Health and Outreach Team)
  • Outpatient clinic assessments and management
  • Meetings associated with management roles such as Drugs and Therapeutics, End of Life Care
  • Teaching experience – Medical Students

The post can be tailored to the educational needs of the trainee. The advanced trainee is a member of the  community learning disability team based in Cheltenham covering three Cotswold towns and surrounding rural areas.

The post is based at Leckhampton Lodge in Cheltenham, where an office, a computer, a lockable filing cabinet and secretarial support are provided.  The supervisor, however, has an office in Tewkesbury in order to facilitate easier access to all of Gloucestershire and Herefordshire as clinical director.

Dr Scheepers is trained in WPBA, supervision, appraisal skills and equal opportunities, is in good-standing with the RCPsych in terms of his CPD and has completed all the educational supervisor required training for Severn Deanery. 

His clinical interests are: Epilepsy, Physical Health issues in people with LD, Mortality, Autistic Spectrum Conditions and mental health issues in people with learning disabilities.  Apart from the clinical experience offered in the above, there is also an opportunity to organise and teach medical students and nurses as part of the ongoing CPD programme.  Dr Scheepers has a strong research base and is happy to supervise research projects and also audit projects associated with service development.

Dr Scheepers is the Clinical Director for the LD service and so the post offers management opportunities.

 Trainee Timetable

AM

PM

Monday

Clinical admin/ Clinical work (home visits)

Local academic  meeting/ clinics/ home visits

Tuesday

Team meeting; Supervision 1 hour

Clinic, home visits

Clinical supervision

Wednesday

Research/Special Interest Session*

Teaching/ Academic meeting Bristol and New Friends Hall meetings

Thursday

Community Visits and Clinics

Research/ special interest session*

Friday

Research/Special Interest Session*

Research/Special Interest Session*

 

09

Learning Disability

Forest of Dean

Dr Paul Winterbottom/Dr Helen Sharrard

This post will offer a trainee an opportunity to develop their clinical skills as well as an opportunity to support management experience

  • Community assessments with Community Learning Disabilities Team
  • Inpatient assessment and management
  • Outpatient clinic assessments and management
  • Management meetings with experienced supervisor
  • Based in locality hub with other psychiatric specialties

The post can be tailored to the educational needs of the trainee. The advanced trainee is a member of the community learning disabilities team (CLDT) based in the Forest of Dean, a rural setting with a catchment area population of 75 000,  but an above average LD population due to the presence of numerous independent sector homes.  The post is based at Colliers Court, the new Forest of Dean locality Hub, where the CLDT are co-located with Adult Mental Health, Older People team, Children and Young People Service plus other specialised teams. The trainee has a desk and access to private office space, a computer, a lockable filing cabinet and secretarial support for all aspects of daily work. 

Both Dr Winterbottom and Dr Sharrard are very experienced trainers and both have held the post of Training Programme Director in the past.

Dr Winterbottom will be the Educational Supervisor and his clinical interests are: autism, challenging behaviour, parenting and psychotherapy. Dr Winterbottom is also the consultant responsible for the County-wide LD inpatient assessment unit in Gloucestershire. He has an interest in medical management having held the role of Medical Director for 13 years and continues to contribute to regional developments through the South West Clinical Senate Board and South West Royal College of Psychiatrists Executive Committee. In addition to the clinical experience offered above, there is opportunity to attend management meetings and to get first-hand experience of senior NHS management.

Dr Sharrard will be the Clinical Supervisor and her clinical interests are epilepsy and working with people with complex health needs. In addition, Dr Sharrard is the longstanding lead consultant in the SW Division of College for Promoting Recruitment into Psychiatry so regular opportunities arise to support these projects.

The trainee will be expected to contribute to the teaching of medical students, staff and independent sector carers.  There will be many opportunities for audit and research in the post.

 Trainee Timetable

AM

PM

Monday

Clinical Admin

Research/Special interest

Tuesday

Team meeting/Outpatients

Community visits

Wednesday

Research/Special interest

Teaching

Thursday

Inpatient/ Outpatient work

1hrSupervision

Inpatient Unit

Friday

Research/Special Interest

Research/Special Interest

 

10

Learning Disability

Bristol North

Dr Suraj Perera

 This post offers an opportunity to work in a well-established team offering a community service to individuals with a learning disability in the North Bristol area. The Bristol North Community Learning Disability Team is based at the New Friends Hall covering a population of over 150 000. The post is based in the community with access to facilities in Adult Day Centres and Residential Care Homes. Typically, specialist psychiatric assessments and advice can be delivered in the patient’s home, but clinics at the CLDT base and the Day Centres are also well established.

Trainees will gain experience in the assessment and treatment of mental illnesses, as they present in people with learning disabilities. A number of service users have epilepsy and trainees will gain experience in its management. Trainees will also gain experience in assessing and managing dementia in people with LD. A large number of service users have autism and trainees will gain experience in assessment, diagnosis and support of people with autism spectrum conditions.

The trainee would be encouraged to develop their own teaching portfolio with supervision, with respect to undergraduate and postgraduate trainees; professions allied to medicine and carers groups. The trainee will also be encouraged to carry out local audits and to develop their management skills.

There is a broad variety of opportunities for Specialist Interest Sessions within the several Teaching hospitals nearby including the Rosa Burden Centre (Neuropsychiatry) and within AWP, especially within the neurodevelopmental field such as the Adult ADHD Service and the Bristol Autism Service. The service is often involved in Research and there is an active and growing Academic LD team within the University of Bristol led by Dr Rai.

Supervision is weekly for an hour in a protected environment (both Clinical and Educational supervision provided) at a mutually agreed time.

The Trainee would also be an active participant of the regional academic programme which includes the Avon LD Education and Research Network which holds monthly meetings.

From a management perspective there are a range of opportunities dependent on the individual  and their needs. These can range from chairing multi agency  meetings to quality improvement projects/Audit, service improvement projects and specific Roles/Responsibilities within the region.

There is regular opportunity to get involved in teaching with medical students, the team and support staff (third sector).

Medical Staff

One consultant: full time

One specialty doctor: part time (2.5 sessions)

One Honorary Consultant: part time (2 sessions)

One part time Core trainee (3 sessions)

Multidisciplinary Team

The Team are a full multidisciplinary health team (Social Services are now separate) and includes: Community Nurses, Mental Health Nurse, Psychologists, SALT, OT, Physio, Creative Therapists and Behavioural Nurses (within a intensive Bristol wide team). The Consultant works 10 sessions and there is an on call system, which means there is clinical supervision available seven days a week.

Trainer

Dr Perera has special interests in Epilepsy and Medical Education and he has completed a Master’s degree in Epileptology and a PG Certificate in Medical Education.

On call duties

The trainee is expected to participate in the LD on call rota - frequency of 1 in 10 with prospective cover. This commitment is non residential covering Bristol, South Gloucestershire, BANES and North Somerset. This will attract pay banding 1C.

 

 Trainee Timetable

AM

PM

Monday

Non- Clinical/Clinical Special Interest Session

Non- Clinical/Clinical Special Interest Session

Tuesday

9.30-10.30 Supervision

Clinical work (assessments/Clinical Meetings)

Clinical work (assessments/ Clinical Meetings)

Wednesday

9-11 Clinical work

11-13.00 Trainee Support Group/Clinical Governance/LD MAG

Clinical Admin/ Academic Meetings/ALDERN

Thursday

Non- Clinical/Clinical Special Interest Session

Non- Clinical/Clinical Special Interest Session

Friday

(9-11 CLDT meeting)

Clinical Work

Clinical Admin

 

11

Forensic Neurodevelopmental Psychiatry

Forensic Intellectual, Neuropsychiatry and Developmental Disorders (FIND) Team Fromeside Bristol

Dr Hannah Toogood

The post offers experience in the psychiatry of learning disability and developmental disorders in a range of settings.  These include: an inpatient specialist medium secure setting at Fromeside; prison settings; assertive case management of patients in a range of secure hospital settings mostly in the independent sector; and consultation regarding patients in the community with behaviours that pose a risk of serious harm to others. 

The advanced trainee will be based at Fromeside at Blackberry Hill, which provides medium secure inpatient services to eight men with learning disability and/or autism spectrum disorders and offending behaviour.  There is a dedicated primary care team, including a GP, and a duty doctor rota, such that the advanced trainee would not be expected to manage physical illness.  These patients have highly complex needs, with interplay between multiple factors, such as learning disability, developmental disorders, mental illness and history of trauma.  There is close multidisciplinary teamworking, with all professionals having expertise in working with people with learning disability. 

The trainee would develop skills in working with patients with learning disability and/or autism spectrum disorders in an inpatient environment, all detained under the Mental Health Act, including diagnostic formulation and analysis of risk behaviours.  They would help to develop treatment plans to reduce risk and promote rehabilitation and recovery.  This could include co-facilitating or delivering adapted psychotherapeutic groups or individual courses of treatment.  Preparing reports and participating in Mental Health Review Tribunals would be encouraged, as would be taking opportunities to attend Court and perform medico-legal work under supervision.  Chairing CPA, S117 and other multidisciplinary meetings would also be encouraged.  The FIND Team provide structured assessments for autism spectrum disorders for patients within mainstream wards at Fromeside and the on-site low secure service (Wickham) when needed.  These cases are always complex and an advanced trainee would be able to participate in these if they desired.

In addition, the trainee would be able to perform new ‘gatekeeping’ assessments for people with neurodevelopmental disorders.  The FIND Team ‘gatekeep’ secure hospital beds for patients with learning disability, autism spectrum disorders and/or acquired brain injury across the West of England, and then case manage these patients whilst they are in secure hospital settings.  This involves assessing patients in prison and other hospital settings, and working closely with commissioners.  Patients who are being case managed are regularly reviewed in out of area hospital placements, mainly in the independent sector, with close liaison with their treating teams, community health and social care links, and commissioners for NHS England and locality CCGs.

The FIND Team aims to safely minimise length of stay in hospital, in line with the Transforming Care Agenda, which often requires creative thinking regarding helping people to move forward in their care pathways.

The trainee would be encouraged and supported to participate in Quality Improvement and management projects, teaching and training.  There would be flexibility in the work available to them, in order to meet their specific learning needs.  Management experience would be available in a range of domains.  Dr Toogood is currently the Principal Investigator for the AWP site of a multisite autism spectrum disorders research study, and an advanced trainee would be able to participate in this if they wished.  The trainee would be able to participate in both the learning disability and forensic academic programmes and forensic peer supervision sessions.

It is expected that a range of competencies could be achieved within this post.  Including, but not limited to, specialist competencies related to Forensic Learning Disability Psychiatry, assessment and management of acute and chronic risk, psychotherapy for people with learning disability, appropriate use of medicolegal frameworks, management of severe and enduring mental illness, communication, teamworking, leadership and management, and also teaching and research competencies.

There is a broad variety of opportunities for Specialist Interest Sessions. Examples include experience in Neuropsychiatry, the Adult ADHD Service and the Bristol Autism Service. There is an active and growing Academic LD team within the University of Bristol with close ties to the Norah Fry Research centre. The SPRICC project within AWP links Trainees with Research opportunities. The Trainee would also be an active participant of the regional academic programme which includes the Avon LD Education and Research Network which holds monthly meetings.

Facilities:  Desk, phone and computer access in a room shared by the MDT senior clinician.  Lockable filing cabinet available. The FIND Team includes a full time equivalent medical secretary. There will be administrative and secretarial support for all aspects of an advanced trainee’s work including out of hours.

Local medical staffing: At Fromeside, there are currently seven consultant psychiatrists, four specialty doctors, two advanced forensic psychiatry trainees and three core trainees.  There is a visiting GP and primary care nurses.

 Trainee Timetable

AM

PM

Monday

Non-clinical special interest

Non-clinical special interest

Tuesday

Ward Round*

CPA meeting/Professionals’ meeting/Business meeting or QIPP/service development work.

4-5pm – Supervision with Dr Toogood*

Wednesday

New assessment or consultation session or visit to review patient in out of area hospital*

Learning Disability academic programme on alternate weeks.

On other weeks: visit to out of area hospital or admin.* 

Thursday

Clinical Special Interest

Clinical Special Interest

Friday

Referrals meeting

Forensic peer supervision

Admin*

Psychotherapeutic work with inpatients/medico-legal work/Tribunals*

*Overlap time with Dr Toogood

 

12

Learning Disability

South Gloucestershire (CAMHS/LD)

Dr Sue Crimlisk

South Gloucestershire Specialist Service for Children with Learning Disabilities provides a community based service for the psychiatric assessment, treatment and continuing care of children and young people aged 0 to 19 with moderate, severe and profound learning disability and emotional and behavioural and mental health problems within the South Gloucestershire CCG area

The multi-disciplinary team consists of medical secretary and admin; Consultant Psychiatrist; Clinical Psychologists; Community Learning Disability Nurses; a Support Worker. The team’s office base is in The Kingswood Hub but clinicians work in the community in schools, local clinics and in homes. The team has access to Art’s Therapy Services for people with Learning Disability. Multi-agency working with South Gloucestershire Children and Young Peoples Services (The 0-25 service) is a substantial aspect of the teams work

There are team meetings for multidisciplinary clinical case discussion. Discussions of referrals into the team take place at this meeting as-well as discussion of new assessments and high risk cases. There are also Service meetings and Senior Management Team meetings held monthly. The Complex Needs Multi-agency Consultation Group is held 6 times a year.

Allocation of cases to trainees is led by the trainee and trainer jointly in parallel to the trainee’s learning objectives. There are opportunities to undertake comprehensive initial assessments and on-going management of complex cases where challenging behaviour presents in the context of significant learning disabilities, neuro-developmental problems and often physical health problems such as epilepsy. There are also opportunities for assessment of neuro-developmental difficulties in young people with learning disabilities alongside psychiatric assessment and treatment of psychological disturbances leading to challenging behaviour or other presentations suggestive of mental illness.  The Nursing Team has significant expertise in behavioural management strategies and there is ample opportunity to observe and join them at work during behavioural analysis and development of management strategies.  Similarly there are joint working opportunities with Clinical Psychologists including observation of ADOS assessments as well as their individual work with patients.

Special interest opportunities include sessions in community and developmental / neuro-disability paediatrics, paediatric neurology and genetics. There are also opportunities to work with members of the team delivering Parenting Programmes; Intensive Positive Behaviour Support Service for children with challenging behaviour. There are also opportunities to attend the Complex Needs Group, a monthly multiagency consultation group providing highly challenging cases with a more focused direction.  There is also an active Service User Participation Group for SSCLD.

Functional Behavioural Analysis and Management Strategies as well as consultations to young people’s professional network (multi-systemic working) are the main therapeutic interventions that are different to generic CAMHS experiences and easily available. Opportunities to consult with Arts Therapists (Art, Music and Drama) in working with a child.

The Trainee would be an active participant of the regional LD academic programme (3 Wednesdays of a month) which includes the Avon LD Education and Research Network which holds monthly meetings. Working in CAMHS there are also opportunities to join the CAMHS Journal Club and Case presentations

There is an active and growing Academic LD team within the University of Bristol with close ties to the Norah Fry Research centre. The SPRICC project within AWP links Trainees with Research opportunities.

The trainee would be encouraged and supported to participate in Quality Improvement and management projects, teaching and training.  There would be flexibility in the work available to them, in order to meet their specific learning needs. 

From a management perspective there are a range of opportunities dependent on the individual and their needs. These can range from chairing multi agency meetings to quality improvement projects/Audit, service improvement projects and specific Roles/Responsibilities within the region.

Finally there is regular opportunity to get involved in teaching with medical students, the team, support staff and core trainees on the MRCPsych course.

 Trainee Timetable

AM

PM

Monday

Non-clinical special interest

Non-clinical special interest

Tuesday

Clinics

1-2pm supervision with trainer

2-5 admin

Wednesday

Clinical special interest session

Academic programme/clinical work and admin

Thursday

9.30 – 11 Team Meeting/clinics

Clinics

Friday

Clinical special interest session

Clinical work and admin

 

13

Learning Disability

Bristol (CAMHS/LD)

Dr Toni Hovey

(Post not available after February 2020 due to consultant retirement)

This post will be a secondment from the Learning Disability ST4-6 Bristol and Gloucestershire Rotation to North Bristol Trust, and trainees need to plan ahead if they wish to include this particular experience.

Bristol Specialist Service for Children with Learning Disabilities provides a community based service for the psychiatric assessment, treatment and continuing care of children and young people aged 0 to 18 with moderate, severe and profound learning disability and emotional and behavioural and mental health problems within the Bristol CCG area.

Clinical experience:

  • Mainly outpatient work in the community, schools, families homes and respite services
  • Psychiatric assessment and treatment of children and young people with moderate, severe and profound learning disability and emotional and behavioural and mental health problems
  • Multidisciplinary  assessments  and multidisciplinary review meetings to  look at a child’s holistic needs with social workers, education, parents, respite services etc alongside other team members
  • Consultation and advice to other agencies including schools, community paediatricians, social services, education and voluntary agencies
  • Attendance at review meetings of a child’s statement of special educational needs.
  • Attendance at multi-agency liaison and consultation meetings with health (including paediatrics, CAMHS and Specialist Children’s LD Team), education (school staff and SEN officials from the Local Education Authority) and social services regarding children presenting with significant needs
  • Joint working with psychology and LD Nursing colleagues including opportunities for psychotherapeutic work in groups and individually
  • Weekly Team Meeting

Academic activities in addition to LD teaching:

  • CAMHS Journal Club and case presentation every 6 weeks
  • Weekly South West Child and Adolescent Psychiatry Academic Programme during academic terms if part of educational plan
  • Special interest opportunities include sessions in child & adolescent psychiatry, community and developmental paediatrics, paediatric neurology, genetics, working alongside community learning disability nurses delivering Webster Stratton Parenting Programme and Sleep Scotland programme, working alongside clinical psychologist who delivers the Positive Behaviour Support Service for children with challenging behaviour in schools.

Audit and management experience:

  • There are local arrangements for clinical audit and clinical governance. Trainees are expected to take part in audit programmes as well as develop their own audits, being encouraged to complete an audit cycle if possible during their training.
  • Involvement in local management
  • Involvement in SSCLD service development (opportunities to take on projects)
  • Opportunities to attend Specialist Services Management meetings
  • Opportunities to observe senior management meetings

On call duties for Avon and Wiltshire Mental Health Partnership NHS Trust Specialist Learning Disability Service or Gloucestershire Health and Care NHS Foundation Trust.

Trainee Timetable:

AM

PM

Monday

Clinical work in community

Research/Special Interest

Tuesday

Supervision

Clinical work in community

Administration

Clinical work in community

Wednesday

Peer support group.

Team Meeting

Complex Needs meetings alternate months

LD Academic Meetings/ Clinical work

Thursday

Research/Special Interest

Research/Special Interest

Friday

CAMHS journal club/CAMHS academic meeting

Research/Special Interest

 

14

Learning Disability

Marlborough, Chippenham, Wiltshire

Dr Fran Ward

Base:

Savernake Hospital, London Road, Marlborough, Wiltshire, SN8 3HL

Wiltshire Community Learning Disabilities Team is an integrated health and social care team comprising of 3 Consultant Psychiatrists (total 2.6 WTE), Community Nursing, Psychology, Speech and Language Therapy, Occupational Therapy, Physiotherapy and Dietetics. There is also a relatively new LD Intensive (LD-WISS) team who carry out crisis prevention and response work. 

Wiltshire LD Psychiatry service is divided into 3 areas:

North East Wiltshire (NEW) – Dr Ward (Substantive Consultant), 0.8 WTE

West Wiltshire and Kennet (WKYD) – Dr Machiwenyika (Locum Consultant), 1.0 WTE

South Wiltshire (Sarum) – Dr Leyland (Substantive Consultant), 0.8 WTE

Out of hours Psychiatric cover for LD Psychiatry in Wiltshire in provided by mainstream services.

Description of Clinical Work:

The post offers the opportunity to work in diverse rural area with a well-established community LD team. Working with rural communities is a useful addition to inner city work to support a broader training experience.

We provide a community based service for psychiatric assessment, treatment and continuing care of adults with mild to profound learning disability in Wiltshire. The postholder will be based at Savernake Hospital along with medical secretaries and a full Community Learning Disabilities Team. The MDT includes Behavioural and Health Facilitation Nurses, Clinical Psychology, Physiotherapy, Occupational Therapy, Speech and Language Therapy and Dietetics.

Wiltshire Community LD Team has seen a number of exciting changes, including the development of a new intensive team (“LD-WISS”) who support service users in crisis.

The trainee will hold outpatient clinics at the team base and at Monkton Park Council Offices in Chippenham.  They will carry out domiciliary visits to a range of settings (including residential and supported living placements), with support from the community team if required.  There will be extensive opportunities for multidisciplinary working which will include attending weekly referrals’, CPA, clinical dementia and complex case meetings. We believe the trainee will benefit from the experience of working very much as part of a team the focus will be on supporting their understanding of the MDT roles.

The post will involve liaison with numerous outside agencies, including GPs and local Neurologists, as well as with colleagues working in mainstream mental health services. 

Teaching and Training Opportunities:

The trainee would be encouraged to develop their own teaching portfolio with supervision, with respect to undergraduate and postgraduate trainees.  This will include participation in the monthly Learning Disability Academic Programme and ALDERN (Avon LD Education and Research Network) meetings in Bristol, as well as opportunities to teach 4th year medical students on clinical placement.

Trainees will also be encouraged to carry out teaching for MDT colleagues, for example for staff in our LD-WISS (intensive) team.

Leadership and Management Experience: 

The postholder would be expected to take an active role in service design and delivery, and there would be flexibility in the work available to them  in order to meet their specific learning needs.  Management experience would be available in a range of domains for example through participation in our Dementia and Epilepsy strategy meetings as well as chairing multiagency meetings.

Care pathways in Wiltshire are in the process of being configured and there will be numerous opportunities to undertake service development work.  The postholder will be encouraged to take on a lead role in a project, for example development of an autism diagnosis and management pathway. There will be opportunities to participate in a range of Quality Improvement and audit work. Close supervision and support will be provided throughout.

Special Interest Sessions:

There is a broad variety of opportunities for Specialist Interest Sessions. We have good working relationships with local Neurologists, in particular with Great Western Hospital, who can be approached for special interest work.  Other examples include experience in Neuropsychiatry, the Adult ADHD Service and the Wiltshire Autism Diagnostic Service. There is an active and growing Academic LD team within the University of Bristol with close ties to the Norah Fry Research centre.

The SPRICC project within AWP links Trainees with Research opportunities. The Trainee would also be an active participant of the regional academic programme which includes the Avon LD Education and Research Network which holds monthly meetings.

On Call:

The Trainee would join the LD On Call rota (Frequency 1:10 pay banding 1c = 20%) which covers Bristol, South Glos, North Somerset and BANES and is non residential.

 Trainee Timetable

AM

PM

Monday

9.30-10.30 Supervision

Savernake HospitalOutpatient Clinic/Home visits

Non- Clinical/Clinical Special Interest Session

Tuesday

Non- Clinical/Clinical Special Interest Session

Non- Clinical/Clinical Special Interest Session

Wednesday

9-11 Clinical work

11-13.00 Trainee Support Group/Clinical Governance/CGM

Clinical Admin/ Academic Meetings

Thursday

Clinical work, NE Wilts (Chippenham)

Clinical work, NE Wilts (Chippenham)

Friday

Savernake Hospital

9.30-10.30 Referrals meeting

Acute case/clinical dementia/MDT meetings

Non- Clinical/Clinical Special Interest Session

       

15

Neurodevelopmental Disorders

Petherton Resource Centre Bristol

Dr Dietmar Hank

The post offers experience in the psychiatry of the developmental disorders Autism spectrum disorder and ADHD in adulthood in community settings. The teams are co-located at the Petherton Resource Centre in Hengrove, Bristol.

ADHD

The Bristol Adult ADHD has its origins in the psychopharmacology clinic lead by Professor David Nutt at the Bristol Royal Infirmary before it became a standalone service. It is now located at the Petherton Resource Centre, sharing its base with a range of other community services, including the Bristol Autism Spectrum Services (BASS), the Pathfinder Service, Advice & Support in Custody and Court (ASCC), Prison Service, Forensic Community Learning Disability Team, Veteran and Deaf Service as well as the Bristol South Recovery Service. ADHD clinicians enjoy active interface working with these services and other AWP Mental Health Services.


This post offers an opportunity to work in a well-established and growing multidisciplinary service, including a part time staff grade and several independent nurse prescribers, psychologist and an occupational therapist. The commissioning remit is that of assessment and treatment of ADHD. We are one of the largest Adult ADHD services in the UK with a case load of more than 1000 service users spanning all adult demographic and social backgrounds.
The service has close links with Bristol University and we support the MSc Neuropsychology course with teaching slots, placements and opportunities for dissertation projects. The Consultant Psychiatrist is the lead clinician for the UK Adult ADHD Network (UKAAN) in the South-West and Bristol is the UKAAN hub for the South-West. The Consultant Psychiatrist has a background in Intellectual Disability and Neuropsychiatry with an interest in sleep disorders (sleep disorders are common in ADHD). We enjoy an active working relationship with the local non-statutory ADHD support group.


The advanced trainee will have opportunities to acquire skills in the assessment and treatment of Adult ADHD. Initially the trainee will shadow practitioners of all disciplines in their assessment work to get acquainted with the multiple facets of Adult ADHD. The trainee will be encouraged to undertake assessment under direct supervision of expert practitioners before conducting assessments independently.
The trainee will work with the medical staff and independent nurse prescribers to learn the skill of prescribing medication for ADHD. Much of the prescribing is done via telephone based reviews with opportunities to experience aspects of telemedicine. There will be opportunities to participate and co-lead short CBT based group interventions (Skills group) for ADHD. Multi-agency working is a common aspect of the work in Adult ADHD due to the high co-morbidity rates with other psychiatric disorders and social deprivation in this service user group. We frequently get asked to contribute to safeguarding, multiagency risk management and child protection procedures.

Bristol Autism Spectrum Service (BASS)

BASS is a nationally renowned specialist autism diagnostic service that also offers post diagnostic support covering Bristol, North Somerset, BANES and South Gloucestershire. It offers trainee psychiatrists an opportunity to be part of a multidisciplinary team offering the gold standard in ASD assessment for the general population and to meet with clients with a pre-existing diagnosis of ASD in our innovative Advice Services. We can offer experience of assessing adults with autism spectrum disorder, attending our advice service and training in how to screen and diagnose adults with ASD. The team uses the ADOS (Autism Diagnostic Observation Schedule), ADI-R (The Autism Diagnostic Interview-Revised) and the 3di (Developmental, Dimensional and Diagnostic Interview) alongside formal clinical and psychiatric interview. Trainees will get experience and training in these instruments. Assessments will be undertaken with other MDT clinicians, including Psychiatry, Nurse specialists, Psychology and Occupational therapy. MDT based case discussions will further the trainees understanding of various symptom and impairment dimension of ASD.


BASS assesses adults of school leaving age right through to the elderly client group. Our referrals come direct from GPs and from secondary care - often with other significant diagnosis and co-morbidity. BASS can help trainees recognise ASD within the complex client group of an adult psychiatrist’s case load and offer differential diagnoses for those who present in a similar way. BASS also have close links with the Forensic Community Learning Disability Team (who share the same building as us at Petherton Road) and the FIND (Forensic, Intellectual, Neuropsychiatric & Developmental Disorders) team at Fromeside. We offer advice to forensic, court and prison services and have a link worker for police liaison and PREVENT.


Diagnostic clinics generally operate on Mondays & Wednesdays. Triage clinics generally run on Tuesday and Thursdays afternoons (an innovative opportunity to screen for ASD in a briefer clinical meeting.) The Advice Service operates every Friday at the Create Centre, and we would advise trainees to spend a few sessions there during the course of their placement. Our Advice Services and post diagnostic groups work with people with Autism Spectrum Disorder with a multi-agency approach led by a senior social worker and OT. In addition to the various groups we run, we also offer 1:1 support around employment, benefits, housing, education and social care. We have a number of people from external and third sector agencies doing sessional work at the Advice Services, and there will be opportunities to work alongside these professionals as required. Furthermore, BASS offer a comprehensive liaison services to agencies across the care pathway who are working with autistic people. Trainees are welcome to participate in this work, and to therefore get experience of working in a specialist autism liaison service.


Regular clinical supervision with an experienced Specialty Doctor with Clinical Supervisor status. Dr Jethro Purkis is the lead for this at BASS. The other Specialty Doctor at BASS is Dr Alison Cape. In addition, the trainee has access to supervision from other MDT members and Dr Peter Carpenter, Honorary Consultant Psychiatrist, and a renowned national expert in the diagnosis and management of Autism Spectrum Disorder.

Educational Supervision

Trainees will be offered clinical and educational supervision for one hour each week. Dr Hank is the educational supervisor for this post.

Academic Program

Trainees are expected to participate in the regional academic programme which takes place on a Wednesday and also includes the Avon LD Education and Research Network (ALDERN) which holds monthly meetings.

Other clinical opportunities:

There is ample opportunity for Specialist Interest Sessions with the services co-located in the same building and services we interface with, in particular community paediatrics, CAMHS and CAMHS-LD. The Rosa Burden Centre at Southmead Hospital offers experience in Neuropsychiatry.

There are opportunities to work at the interface with the Avon Forensic Community Learning Disability Team, ASCC, prison service, probation, Substance Use Services and the whole range of other psychiatric services. Due to the high rate of transition from childhood/adolescent ADHD to adulthood and the generally life-long persistence of ASD, developing a good understanding of the work in CAMHS and Community Paediatrics is particularly useful in our services. Opportunities can be arranged as one-off clinical experience or for more comprehensive insights and learning, Special Interest Sessions could be considered.

Leadership and management:

There are opportunities for management and leadership experience with chairing the MDT meetings and the monthly facilitated service user meetings organised by the ADHD service. A service user steering group has recently started up. Trainees are encouraged to engage in quality improvement projects/audit, service improvement projects and specific Roles/Responsibilities within the region.

Teaching:

There are ample teaching opportunities in both services. BASS has a dedicated Training and Liaison officer and there will opportunities to both shadow and participate in Autism training locally and nationally. Teaching about developmental disorders takes place on an annual basis at the University of Bristol and on the MRCPsych course. A formal teaching programme about ADHD is being developed for primary care and secondary MH teams and the trainee could contribute to writing and delivering such as programme.

Research:

The Adult ADHD service conducts service evaluation projects and is involved in research. Research opportunities are also available through Dr Rai at the University of Bristol. AWP has an active R&D department.

Administration support & Office:

Both teams have a very friendly team of administrators who will be able to support the trainee with administrative tasks. Administrative support is available for all aspects of the trainees’ work. In addition to the dedicated admin slot in the weekly timetable, admin time is included with all clinical tasks. The trainee will be accommodated in the multidisciplinary office with the other team members. Desk space, telephone and fully internet enabled computer access as well as a lockable filing cabinet is available for trainees.

On call:

The Trainee would join the LD On Call rota (Frequency 1:10 pay banding 1c = 20%) which covers Bristol, South Glos, North Somerset and BANES and is non-residential.

Trainee Timetable

AM

PM

Monday

Clinical work BASS (assessments)

Clinical work BASS (assessments)

16.00 -16.30 Clinical supervision

Tuesday

Clinical Special Interest Session

Clinical Special Interest Session

Wednesday

 9.00-11.00 Referral meeting/Team meeting

11.00 -13.00 Trainee Support Group/Clinical Governance/CGM

Clinical Admin/ Academic Meetings 

Thursday

Clinical Work ADHD (assessments)

Clinical Work ADHD (prescribing)

16.00 -17.00 Clinical & educational supervision

Friday

Non- Clinical Special Interest Session

Non- Clinical Special Interest Session

 The time table could be adjusted so that the trainee spends two days per week in each service, alternating weeks