General Adult Core and Sub Specialty Job Descriptions

1

General Adult

Core community

Bath

Intensive (Crisis/HT)

Dr Chris Lucchese

This is an exciting post in which the trainee will have the opportunity to experience and input to the BANES Intensive Service. The Intensive Service is a community mental health service based out of Hillview Lodge, on the Royal United Hospital site in Bath. This service provides daily support, 24 hour rapid assessment and treatment for those in crisis, “gate keeping” admissions and supporting discharge for patients leaving Inpatient services. The average caseload is between 15 and 25 but the turnover is high with patients entering and leaving the Team each day.

The caseload mix is adults with acute presentations including psychosis, affective disorders and personality disorders often with associated substance misuse, physical health problems and social difficulties. The team typically assesses patients in their own homes, at Bath NHS House / Hillview Lodge or RUH depending on circumstances.

The trainee will work within the multidisciplinary team covering the caseload and is well supported by the Consultant Psychiatrist and Specialty Doctor posts. The post holder will be working with F2 and CT1-3 doctors with opportunities to develop supervision skills if desired.

The role will include new patient assessments, reviews and discharges along with making referrals / liaising with other services. The trainee will be expected to develop their clinical management skills during the post. There is daily team discussion of all patients on the caseload and opportunity to undertake MHA assessments.

There will be the opportunity to become involved in Audits / QIPs, develop clinical leadership and management skills with opportunities to take on management projects. There is also the opportunity to develop teaching skills with the local trainees and students. A fortnightly academic meeting takes place at the Postgraduate Medical Centre along with a monthly journal club.

2

General Adult

Core community

Bath

Recovery

Dr Thom Proven

“The post covers a diverse urban and rural catchment area, affording the post holder opportunity to gain a broad range of competencies in general adult psychiatry and provide a recovery-focused experience in a community setting. You should see a extensive range of complex (and routine) presentations, and community treatment options. There is ample opportunity for joint working with MDT colleagues, supporting other members of the team and liaison with other services, including close working with GPs and colleagues within the locality.

There’s lots of scope to personalised your experience here, and we could think about various learning objectives and aspirations in initial meetings. This could involve gaining experience in specific facets of the Recovery team workload including, for example legal aspects, long term medication management, psychotherapy, rehab, dual diagnosis, etc. etc.

The post will also offer good opportunity to develop skills and competencies for your first consultant post including medical leadership and management roles within the team, complex decision making and supervising junior colleagues.

Bath is a friendly and welcoming locality (I hope), and is a not too burdensome commute from Bristol. We have an active and varied locality postgraduate academic programme and a nespresso machine.

If you would like to meet and discuss a rotation here, I’d be more than happy to chat!”

3

General Adult

Core community

Bath Early Intervention

Dr Liz Ewins

The EI team in BANES provides care for people aged 14-64 presenting to mental health services, often for the first time, with At Risk Mental States (ARMS) or First Episode Psychosis (FEP).

The trainee’s role will include undertaking specialist assessments of new patients, managing a caseload of patients with emerging mental illnesses and psychosis, and undertaking urgent referrals both in and out of hours (BANES on call rota is 1:15). The trainee will work with families, attend CPAs on the acute wards (private and NHS) and work closely with other mental health professionals and teams to jointly manage mutual patient’s care.

The excellent multidisciplinary team is highly innovative, and many opportunities are available for trainees, including within medical education, quality improvement, research, leadership and management. The trainee will be supported and strongly encouraged to become actively involved and to take a lead in such opportunities.

Additionally, there are a wide range of clinical special interest opportunities locally (including Specialist Drug & Alcohol Services, Autism Specialist Services, Liaison, Intensive Team) as well as a wide range of psychotherapy opportunities (including Art & MBT, EMDR, CBT).

4

General Adult

Core community

Bristol Central Recovery

Dr Simon Downer

In this post, you will have the opportunity to work in an Inner City assessment and recovery service. You will work with the most diverse community in the Deanery, and begin to understand this population’s particular needs. You will be encouraged and supported to truly engage with the role of culture and context in mental disorder. There is ample opportunity to work with asylum-seekers and refugees, in many different ways, and to work closely with local GPs and understand the challenges and rewards this interface can bring.

You will join the senior clinicians in the team, and will be encouraged to see yourself as a clinical leader as well as a trainee. You have a lot to offer this team, and will be encouraged to get involved in service and team development.

You will also be able to undertake regular clinical work to further develop the skills you have acquired as a core trainee. This will include: completing regular initial assessments; taking on longer term individual work (if you would like to, and agree as part of your learning objectives for the post); reviewing patients at the request of care coordinators; completing emergency assessments; gaining experience producing reports for MHA managers or MoJ (if you wish); having the opportunity to attend MHAAs; attending regular assessment review meetings; attend team meetings (including reflective practice meetings); working closely with multiple other agencies.

Most importantly, in this post, hopefully you will be provided with an environment in which you can begin to explore how you want to practice as a psychiatrist. You will be supported to find your own way with clinical approaches that feel right for you.

The trainer is a psychodynamic psychotherapist, as well as a psychiatrist, and is particularly interested in psychological and social approaches to serious mental disturbance, the historical and philosophical underpinnings of psychiatric practice, and tries to encourage a dialogue about conceptual and ethical issues. He is advisor ally for the Bristol Hearing Voices Network, current interim chair of ISPS UK, and director of the Psychosis Health Integration Team.

5

General Adult

Core community

Bristol North

Recovery

Dr Dan Hodgson

This post will be based in the North Bristol Recovery Team based at the Greenway Centre, Southmead.  The Recovery team covers a total population of approximately 175 000, with this being divided into three work streams (clusters), each with approximately 1.0 WTE consultant. There are 5 consultant psychiatrists working in the ageless recovery service (Drs Hodgson, Buckley, Nikolov, Farooq and Mundasad). The North Crisis team spoke is also based at Greenway with opportunities to be involved in home treatment if desired. North Bristol has a diverse urban population with wide variation in ethnicity and morbidity (reflected in mental health indices). Outpatients and specialist recovery services are based at Greenway centre but patients are seen in range of settings including GP practices. 

The role of the ST4-6 will be to gain experience in the diagnosis, assessment, and treatment of the full range of mental health disorders affecting adults of working age. The team is an amalgamation of past CMHTS, AOT, Community Rehabilitation and Later Life functional illness. There are opportunities to gain experiences in a variety of settings, including inpatient unit, community base, general hospital and primary care.  The Assessment service is integrated within the Recovery team so a key role for the trainee is to become expert in assessing referrals from primary care. The service model promotes an increasing model of Primary Care liaison with interface meetings with GP practices with opportunities to evolve primary care liaison services. The Complex Psychological Interventions service (embedded) offer a range of interventions and trainees can gain experience and supervision accordingly.  The trainee will be directly supervised by Dr Hodgson, with weekly formal supervision. 

As well as a broad range of general adult experience this post can be developed by the trainee to include special interest sessions in a wide range of clinical, teaching and management skills. There are F2, GP trainees and core trainees to gain experience as a trainer/supervisor. Dr Hodgson is a senior medical manager with management experiences to share. Dr Hodgson also has an interest in student health (as the University of Bristol link psychiatrist) and gender identity (as a gender specialist and LGBT champion).

6

General Adult

Core Community

North Bristol

Crisis Service

Dr Syed Husain

Want to start your consultant career with the confidence of knowing how to deal with all types of psychiatric emergencies? Then you need this job!

Working with the North Bristol Crisis Service will allow you to assess and treat a variety of urgent mental health difficulties ranging from the acutely suicidal teen to the post-partum psychotic to the elderly with agitated depression. You will become skilled at risk assessment and management, by treating patients and their immediate high risk behaviours in their own homes as an alternative to hospital admission. You will hone your diagnostic skills and collaborate with GPs, other referrers, families, AMHPs through our bed gate-keeping role and inpatient teams through our facilitated discharge role.

You will provide leadership to the multi-disciplinary team, appropriate to your level of training. The team includes a foundation doctor, core trainee and medical student whom you can supervise and teach as required. Our base is Southmead Hospital. There will be opportunities to carry out Mental Health Act assessments and you are welcome to accompany the consultant Dr Husain during his role as second doctor to the Place of Safety. Any other required or requested experiences will be facilitated as much as possible.

7

General Adult

Core Community

Bristol Central

Assessment & Recovery

Dr Jacek Kolsut

The team supports and empowers community patients who require secondary mental health services. We receive direct referrals from Lawrence Hill Health Centre, Montpelier Health Centre. Dr Kolsut is also the link consultant for Broadmead Medical Centre (City-wide GP surgery) and for The Compass Centre (City-wide GP practice for homeless patients). We have excellent links with all our GP colleagues. This post will give you a very unique opportunity to work closely with our primary care colleagues. If you would like to help the most vulnerable homeless patients in Bristol we are the best place to be. Our team works very closely with other Central teams including the Crisis Team and ROSE Team who provide additional flexible and assertive support for difficult to engage patients. Our psychologists have specialist expertise in the evidence based treatment of personality disorders, depression, anxiety disorders. We work closely with the Complex Psychological Intervention Team and they will be happy to provide advice and supervision if you would like to pursue your special interest in talking or behavioural therapies. The team consists of experienced nurses, social workers, psychologists, occupational therapists and are able to offer a range of therapeutic interventions. The multi-disciplinary team is enthusiastic and experienced. The consultant is committed to providing clinical leadership to the team. We are supported through a staff supervision group which the trainee would be encouraged to attend. The doctor in training will be encouraged to participate in twice weekly new assessment meetings, weekly MDT and governance meetings. It is expected that the Specialist Trainee in this post would be interested in the acute care pathway, working directly with the supervising consultant and liaising with the crisis teams and inpatient wards in order to ensure medical handovers and safe transfers for care between the teams.

8

General Adult

Core Community

Bristol North

Recovery

Dr Ivan Nikolov

The trainee will have the unique opportunity to work with one of the most diverse and socio-economically mobile populations in Bristol. The trainer has well established links with local GPs some of whom have special interest and are engaged in the mental health service provision and there is a valuable opportunity for service development in truly collaborative way. The trainee doctor will have the opportunity to gain indispensable skills in primary care liaison and professional communication.

The trainer is a Member of British Association for Psychopharmacology and holds Clinical Certificate in Psychopharmacology, and there will be opportunity for the trainee to develop their expertise in biological treatment for mental disorder. The trainer also has special interest in neuropsychiatry and Mental Health Legislation.

9

General Adult

Core Community

Bristol Early Intervention in Psychosis

Dr Clare Trevelyan

Main educational opportunities offered by this post:

• Assessment and management of young people  (aged 14-35)who have experienced first episode of psychosis. This involves experience working with people with primary psychotic illness and affective disorders.
• Working closely with a multidisciplinary team using an evidenced based approach focusing on medical, psychological and social support.
• Development of risk management and safeguarding skills an essential part of work.
• Supporting people who have experienced psychosis who might have common comorbidities such as neurodevelopmental disorders, substance misuse, mood and anxiety disorders, personality disorders and other sequelae of trauma. Developing trauma informed approach to care.
• Opportunity to take part in service user support groups, reflective practice groups. Audit and service development opportunities.
• Working with people subject to Community Treatment Orders, and experience considering thresholds for use of MHA.

10

General Adult

Core Inpatient

Bristol – Callington Road PICU

Dr Jochen Binder-Dietrich

This is an exciting opportunity for a core General Adult Inpatient placement on the newly opened female PICU Elizabeth Casson House; where you will develop competency in the assessment of florid psychopathology, management, treatment and reduction of risks associated with acute episodes of mental illness in a contained, safe and closely supervised therapeutic environment.

After a period of building work, ECH was reopened as a psychologically informed unit in August 2022. You will have the pleasure to work in a freshly refurbished and especially designed environment with state-of-the-art enhanced care areas and sensory room, to meet the complex needs of our patient group.

ECH specialises in the assessment and comprehensive treatment of women with a broad spectrum of acute and enduring mental health needs. The main diagnoses of our patient group are psychotic episodes associated with affective and schizophreniform disorders, occasionally developmental and personality disorders.  We provide care and treatment to inpatients experiencing the most acute phases of their mental disorder; acute distress, absconding risk and suicidal or challenging behaviour needing a secure environment beyond that which can normally be provided on an open psychiatric ward. High staffing ratios including a wide range of therapists allow for intensive input to resolve issues quickly.

You will work as a fully integrated member of the MDT; taking on clinical leadership as required. We have appointed an experienced Psychologist who will support the MDT in the delivery of a trauma informed model of care and treatment.

You will have the opportunity to learn and practice the preparation of tribunal reports and presenting your findings at hearings.  You will have time and flexibility in your timetable to access the many other inpatient services on the hospital site. The unit also liaises closely with our onsite ECT for the management of therapy resistant mania.

Some of our patients require forensic input regarding the management of their risks to others. This interface will give you an insight into the forensic referral and assessment process and the criteria necessary for transfer to low or medium secure.

The ECH team is a tight-knit team who demonstrate that professionalism and well-rehearsed procedures in a challenging inpatient environment can be combined with a high level of care and compassion for our patients.

11

General Adult

Core Inpatient

Bristol – Callington Road PICU

Dr Narendra Singh

A General Adult Psychiatry Senior Trainee Post is available at Hazel Unit an all-male 12 bedded purpose built Psychiatric Intensive Care Unit with high care and seclusion facilities.

Hazel Unit is situated within the grounds of Callington Road hospital Bristol with varied specialised inpatient facilities serving up to 122 psychiatric inpatients, including a female PICU, open acute, old age including dementia care, open rehabilitation and subacute units, OT, Psychology, ECT, Mental Health Act offices, Library, academic & therapies areas.

All Forensic, Prison, Courts, Community and Social service bases are within less than 3 mile perimeter of the Callington Road Hospital. Bristol Royal infirmary, Neuropsychiatric and Brain Injury Rehabilitation Units are also available in Bristol.

The role of the Senior Trainee will be to gain experience in the diagnosis, assessment and management of the full range of mental health disorders in some of the more complex and challenging clients in Psychiatry. The unit serves a wide geographical area with large population of various ethnicities and backgrounds.

The post offers experience in multi-disciplinary working, developing clinical leadership skills, learning intensive pharmacological and psychological approaches. Post holder is expected to learn nuances of liaison for complex needs patients with the Forensic, Prison, Courts, Community, Open Acute, Early Intervention, Drugs Services, Learning Difficulties, Elderly, Rehabilitation, Female Intensive Care, Neuropsychiatry, Neurology and Liaison services. There is opportunity to participate in mental health review tribunals and learn assessments and reports writing for tribunals/courts.

The post holder is expected to be important part of local management meetings, academic programme, supervising & teaching trainees, nursing/medical students, get involved with audits/research/quality improvement projects and contribute to pan Bristol-South Gloucestershire-North Somerset senior on call rota.

12

General Adult

Core Inpatient

Bristol Callington Road

Open Acute

Dr Phillip Charles

This is an exciting opportunity for a core General Adult Inpatient placement where you will develop competency in the assessment of acute psychopathology, management, treatment and reduction of risks associated with acute episodes of mental illness in a contained, safe and closely supervised therapeutic environment.

Silver Birch specialises in the assessment and comprehensive treatment of patients with a broad spectrum of acute and enduring mental health needs. We are a nineteen-bed female open acute ward. The main diagnoses of our patient group are serious mental illness specifically major affective disorder and psychotic disorders but there are often comorbid illnesses such as neurodevelopmental disorders, personality disorders, eating disorders, alcohol and substance misuse.  We provide care and treatment to inpatients experiencing the acute phases of their mental disorder, acute distress, absconding risk and suicidal or challenging behaviour needing an inpatient environment beyond that which can normally be provided via intensive community support. Furthermore, we are a diverse MDT including psychologists, art & music therapists, OTs, dieticians, physiotherapists, activity co-ordinator and active life practitioners to deliver a comprehensive assessment of individual need. Discharge planning is a fundamental aspect of the role and provides an opportunity to liaise with the wider treatment system to facilitate a safe and effective discharge into the community or further placement.

13

General Adult

Core Inpatient

Bristol Callington Road

Open Acute

Dr Jonathan Davies

Cherry Ward is an excellent place to gain broad experience in acute inpatient psychiatry.  We benefit from being a busy, mixed, 18-bedded unit for adults of working age, so you will see a wide variety of common, severe and complex presentations.  Cherry is an exceptionally friendly ward and offers a bright and spacious environment, having opened in 2020 after a full refurbishment.  One of its founding principles was to strive for more psychologically informed care and it continues to host a range of therapists and favourable nursing ratios to support this.  Cherry also profits from being on the Callington site, so you are likely to have fellow higher trainees based here, as well as being able to rely upon a stable body of experienced and newer consultants.

The post will allow you develop your skills in assessing, managing and directing patients’ inpatient care.  You will be liaising with our CMHT and Crisis colleagues in the community, and at times with more specialist services, such as the on-site PICUs and ECT suite, and local LD teams.  You will also be involved in the tribunal process, including the preparation of reports and providing medical evidence, as well as Mental Health Act responsibilities more generally.

Cherry currently has the support of a full time staff grade psychiatrist, a core trainee and a foundation year 2 doctor, so there should be ample opportunities and flexibility for you to focus on and develop those training areas you want to prioritise.  There will be opportunities to offer leadership and management of our junior medical staff, as well as audit and quality improvement initiatives. 

14

General Adult

Core community

South Glos (Bristol)

Recovery/EI

Dr Andrew Brindley

This is a community post covering General Adult Psychiatry and Early Intervention in Psychosis in the South Glos. area.  The trainee will see a diverse range of patients across the spectrum for all disorders from Schizophrenia, Bipolar Disorder, Depressive Disorders, Personality Disorders and Anxiety Disorders in a variety of settings including clinics and the home environment.  The post is within easy access of Bristol and is supported by an experienced and well established multi-disciplinary Recovery Team and Early Intervention Team.  There is excellent admin support.  Alongside gaining extensive clinical experience the trainee will be supported to develop teaching, quality improvement and leadership skills.  The trainee will be an integral member of both the General Adult Recovery Team and the Early Intervention Team with dedicated timetabled time in each service.  There will be flexibility in the timetable to suit the needs of the trainee.  The trainee will have direct supervision with Dr Brindley and will have the support of Specialty Doctors, a GP Trainee and a Foundation Doctor in the team.  There will be excellent opportunities to develop experience in CBT for Psychosis, Family Intervention in Psychosis and therapeutic ways of working with people with Personality Disorder. 

15

General Adult

Core community

South Glos (Bristol)

Recovery

Dr Avneet Sharma

This is an exciting post offering experience in General Adult Psychiatry in South Gloucestershire. . The South Recovery team South is based at Kingswood Civic Centre. The Recovery team case load typically consists of Psychosis, Mood disorders and Personality disorders who are managed by experienced    clinicians including senior Practitioners, CPNs, Social Workers, and Occupational Therapists. The overall approach is recovery oriented with a focus on empowering the patients and supporting them through personal and clinical recovery.

The advanced trainee will gain experience as senior medical member as follows:

• Community reviews and work alongside the multi-disciplinary Recovery Team.
• Urgent review of patients
• Opportunity to work with a variety of patients in a variety of settings both urban and rural.
• Opportunity to gain experience in treatments with a focus on using complex/combination interventions in patients who appear to ‘be stuck’ with in services.

Senior trainees (who have worked previously) have found the post as very useful learning experience in Clinical Psychiatry especially in gaining valuable confidence under a highly supportive environment in applying different treatment approaches including complex Psychopharmacology regimens. Post holder will also have the option of working with the local Primary care liaison team . The locality has the benefit of   an extremely well developed Psychotherapy Service offering  range of therapies .

The advanced trainee will be actively encouraged to attend all management meetings with senior management staff.  The trainee will have ample opportunities to be involved in teaching including teaching medical students and GP trainees.

16

General Adult

Core community

South Glos (Bristol)

Intensive Support Team

Dr Ruta Kuzminskyte

The trainee will be part of the team and will take part in joint assessments, including emergency referrals with other members of the team.  There will also be follow-up appointments.  There will be opportunity to assess patients, devise treatment plans and follow the patients up in their journey of the episode of home treatment or, in cases where a hospital admission becomes necessary, follow the patients during and post admission and get the experience of acute psychiatry both in hospital and in patients homes. Assessments and follow-ups are usually carried out in patient’s homes. Occasionally patient will be seen at the team base, where rooms may be booked, but there is no routine outpatient clinic. Patients are usually referred to the IST by the Recovery teams, EI, the Primary Care Liaison Team, Mental Health Liaison teams in BRI and Southmead, Later Life team due to increasing risks, when more intensive treatment is required, as an alternative to hospital admission. The trainee will gain experience in risk assessment and management, acute psychiatric disorders and their management. The team works in a holistic way, incorporating mental health, physical health, social and psychological support. The trainee will have opportunities to practice psychotherapy skills in brief interventions and work closely with team psychologist. The team has adopted an SCM model working with patients with personality disorders. As part of clinical work the trainee will have opportunity to observe and later undertake Mental Health Act assessments.

17

General Adult

Core community

Swindon

Early Intervention

Dr Sherlie Arulanandam

This post is based with the Early Interventions in Psychosis Service (EIP) Swindon, which assesses and manages individuals between the ages of 14 and 65 who are experiencing first episode psychosis and monitors persons who present with At Risk Mental State (ARMS). The service also works with 14 – 18 year old service users and families in conjunction with the CAMHS service operated by Oxford Healthcare NHS Trust.

The EIP service works with individuals for up to three years during the ‘critical period’ to maximize the chances of a symptomatic and social recovery. The team uses a Multidisciplinary approach to this end. The team acts as a resource to the adult mental health community and inpatient services, by raising awareness of the needs of this client group, providing information and consultation about psychosis.

There are staff within the team who are trained and deliver CBT and Family interventions, as well as physical health assessments, in line with the national standards. Exercise and physical health are also major areas of focus with the team running several community groups (badminton, football, golf, rock climbing, gardening, etc)., The team is well resourced, to work a maximum caseload of 15 per WTE clinician.  The team is motivated and supportive; it comprises one consultant (0.7 wte), one team manager, one senior practitioner, two clinical psychologists and a full multidisciplinary team comprising nurses, occupational therapists, social workers, dietitian, support workers and physiotherapist.

18

General Adult

Core community

Weston

Early Intervention in Psychosis

Dr Kristina Gintalaite

This is a great opportunity to work with the integrated, experienced and enthusiastic team which is very supportive of trainees to provide evidence-based care for people aged 14-35 presenting to mental health services, often for the first time with First Episode Psychosis (FEP). The trainee’s role in the team will include undertaking specialist comprehensive assessments of new patients in outpatient and community settings, managing a caseload of clients with psychosis, and undertaking urgent referrals. The trainee will work with families, attend CPAs on the acute wards and work closely with other mental health teams to jointly manage mutual patients’ care and facilitate smooth transitions across different services. The timetable will be tailored to the needs of the individual trainee. Higher trainees will be encouraged to develop their full potential and be stretched in directions of their choice. There is a great opportunity to link with the local services such as We Are With You, Drug and Alcohol service (Weston-super-Mare), Learning Disability service (Weston-super-Mare), community Recovery service (Coast Resource Centre), Emotionally Unstable Personality Disorder team (working within the structured clinical management model, Coast Resource Centre, WsM), Family therapy service (Coast Resource Centre, WsM), hospital based Liaison service (Long Fox Unit) and community Liaison team (based in Long Fox unit).

19

General Adult

Core Community

Gloucestershire Recovery

Dr Olaniyi Olaniyan

The advanced trainee with be joining a team with an active caseload of about 300 patients covering 17 GP practices split over the Stroud , Cam and Dursley areas. They will only be expected to see patients from the Stroud area which covers 10 surgeries. Most patients are care co-ordinated on enhanced CPA. The team is responsible for the assessment and treatment of patients with chronic severe mental health conditions and we accept both internal and external referrals. We provide support to the primary care team and liaise with a variety of professional agencies. The post will provide an excellent opportunity to develop senior clinical management and leadership skills by engaging in assessing and managing patients with a diverse range of mental health difficulties, running outpatient clinics, providing multidisciplinary and inter agency support and advice, joint assessments, domiciliary visits and Mental health Act assessments.

There are also excellent opportunities to develop additional clinical skills and competencies through clinical special interest sessions in a variety of sub-specialties like the Crisis resolution and home treatment team, Early intervention team, Assertive Outreach team, Mental health liaison team, Eating disorders service and low secure forensic unit. The trainee would also be fully supported to identify and implement bespoke special interest sessions relevant to their training.

20

General Adult

Core community

Gloucestershire

Early Intervention

Dr Jon Haynes

The post is based with the Gloucestershire Recovery in Psychosis (GRIP) team, 2gether Foundation Trust, which assesses and manages individuals between the ages of 14 and 35 who are suffering first episode psychosis (FEP), and monitors persons who present with At Risk Mental State. (ARMS). The multi-disciplinary team covers the entirety of Gloucestershire (Population 600,000) and is divided into three sub-teams to cover different geographical areas. The consultant and specialty doctor provide medical input into each team; the trainee may choose to focus on one sub-team, or work across all teams.

The GRIP is well resourced, to work a maximum caseload of 15 per WTE clinician.  The team is motivated and supportive; it comprises 1 consultant, 1 specialty doctor, 1 team manager, 2 clinical psychologists, and a full multidisciplinary team comprising nurses, occupational therapists, social workers, support workers and sports therapist/ physiotherapist. Clinical duties are restricted to patients over the age of 18, and include assessments, MHA assessment, medication review and prescribing, and collaborative working to a recovery model with other team members. There is opportunity of preparing medicolegal reports under supervision. Risk assessment is core business for the team as the patient group are often impulsive and disturbed. 

Interested candidates are encouraged to call Dr Haynes on 01452 894862.

Locally research opportunities are available through the team, and through trust research committee. We have links with the EI research streams at the University of Bristol.

Teaching opportunities are available for medical students based in the Gloucester Academy, and to other professions.

Trainees will be invited to join the Medical Staff Committee on a monthly basis. There are opportunities to shadow Dr Haynes, as Clinical Director, and to take lead responsibility in management projects.

21

General Adult

Core Community

Gloucestershire

Crisis/Home Treatment

Dr Faisal Khan

The population of the County of Gloucestershire is approximately 623,000. The age profile of the area is equivalent to national averages for children, working age and elderly populations. On the whole the population enjoy a good standard of living and health with higher than average levels of life expectancy when compared to other areas of the south west and the rest of the UK. The mean Jarman Index is 24-29. However, despite the relative affluence of the area, with unemployment rates of 3.4% compared with 4.7% nationally, two wards in the county (both in Gloucester) fall within the 10% most deprived areas in England based on the 200 indices of deprivation. Numbers of people from ethnic minorities are below the national average in the county, but approaching this in Gloucester city (about 8%). In addition, the figures for people with a learning disability registered with a GP in Gloucestershire are significantly higher than the national average. This is due to people being placed in residential placements in Gloucestershire from other areas. The area covered by this post i.e. Cheltenham, Tewkesbury and North Cotswold is one of the most affluent areas of the county, if not the country.

This post would give trainees an excellent opportunity to work in a multidisciplinary team covering the beautiful areas of Cheltenham, North Cotswold and Tewkesbury. The post holder will work with Dr Faisal Khan, Consultant Psychiatrist, a GMC approved trainer for Core and Advanced training in psychiatry. Dr Khan is currently the Associate Medical Director for the Trust covering countywide services i.e. Crisis, Inpatients, Liaison, Psychotherapy/Eating Disorders, Rehabilitation Psychiatry and Assertive Outreach Teams. The trainee will also have the support of an SAS doctor 2 days a week and there is a core trainee in post as well. The trainee would also be expected to gain management experience and available opportunities would be explored and encouraged to take. The trainee would be expected to attend our local weekly academic programme and encouraged to present if possible. Excellent audit and research opportunities are available to trainees. Trainees also get opportunities to carry out Mental Health Act Assessments in the community and inpatient settings. Weekly supervision would be offered and accommodated in the trainees timetable. The local crisis teams and PICU have been rated excellent at national level.

22

General Adult

Core community

Gloucestershire Recovery

Dr Theo Lerescu

This Gloucester City post will provide a broad exposure to psychiatric practice in the community. Our team is responsible for assessing and treating new referrals from primary care and other agencies, and for the ongoing treatment of patients with long-term severe and enduring mental illness.

I believe that our setting, resources and location put us in the position to offer a very good training job with excellent support and supervision in the new Gloucester Hub, Pullman Place, with Recovery Team Glevum. Gloucester Recovery team (which is divided in 2 sub teams) has 25 members including 4 consultants, 2 SAS doctors, 2 OTs, 3 social workers, 10 band 6 CPNs, vocational workers and support workers. At present our team helps 600 patients living mostly in inner city Gloucester. Team Glevum covers 9 busy surgeries serving a population of 90000 people. More then half of the patients suffer with SMI with a great variety of diagnoses and clinical presentations. Our team also runs Gloucester Clozaril clinic.

The medical support for Team Glevum is provided by myself, a full-time staff grade doctor and a GPVTS trainee. The administrative support is excellent; full time dedicated medical secretary, personal laptop and mobile phone, in an office shared with the team. The trainee will have the opportunity to undertake assessments of new patients. There are other opportunities to do joint work in the community-joint DVs with members of our team or crisis team and opportunities to do MHA assessments. Our team has excellent links with other Gloucester functional teams: Crisis Team, GRIP, PMHT, OA, LD and AOT which are all based in Pullman Place hub building. Our team base is within 5 minutes walking distance to Wotton Lawn Hospital and the Redwood education center. There are some interesting opportunities for special interest sessions locally: GRIP (early intervention team) and Montpelier Low Secure Unit. There will be weekly formal individual supervision. The timetable offered is flexible to pursue existing research, teaching projects and special interest commitments. Interested candidates are encouraged to call Dr Lerescu on 07919 574159.

23

General Adult

Core community

Gloucestershire Recovery

Dr Raj Choudhury

This post would provide the trainee with an excellent breadth of training in developing clinical leadership in a multidisciplinary team that provides holistic ‘personal recovery’ oriented care and treatment of people in the community within a secondary mental health service. This post in based at Leckhampton Lodge in leafy Leckhampton in the regency town of Cheltenham. The trainee will have their own desk with computer and telephone in an office shared with 2 or 3 other doctors and full medical secretary support. The trainee would be expected to see no more than 8 patients in the six core clinical sessions per week, as I believe in deeper holistic learning by seeing few carefully selected patients and thereby develop adequate competence and confidence in managing patients with multidisciplinary and inter-agency support which would be the fundamental role of a Consultant Psychiatrist in the first few years in that role. In the core clinical sessions, the trainee would have opportunities to: assess and formulate treatment plans for patients across a range of psychiatric diagnoses; develop supervision skills by supervising medical students and junior trainees; learn to manage interface challenges across different services, and thereby develop negotiation skills; attend weekly local academic programme and the monthly medical staff committee meeting. The trainee would be expected to join the multidisciplinary team meeting on Tuesday mornings. The trainee would have ample opportunities for developing additional knowledge and competencies in other areas by doing ‘special interest sessions’ in the Gloucestershire Early Interventions Service for People with Psychosis, the Mental Health Liaison Team, the Crisis Service, Assertive Outreach Service, Eating Disorders Treatment Service, Low Secure Unit, ADHD and Autism Service, Medical Psychotherapy, Medical Education, Medical Management, Quality Improvement Projects etc. The trainee would be welcome to take an active role within the Fritchie Centre which is a specially developed research centre within Gloucestershire Health and Care NHS Foundation Trust that manages both NIHR funded and commercial research studies and it is led by two consultant psychiatrists with extensive research experience. On-calls are 1:20, and on weekdays it is from 5 pm – 9 am and on weekends it is for 24 hours from 9 am till 9 am with Consultant supervision and support available for the whole period. On-call work covers all specialities which is an excellent learning opportunity as increasingly many Trusts expect Consultants to cover all specialities when on-call. Hour-long formal supervision will be provided weekly.

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General Adult

Core Community

Gloucestershire Recovery

Dr Sarah Greef

This post provides exposure to community psychiatric practice with input from two trainers across a patch covering inner city and rural areas that encompass some of the most and the least deprived areas of Gloucestershire. There is a very varied caseload and the opportunity to develop skills in a variety of styles of management. The Recovery team is responsible for assessing and treating new referrals from primary care and other agencies and for the ongoing treatment of patients with complex mental health problems including severe and enduring mental illness.

Our setting, resource level and approach allow us to offer advanced trainees excellent and tailored opportunities for training and professional development that would suit both those transitioning from core to specialist training and those preparing to take a consultant post.

Trainees will be able to do independent and joint assessments (i.e. with medics, our psychologist and other professionals) of routine and urgent referrals and, depending on their needs and experience, they will be able to build a caseload of patients care co-ordinated by other team members. Multidisciplinary working will be expected with patients in the community and it would be expected that the trainee would get opportunity to both work with. patients referred to CRHTT and to do Mental Health Act Assessments. The post also has the opportunity to link up with other local teams, e.g. AOT, Older Adult, Eating disorders, Liaison etc.

The team is based at Avon House, Tewkesbury, but also works out of Leckhampton Lodge, Cheltenham. The medical support for the team is provided by Dr Christopherson, Dr Greef and Dr Milroy, Specialty Doctor. The multidisciplinary team consists of: 1 x team manager, 2 x 0.5wte OT, 1 social worker, 3 x band 6 CMHNs, 1 x band 5 CMHN, 1 x vocational worker, 1 x psychologist and 2 x support workers. GPVTS trainees and medical students are commonly present. The trainee is encouraged to attend the local academic programme and will be facilitated to gain management experience. The timetable is flexible and there is the potential to pursue new or existing research, teaching or special interest commitments. A provisional community timetable is shown below, but elements can be switched out for inpatient or other relevant work as agreed in supervision.

Interested candidates are encouraged to call Dr Sarah Greef and/or Dr Simon Christopherson on 01684 861150

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General Adult

Core Community

Gloucestershire Recovery

Dr Claire Dibben

Supervised clinical experience in a busy MDT Recovery team for working age adults with severe mental illness giving ample opportunity to further develop clinical and leadership skills e.g. new assessments, FUs of patients, formulation of effective management plans; risk assessments; providing advice to the MDT team; joint assessments with the team and also the complex psychological intervention service, S117/CPA/CTOs/MHA assessments, GP liaison, MHICT medication advice, liaison with external agencies and other teams, clinical leadership appropriate to trainee level etc

Excellent opportunities to develop additional clinical or non-clinical skills and competencies through special interest sessions. Several clinical teams are based at Weavers Croft such as the Crisis Resolution and Home Treatment Team, and Assertive Outreach Team. Other teams offering sessions include Mental Health Liaison Team, Eating Disorders service, Perinatal Service and low secure forensic unit. There are good links with the Fritchie research centre in Cheltenham with opportunities to take part in NIHR studies and good links with the Trust Quality Improvement Team.

ST doctors will be encouraged and supported to gain management training   

Possible opportunities to get involved in NIHR research projects

I have an interest in Mindfulness and staff wellbeing so opportunities to learn more about mindfulness based cognitive therapy

26

General Adult

Core Inpatient

Gloucester

Dr Kaiser Ikram

Core educational opportunities include:  Management of patients admitted to the ward, participating and taking lead in ward rounds and MDT meetings, CPA reviews and discharge planning meetings. Experience of or teaching in ECT also available. There are a range of teaching opportunities, including at the weekly academic program, journal club, and weekly Balint group meetings.

Throughout the academic year Kingsholm ward hosts medical students from Bristol University and physician associate students from UWE and Worcester University, during their psychiatry placements. This post is based on Kingsholm ward, Open Acute Inpatient Unit at Wotton Lawn Hospital, Gloucester. Kingsholm unit is a 15 bedded male unit. A high proportion of patients have substance misuse, dual diagnosis and homelessness.  The ward works with recovery, GRP and intensive teams to the benefit of our service users.

The ward is fully multidisciplinary with a SAS and 2 Foundation years doctors attached to the unit. The higher specialist trainee works directly with the supervising consultant and the multidisciplinary team to offer assessment and treatment of a wide range of conditions within general adult psychiatry.  Typically, 70-90% of inpatients are detained under the Mental Health Act.  This is a busy post offering varied clinical experience. All of the admissions are triaged by the crisis teams with whom we have close links and communication.  The inpatient team interfaces with a range of community as well as the a PICUs and two rehabilitation units.

The post-holder will have the opportunity to focus on a range of different aspects of acute care, depending on individual preference and educational requirements

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General Adult

Core Inpatient

Gloucester

Dr Dimitra Kleftogianii

This post is based at Wotton Lawn Hospital in Gloucester, on Abbey ward which is an 18-bed mixed gender acute inpatient unit.

The role of an advanced trainee in psychiatry will be to consolidate experience in the assessment, diagnosis and treatment of an extensive range of mental health disorders working in a multi-disciplinary team, learning holistic approaches to treatment and developing clinical leadership skills.

The trainee will have the opportunity to learn and practice the preparation of tribunal reports and presenting cases at hearings. There will time available and flexibility in timetable to access other inpatient services on the hospital site -PICU, ECT suite-.

The trainee could be involved in team quality improvement projects, be linked with the Trust Quality Improvement Team or pursue their own particular interests.

28

General Adult

Core Inpatient

              Gloucester

Dr Joseph Miles

This post is an inpatient general adult acute psychiatric ward, mixed sex, 18 beds. We manage patients informally and under section of the Mental Health Act with a wide variety of mental illness, for whom it is unsafe or inappropriate to manage in the community.

This post will give trainees the opportunity to develop their skills in managing severe mental illness in an acute setting, opportunity to develop and implement management and treatment plans, supervise core trainees, to be closely involved in MDT decision making, to work with the Mental Health Act with opportunity to present at Mental Health Act tribunals and managers hearings.

Being based in Wotton Lawn opens up other areas for additional educational opportunity including working with occupational therapy, psychological therapies, ECT, experience with PICU and forensic wards and supervision of CT group. There are opportunities to be involved in audit and research projects as well as quality improvement projects.

Timetable below – Trainee would need to attend at least one ward round day/week. There is flexibility other than this and timetable is open to negotiation.

29

General Adult

Core community

Wells Somerset

Recovery

Dr Linda Heaney

This post in the Mendip Recovery Team is based at The Bridge in Wells. Wells is an attractive place to work, within easy commute from Bristol / Bath, a lack of traffic congestion and easy parking. Somerset Foundation Trust is the current holder of Mental Health Trust of the Year. There are four consultant psychiatrists working in the team: Dr Linda Heaney, Dr Philip van Driel, Dr Martin Marlowe and Dr Fatin Hussain, as well as two SASG Doctors. Each consultant covers a specified catchment area, with Dr Heaney covering Wells and Street. Inpatient services are based on the same site, as are the Home Treatment Team, Early Intervention and Later Life services, and two Wells GP practices, allowing for ease of primary care liaison. The post covers the full scope of general adult psychiatry, including Assertive Outreach, and Primary Care Liaison through the Open Mental Health service

The role of the Trainee will be to consolidate experience in the diagnosis, assessment, and treatment for the full range of mental health disorders affecting adults of working age, and starting to work more independently.  There will be ample opportunities to see patients with disorders ranging from schizophrenia through to personality disorders.  There are opportunities to gain experiences in a variety of settings, including the inpatient unit, community base, home treatment services, early intervention and assertive outreach services.  The trainee will have the opportunity to attend managerial meetings, and take on projects if desired.  The post will give the trainee opportunities to become experienced in MHA implementations as well as developing expertise in the pharmacological, psychological and physical treatment approaches to mental illness.  There are also ample opportunities to become involved with audit (quarterly audit meetings) and quality improvement activities. Psychological therapies experience is also available. There is an active educational programme locally.

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General Adult Core community

Taunton Somerset

Recovery

Dr Sathya Cherukuri

This post will be based in the Taunton Community Mental health Team at Foundation House, Wellsprings Hospital site. Taunton CMHT psychiatrists also provide medical input to the well-staffed Assertive Outreach Team (AOT); this service is expanding and has recently merged with the Dual Diagnosis service and offers intensive service to complex patients with significant substance use.  The community mental health services have expanded across the Trust with concomitant expansion in staff as we have built up a new service called Open Mental Health, in the last 2 years. This service works closely with primary care, the wider community and the voluntary sector. This service includes psychologists, assistant psychologists, liaison staff, eating disorder leads and support workers. This staff body is linked in closely with CMHTs through team meetings and supervision. This affords greater skill mix and appropriate input for patients depending on risk level, diagnoses and previous mental health treatment. This gives many more options for patients referred to or being discharged from mental health services.

The role of the Trainee will be to consolidate experience in the diagnosis, assessment, and treatment for the full range of mental health disorders affecting adults of working age, and depending on training level, starting to work more independently.  There will be ample opportunities to see patients with disorders ranging from schizophrenia through to personality disorders and Adult ADHD.  There will be opportunities to gain experiences in a variety of settings, including the community base, and assertive outreach services. 

There will be good experience in multi-disciplinary working, with the opportunity to develop clinical leadership skills. The trainee will have the opportunity to attend managerial meetings, and take on projects if desired. 

The post will give the trainee opportunities to become experienced in Mental Health Act implementations as well as looking at developing expertise in the pharmacological, psychological and physical treatment approaches to mental illness.  The trainee will be directly supervised by the Consultant, with weekly formal supervision and ongoing informal supervision on a day to day basis.  There are ample opportunities to be involved in the Academic Programme.  There are also ample opportunities to become involved with audit and quality improvement activities. Psychological therapies experience is also available.

31

General Adult Core community

Bridgwater Somerset

Recovery

Dr Chris Mortimore

Dr Anton Muller

The trainee will be supervised by Chris Mortimore and Anton Muller, both part-time Consultants in General Adult Community Psychiatry. The post is based with the Bridgwater Community Mental Health Team at Glanville House. This base is located 45 minutes by car from Bristol and is easily accessible from the M5. Chris Mortimore works at Glanville House on Mondays and Tuesdays and Anton Muller on Thursdays and Fridays.

The trainee will gain experience across a wide range of general adult psychiatric disorders, working with the supervising consultant and with the multidisciplinary teams in a community setting. The medical team provides senior medical advice to the Somerset Coast Crisis Resolution / Home Treatment Team, the Bridgwater Community Mental Health Team, the Somerset Coast Assertive Outreach Team and the specialist Eating Disorder team. The trainee will therefore have opportunity to work closely with these services, all of which are based at Glanville House. There will be opportunity for Mental Health Act work.

There is a psychotherapy service at Glanville House which includes clinical psychology, family therapy, cognitive behavioural therapy (CBT), cognitive analytic therapy (CAT) and dialectic behaviour therapy. There are opportunities for training under supervision in CBT and CAT. There is also a specialist personality disorder lead and a dual diagnosis lead.

Consultant leave is coordinated so that at least one consultant is available for urgent advice and supervision. Chris Mortimore’s post covers GP surgeries in Highbridge, and the Polden Hills. Dr Muller’s post covers GP surgeries in Bridgwater. The combined whole population is c, 40,000.

The trainee will always have access to a dedicated workstation equipped with a computer, internet access, lockable filing cabinet and both a landline and mobile telephone.

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General Adult Core community

Somerset

EI

Dr John Parker

This post is working with the Early Intervention in Psychosis Team for Somerset, primarily providing clinical sessions covering the West side of the county. The main geographical locations will be Bridgwater, Taunton and surrounding areas.

The Early Intervention in Psychosis Team is a multidisciplinary team with nurses, social work, CBT, therapists and psychologists. Medical leadership is provided by the consultant psychiatrist who also supervises an associate specialist psychiatrist who covers the East side of the county. The EIP team assesses and treats individuals with first episode psychosis for an approximate three-year period covering age ranges 14 to 65. Individuals under the age of 18 are primarily the responsibility of CAMHS services but we work in close consultation with them to provide support.

There will be ample opportunity for a variety of clinical experiences. . There will be opportunities for shadow experience and developing knowledge in the area of patient safety and leadership. This role would provide experience working across the whole health system as SFT is an integrated Trust providing acute care, community services, community hospitals and mental health.

Teaching of medical students who are on regular placement with the team. Access to audit department / regular audit meetings / PGME. Teaching to junior medical staff and the multi-disciplinary team

Attendance at Deanery wide ST Balint group .Support to take on brief intervention/CBT case from EIP caseload

33

General Adult Core

Inpatient

Taunton Wellsprings

Holford PICU

Dr Wajid Iqbal

Holford Psychiatric Intensive Care Unit is the only PICU in Somerset NHS Foundation Trust. We have ten beds and are used across the gender spectrum. The smaller number of beds means a very manageable workload.

It is lead by Dr Iqbal who became consultant in 2020 so is very aware of the needs of current trainees. He was awarded clinical supervisor of the year award in 2022, using feedback from trainees. Trainees are seen on the ward as very valued colleagues who thrive and help the team grow and develop.

There will be opportunities for higher trainees to lead on the care of patients with support from the team. The focus for higher trainees is to develop the skills that make the transition to consultantship as smooth as possible. They have protected special interest days where they are not expected to come to the ward. They will be fully supported to complete psychotherapy training. There are weekly post graduate sessions (online). The higher trainee will be encouraged to participate in tribunal hearings. A proactive approach will be taken to complete WPBA to prepare early for ARCP. Higher trainees will be helped and supported to develop leadership and management skills. There is an ECT and rTMS clinic nearby and trainees can gain experience subject to agreement from the lead clinicians. The site hosts medical students and there are ample teaching opportunities.

Finally, we are relaxed team that believe that coming to work can and should be fun and never be dull

34

General Adult Core

Inpatient

Yeovil

Open Acute

Dr Roberta Orton

The post is in 16 bed Acute psychiatric ward, Rowan, based in Summerland Hospital Site, (56 Preston Road, BA20 2BX) in Yeovil. There is a dedicated place for Section 136 place of safety.

The medical team, consists of a 2 full time psychiatrists: Consultant and specialty doctor

There are FY1 and FY2 doctors. The ward is a psychiatric placement for Y4 medical students. The Advance trainee will receive weekly supervisions with Consultant.

There will be plenty of opportunities to improve skills to provide teaching, supervision for doctors and medical students.

The Advance trainee will participate in audit and research.

The Advance trainee will gain expertise in differential diagnosis for various acute mental health conditions.

The duties on the ward involves assessment and treatment of mental health disorders. The ward has strong psychology and occupational therapy teams

There are 2 ongoing groups (CBT and Emotional skills regulation). The advanced trainee can be involved in these groups and improve psychological intervention skills.

The post will give the advanced trainee a chance to observe and be a part of mental health act assessments and preparing reports for mental health tribunal.

Moreover the advanced trainee will develop expertise in psychopharmacological as well as physical and psychological approaches.

The team provides opportunities to develop management skills, vice-chairing meetings, family liaison meetings and planning patient’s pathway from admission to discharge.

We work closely with Home Treatment Team (HTT) and Community Mental Health Team (CMHT) who would allow the advanced trainee to develop skills in professional communication in providing information about the ward patient.

Somerset NHS Foundation Trust supports education. Every week we have educational meetings and this will be an opportunity to present difficult and interesting cases and will be supported for continuous professional development.

Consultant supports to develop all skills needed to reach goal and move smoothly towards ARCP and prepare for interviews for future posts.

35

Neurodevelopmental disorders

Bristol

Dr Dietmar Hank

This is a shared post between Adult ADHD and ASD.

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 and treatment approaches 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. The ADHD Clinic operates both face to face as well as remote working. The service developed and piloted a web based system to capture clinical baseline and outcome data. This system is currently being fully implemented in the routine work of the clinic. There is a considerable interest by other ADHD services and with opportunities for service evaluation and research on large data sets. The trainee can participate in and co-lead short CBT based group interventions (Skills group) for ADHD. We enjoy a very active working relationship with the voluntary sector and attending peer support meetings offers additional insights into the world and experience of a person with ADHD. We are actively involved in the commission of services and meet with commissioners on a monthly basis. There will be opportunities to get in involved in local and national neurodevelopmental disorder learning/teaching/ development initiatives, such as a weekly MDT forum, the RCPsych Neurodevelopmental Disorder Specialist interest group and the South-West branch of UKAAN (UK Adult ADHD Network).

The ASD team (BASS) can offer experience in the assessment and management of adults with autism spectrum disorder including those with complex co-existing mental health problems, time with our highly regarded post diagnostic advice service, and training in how to screen and diagnose adults with ASD. We now have a dedicated liaison team that works directly with mental health professionals on complex cases. The team uses gold standard assessment tools including 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. We use both face to face and remote diagnostic assessment. Trainees will get experience and training in these instruments, in addition to supervision from highly specialist, extremely skilled clinicians. BASS is a truly multidisciplinary service with involvement from specialist SALT, OT, Social Workers and Social Prescribers. We maintain links with a number of academic groups undertaking research in the diagnostic assessment of autism and treatment of co-existing mental problems, with opportunities for trainee involvement. At a national level we are involved with far reaching strategies to improve care pathways for autistic adults.

Both teams offer liaison experience with many other specialized services.

36

Addictions

Bristol/South Gloucestershire

Dr Ben Watson

This post offers a broad experience in addiction psychiatry including developing specialist skills in managing dual diagnosis and a range of treatments for persons with addictive disorders. The advanced trainee will have a diverse range of opportunities to develop as a clinical leader and gain experience in teaching, management, research and audit, all in preparation for applying and becoming a future NHS consultant.

The trainee will be a member of the integrated multidisciplinary team within the Bristol Specialist Drug and Alcohol Service (BSDAS), which is part of the Bristol ROADS service (Recovery Orientated Alcohol and Drug Service) that covers a population of approximately 500,000.

The trainee will be involved in the assessment and management of drug and alcohol abuse, dependence, and dual diagnosis in both community and inpatient settings. They will support the delivery of treatment plans as formulated following discussion with the multidisciplinary team, involving direct or shared care with GP’s and other doctors. They will provide support, advice and supervision to the multidisciplinary team, and through liaison to primary care services, local psychiatric teams.

37

Liaison Psychiatry

Bristol

Southmead

Dr Anish Patel

This post is based at Southmead Hospital within the NBT Mental Health Liaison Team. The post enables you to gain experience in Consultation-Liaison Psychiatry across the age range from 16+ in a large modern state of the art teaching hospital and receive their RCPsych endorsement in Liaison Psychiatry.include medical education, quality & service improvement and management.

The work can be busy but varied, and exposes you to a comprehensive range of psychiatric presentations 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.

General Adult Liaison Psychiatry: You will be able to experience the full range of psychiatric presentations in a general hospital across psychotic, affective and cognitive domains, as well as medically unexplained symptoms and addictive disorders. You will gain advanced experience in the management of depression in the setting of a physical illness; management of agitation in an acute setting, allowing safe prescribing whilst recognizing common drug interactions. Additional experience will be gained in the 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.

Specific Liaison Psychiatry experience can also be obtained working with the regional services based in NBT including: Major Trauma, Renal, Plastic Surgery & Burns. There are allied services on site that link in with Liaison Psychiatry services including Perinatal Psychiatry, Eating disorders and Neuropsychiatry and opportunities to undertake out-patient clinics. 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).

Education is a key part of the role and effectiveness of a Mental Health Liaison service and you will have opportunities to develop skills and experience in the delivery or development of bespoke educational training to general hospital staff across a variety of medical specialties.

There is plenty of scope for service development and joint QI ventures with fellow medical/surgical colleagues. Attendance with senior liaison clinicians to the Mental Health Operational group and STP level meetings will also assist developing higher management/leadership skills.

38

Liaison Psychiatry

Bristol

Southmead

Dr Shilpa Zacharia

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 Emergency dept/Acute Medical unit and In-patient.  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.

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, and Neuropsychiatry whereby the postholder will have opportunity to have exposure to out-patient clinics I they wish. We see a lot of complex eating disorders and obstetric cases which involve large professionals meetings and can lead to Court of Protection.

Dr Zacharia is the Undergraduate Unit Tutor at Southmead and there are many opportunities to teach medical students, develop workshops and input into the design of the Undergraduate student placement

Projects for trainees to develop their leadership and management skills are always available as the team is growing and expanding its remit within the Acute Trust. 

39

Liaison Psychiatry

Bristol

BRI

Dr Nicola Taylor

This post is based at Clinic A214, Bristol Royal Infirmary and the UHBW Bristol campus and enables the post holder to gain experience in Consultation-Liaison Psychiatry and receive their Royal College endorsement in Liaison Psychiatry. 

UHBW has around 500 beds including the Heart Institute, the Haematology and Oncology Centre, Bristol Eye Hospital, Bristol Dental Hospital and Bristol Royal Infirmary.

There is ample opportunity to gain experience in the assessment of DSH, medical and surgical referrals, medically unexplained symptoms and range of outpatient referrals. We have access to CBT, EMDR and ACT therapists as well as trainee counsellors in the team, and a cohort of highly skilled nurses. We recognize the importance of close working relationships with our acute care colleagues, and want our trainees to foster those relationships further. We have a successful track record of supporting trainees to develop clinical services and business cases as part of their special interest which has resulted in recurrent funding.

We want to allow our trainees to acquire a scope of diverse skills and so would encourage them to take clinical and managerial leadership opportunities as appropriate with all necessary support and supervision.

Education is at the centre of our team, and there are lots of chances to deliver formal and informal teaching sessions to a variety of people: from our regular medical students in 2nd. 3rd and 4th year, to consultant surgeons and physicians. The development of teaching programs is also encouraged and valued. We are a research active department, and there are often opportunities to work on recruitment for multicentre trials as well as smaller scale projects.

We work in an office suite in Bristol Royal Infirmary, and are located with the older adult liaison team, the specialist drug nurses and our administrative team.

40

Liaison Psychiatry

Bath

Dr Bill Bruce-Jones

Ageless Liaison service based in the Royal United Hospital.  The trainee will be supervised by Dr Bruce-Jones who is consultant liaison psychiatrist at the Royal United Hospital in Bath (RUH). The RUH has nearly 600 beds and has a catchment population of around 500,000 in B&NES, Somerset and Wiltshire. The hospital has the full range of acute specialities and has a very busy Emergency department. Dr Bruce-Jones works with a growing team of specialist nurses working with patients of all ages above 18. Some of the nursing staff particularly work with older adults, especially with dementia. A half time consultant post was appointed in early 2013 to focus on this older patient group.

The Liaison Service in B&NES is collaborating with the University of Bristol in setting up a Self-Harm register and this will provide opportunities for service evaluation and research.

Dr Bruce-Jones also works with the Primary Care Liaison Service providing the trainee to gain experience in this growing area of mental health care should they wish.

Dr Bruce-Jones is Clinical Director for AWP mental health services in B&NES.

The trainee will be able to obtain training and experience in Liaison Psychiatry. This includes: Assessment of new patients presenting with the full range of mental health problems in the general hospital; Development of complex management plans including advice on medication, Mental Capacity Act & Mental Health Act; Opportunities to further developthe servicein particular clinical areas eg. Gastroenterology, Perinatal, Neurology; Opportunities to develop innovative services eg. MUS; Provide support, advice and supervision to the liaison team; Management experience through working in a well functioning, multi disciplinary team.  Audit of clinical practice and research within the Clinical Governance framework.

41

Liaison Psychiatry

Gloucestershire

Dr Karen Williams

This post is based at Gloucestershire Royal Hospital and Cheltenham General Hospital and the post holder will be able to gain experience in Consultation-Liaison Psychiatry in an all age liaison service in these 2 district general hospitals and to achieve a Royal College endorsement in Liaison Psychiatry.

The work experience is varied and includes: the assessment of DSH, medical and surgical ward referrals, obstetric referrals, alcohol hospital liaison, older peoples hospital liaison, management of frequent attenders and medically unexplained symptoms outpatient and inpatient work. 

Our team works in an ageless service and we provide 24/7 cover for the hospitals. We have a separate self-harm team, an older people’s liaison team and alcohol liaison nurses. In addition we have a frequent attender worker.  The trainee would work in normal working hours.

The team enjoys good working relationships with the general hospital staff and the post would offer opportunities to engage in quality improvement projects, attendance at hospital liaison management meetings and other service development work.

Liaison psychiatry is an expanding field and our service is continuing to develop and there are plans for extending the scope of the team. Trainees would be encouraged to develop small projects to enhance the work of the team.

The consultant psychiatrist has an endorsement in addiction psychiatry and works with the family drug and alcohol court team and could offer special interest sessions in this if required. She is currently involved in a countywide project looking at pain management and liaison psychiatry.

The team is commissioned to provide formal training to medical, nursing and other staff in the general hospital and the post will provide ample opportunity to deliver training formally and informally to a variety of staff on different aspects of psychiatric liaison.

The team does have core trainees and also provides regular taster days to junior medical staff and to medical students. The post would offer opportunities to develop skills in mentoring and supervision.

We work with the Gloucestershire Hospitals Trust to develop protocols and guidelines for a variety of management issues include hospital transfer, rapid tranquilisation and management of substance misuse problems and are actively engaged with audit and QIP work in these areas.

The team works closely with other GHC services and the post gives opportunities to work across the interfaces and for example to have experience of MHA assessments and crisis team joint assessments.

The team uses Rio and we are using a digital dictation system

42

Liaison Psychiatry

Swindon

Dr Michael Obidoa

This post is based at Great Western Hospital [GWH], a 530-bedded General hospital located in Swindon. The Liaison team is an accredited member of the Psychiatry Liaison Accreditation Network [PLAN] of the Royal college of Psychiatry.   

The post is designed to offer a broad range of Liaison psychiatry experience. Trainee will gain experience from exposure of working using full range of consultation-liaison model for an Ageless service at the ED/Inpatient wards at GWH supported by an experience multidisciplinary team. The post will provide excellent opportunity to develop senior clinical management skills by assessing existing or new patients presenting with diverse range of psychiatry problems ranging from Core Psychiatry difficulties inclusive of perinatal psychiatry and/or physical health illness presenting with neuropsychiatric symptoms and at the same time developing requisite skills around managing complex pathologies whilst integrating body and mind as one entity. Additional experience will be gained in complex capacity assessment and its interplay with Mental Health Act plus the added opportunities to undertake and experience many MHA assessments.  

There are several opportunities to become involved in new service developments such as the Medical Unexplained symptoms clinics or to help develop newer areas of practice for Liaison service needs or in collaboration with the General Hospital, according to trainee’s personal educational and developmental needs.  

The post will also offer trainees opportunities to develop skills and competencies for first consultant post including medical leadership, management experience, complex decision making, mentoring and provide supervision to junior colleagues [Core, GP and Foundation trainees]. Education is key component of the liaison team role to the Acute Hospital and there are vast opportunities to develop teaching skills and educational program packs. Trainee will be supported to participate in the locality academic program and Grand rounds at GWH. 

The Liaison team shares the same building with the prestigious Kingshill research centre and there are many opportunities for audits, quality improvement and research projects for interested trainees.  

43

Liaison Psychiatry

Taunton

Dr Siân Hughes

This post is based at Musgrove Park Hospital, a 500 bedded District General Hospital in Taunton.  We are a growing team, which has only been commissioned since 2017, representing a commitment to the establishment and expansion of Liaison Psychiatry in the county.  We gained PLAN accreditation in 2021.

You will gain experience of the full range of consultation/liaison psychiatry, for all patients aged 18 and over.  Ward referrals come via the intranet and are seen based on priority. Referrals come from all areas of the hospital including maternity.  Medical staff are involved in the most complex cases and work closely with physicians to develop multidisciplinary care plans.  There are opportunities for service development, for instance in developing  joint clinics with  other specialties.  We are also developing a service for medically unexplained symptoms, and looking at frequent attenders to the ED to reduce or prevent unnecessary admissions.  You will have the opportunity to take a lead role in one of our areas of practice according to your educational and developmental needs. 

There are opportunities for leadership and management experience working alongside colleagues in the general hospital to develop services as appropriate.  There may be the opportunity to provide supervision to junior colleagues (F2 and/or core trainees). 

The post offers ample opportunity for quality improvement, research, quality improvement projects and audit. All patients attending Musgrove Park Hospital due to self harm are offered a psychosocial assessment, and there are opportunities to develop close working relationships with ED and AMU staff, and to provide training and education to the general hospital.  You will have the opportunity to work in all aspects of Liaison psychiatry, across a range of specialties. 

Taunton Academy is teaching hub and has a well-stocked library and helpful librarians on site.  There are opportunities to contribute to teaching programmes for foundation doctors and medical students, as well as the local postgraduate medical education programme in psychiatry. 

44

Perinatal Psychiatry

Gloucestershire

Dr Sally Morgan

This post covers the county of Gloucestershire and offers experience in Community Perinatal Psychiatry. The Gloucestershire Perinatal Mental Health Team was commissioned following  GHCFT’s  (formally 2gether NHS Foundation Trust) successful bid for NHSE funding  available as part of the national phased, five-year transformation programme to increase access to specialist perinatal mental health services to ensure women  receive evidence-based treatment, closer to home, when they need it.

In Gloucestershire there are approximately 6500 births per year. 4% of women will experience severe and complex mental health needs during the perinatal period and 8% will require mental health support and/or appropriate onward referral. The Gloucestershire Perinatal Mental Health Team provides consultation, advice, treatment and liaison for women with a moderate to severe mental disorder who are planning a pregnancy or during the perinatal period (through pregnancy and up to 12 months postnatally). The service monitors, supports and provides safe effective care for mothers discharged from mother and baby units and as part of the Maternal Mental Health Pathway, works with GHCFT’s Contact Centre and other services to provide a triage response for referrals for women with mental health needs or who are at risk of developing mental illness in the perinatal period. The service also supports families of women who are accessing the service.

Assessments are undertaken in a variety of locations including the patient’s own home, maternity and mental health bases, working closely with other professionals involved in their care. Experience and skills will be gained in:

• The ability to think about the mother’s needs, the infant’s needs, and the mother-infant relationship, as three distinct areas of interest for health and wellbeing. -   Common physical and psychological changes during pregnancy and the first postnatal year, issues around contraception and the importance of planning a pregnancy for women with a mental illness. 
• Identifying the various types of mental disorder, the treatments for each of these along with knowledge of prevalence and likelihood of occurrence and the impact on mother and baby.                
• Knowledge of key risks to the mother and her infant during pregnancy and 1 year after the birth of the infant and what actions must be taken to protect the mother and her infant from injury.
• Knowledge of attachment and bonding and the importance of the mother-baby relationship in ensuring an infant’s wellbeing and development.                                                                                            
• Improved awareness of barriers to accessing care, including stigma, and the importance of good and effective multiprofessional and multiagency working.

45

Eating Disorders

Bristol

Dr Fran Burton

• Specialist post offering evidenced based treatment for patients with eating disorders in the community (anorexia nervosa, bulimia nervosa, atypical presentations)
• Psychological and physical management of these illnesses. Trainee would have the opportunity to do therapeutic work (CBT-E, guided self help CBT-E, SSCM) and physical health assessments (high risk clinic, OBS clinic)
• To do assessments of STEPS patients when they are admitted to an acute hospital. Liaison work with the MHLT and GPs.
• CPAs/professionals meetings/medication reviews
• To undertake new referral assessments
• To do MHA work
• To see a patient through their inpatient admission to the community again

46

Eating Disorders

Marlborough

Dr Francesca Battisti

The trainee will have the opportunity to cover all 19 expected learning Outcomes, which will include:

• Opportunities to experience assessments and treatment of Eating Disorders in different treatment settings.
• Opportunity to learn how to provide multidisciplinary treatment alongside a very experienced and skilled community team.
• To attend Clinical Governance forums for both In patient and Community settings
• Liaising with professionals from local Acute Hospitals.
• The opportunity to learn about the use of the MHA in patients with severe eating disorders and learn about working collaboratively with multiple agencies, including third sector organisations, Primary care, Secondary care MH services, Social Services
• Weekly opportunities to attend Academic Meetings

The team has recently expanded to offer a FREED (Early Intervention in ED) pathway and also progressing towards the development of an all-age ED service with the well-established BSW CAMHS ED team.

Opportunity to provide evidence of meeting learning outcomes via a range of assessment methods.

The trainee will have access to local ED training held in the service twice a year.

The trainee will be able to access ad hoc specialist ED specialised training available to the team, such as CBT.

Trainee interested in developing skills in short term psychological therapy will be given the opportunity to take on a case under supervision.

To facilitate Teaching Sessions with the Wider Team. Sharing evidence and facilitating modification of practice.

Opportunity to provide educational teaching for AWP medical students.

The trainee will have access to resources and support from the Trusts Research and development Department.

Access to the Trust's library services including Athens and Ovid Discovery.

47

Eating Disorders

Somerset Glanville House

Dr Michelle Butterworth

This is a Community Eating Disorders based in Somerset. The trainee will have the opportunity to gain experience in  assessment and management of a variety of diagnosed eating disorders including AN, BN, BED and ARFID. The trainee will be supported and supervised in managing progressively more complex cases during their placement.

More specifically, this includes the management of physical manifestations, treating psychiatric co-morbidity and  community treatment options including re-feeding. There will  be the opportunity to gain experience in various group psychological interventions including Emotional Skill for ED, contributing to the carers group and ad hoc interventions such as the pre-christmas groups. There may also be the opportunity to gain experience in shorter interventions such as CBT-T, Guided Self Help and observe the MANTRA group.

The above activity would be via a range of experience including direct consultations/shadowing a variety of the MDT (dietetics, psychology, nursing, OT) as well as attendance at the weekly MDT team meetings. There may also be an opportunity to observe ED related MHA, capacity assessments and best interests meetings.

As well as community adults experience, trainees will be able to visit the 3 inpatient units and attend CAMHS CEDS liaison meetings.

48

Psychotherapy

Bristol

Dr Thanos Tsapas

This post is based at the Bristol Complex Psychological Interventions Service in Bristol (Callington Road hospital). The CPI service provides tertiary psychological assessment and treatment to patients under the care of all three Assessment and Recovery teams in Bristol. It offers a variety of therapeutic modalities, such as Psychodynamic Psychotherapy, Narrative Therapy, Art Psychotherapy, CBT, DBT, Compassion Focused Therapy, EMDR, Family Therapy and others.

The advanced trainee will have the opportunity to enhance their existing, and gain new, psychotherapeutic skills which s/he will be able to apply in General Adult settings (inpatient, community and emergency). The trainee will also become more confident in risk assessment and management with the use of psychoanalytic and other psychotherapy relevant theory. Additionally, they will become more skilled in understanding group and institutional dynamics. The trainee will become more familiar with the developmental perspective of psychological, psychiatric and psychosomatic presentations and with the holistic approach to mental health care that includes conscious and unconscious dynamics and emphasises autonomy. Overall, the trainee will have a number of opportunities to gain new skills and knowledge that would allow them to practice relational psychiatry.

The advanced trainee will have the following opportunities:

• See 3-4 patients for psychodynamic psychotherapy and 1-2 patients (up to 6 in total) for Narrative Therapy with the help of weekly supervision in a group and individual setting
• Co-facilitate an Art psychotherapy group, Metallisation Based Treatment group or a group within the Inpatient Arts Therapies service. This is dependent on the availability of such groups
• Conduct assessments for psychotherapy
• Participate in CPI referral meetings and liaise with the Recovery teams

The trainee is encouraged to undertake training in a psychotherapeutic modality, e.g. Narrative Therapy, during the year of the post.

The trainee will have protected non-clinical and clinical special interest sessions, which are often in General Adult Psychiatry, so that the General Adult Psychiatry and Medical Psychotherapy “training dialogue” is maintained.

The trainee is also expected to contribute to the Local Postgraduate programme and maintain their active interests in research, teaching and management / leadership.

49

Psychotherapy

Gloucester

Dr Svetlin Vrabchev

Medical Psychotherapy Post, based with the Medical Psychotherapy Trainees’ Team, Gloucestershire. The Team is a psychological therapy structure closely linked with the psychological therapy service (CPI) integrated within the secondary mental health services in the community and also linked to the primary mental health psychological therapies (IAPT). The team offers the clinical governance structure of psychiatric trainees delivering a psychological therapy under supervision and at times co-facilitating psychological therapy with another trained/registered therapist. The team takes patients referred by the primary mental health psychological therapy service and from the CPI.

The post will offer experience of evidence based psychological therapies – individual and group format. The post holder will take part in joint assessment with the Clinical Supervisor and will work towards reaching competence to complete such assessments under clinical supervision. There will be relevant training included in the time. The post holder will have a small caseload of patients that will be seen in time limited course of psychotherapy (group and individual). The post holder will gain experience in considering the suitability of referrals to the team.

The post holder will have the opportunity to experience a variety of psychotherapeutic modalities – CBT, CAT, psychodynamic psychotherapy, DBT and compassion focused trauma therapy. Some of the experience will be supervised by Dr Vrabtchev and some will be supervised by registered psychotherapists with the relevant services. The post-holder will have the option the consider the modalities of psychotherapy that will be most relevant to their future clinical roles as consultant psychiatrists in the NHS.

50

Rehabilitaton

Low Secure

Bristol

Dr Claire Taylor

The post offers experience in Rehabilitation in a Low Secure environment. The Advanced Trainee will be based at Wickham Unit which provides a forensic low secure inpatient services to 31males, all of whom are detained under the Mental Health Act. We work closely with our medium secure colleagues and with the South West Provider Collaborative, our commissioners.

The service works with a service user group who experience long-term mental health problems and is therefore structured to offer an extended period of engagement using a well resourced multidisplinary team to help individuals maximise their potential. The trainee will be involved with the MDT in the development of appropriate treatment plans for those taken into service, regularly reviewing such treatment plans and promoting rehabilitation and recovery.

It is an excellent opportunity to gain confidence in completing a range of complex assessments including using structured risk assessment tools such as the HCR20. The trainee will get valuable experience in preparing reports and providing the medical evidence for MHRT’s and court. They will gain experience in working with restricted patients which will include reporting to the Ministry of Justice.

There will be an opportunity for the trainee to become involved in team quality improvement projects or pursue their own particular interests.

51

Rehabilitation

Bristol

Dr Will Hall

The rehabilitation services in Bristol comprise of a ten bedded inpatient ward (Alder Unit) at Callington Road Hospital and a Bristol-wide Community Rehabilitation Service, provided in Partnership with Second Step and based out of their offices in Brunswick Square, St Pauls. The trainee will work under the supervision of Dr Hall who is a part time (60%) consultant psychiatrist working across both services. The other consultant is Dr Rebecca Sullivan (50%) who works closely with Dr Hall as a job share and is also able to offer trainees supervision and learning opportunities.

Callington Road Hospital is a modern psychiatric inpatient facility opened in 2006 with general adult, older adult, PICU (male and female), step down and rehabilitation wards. It has a well-resourced therapies unit, library and a flourishing academic programme. Alder Unit looks after men and women with Severe & Enduring Mental Illness (SEMI), who often have complex needs and have often been in hospital for prolonged periods of time. There is a full multidisciplinary team and the ward works within the Safer Wards framework and has an emphasis on working positively with families and carers. The core training opportunity is to understand and develop skills in working with this group of people, in how their care is optimised, how to work with hope and recovery, and care pathways out of hospital into accommodation with sustainable support. The trainee would be involved in the multidisciplinary assessment of referrals to inpatient rehabilitation and could take a lead in providing senior medical input for to the unit for some people, if appropriate to their training needs. There is the opportunity to be involved in Mental Health Act work including writing reports and giving evidence at tribunals.

The Bristol Community Rehabilitation Service (BCRS) looks after about 100 people at any one time, most of whom are living in their own homes. The team is made up of clinical staff, staff whose primary experience is of working in the voluntary sector with a very wide range of skills, and peer workers whose expertise draws on their mental health experiences. There is a dedicated community home (Wellbridge House) which provides time-limited accommodation within a psychologically informed environment that enables work on engagement, assessment and recovery planning. The service won a national award for partnership working in December 2017.

52

Rehabilitation/Assertive Outreach                   

Gloucester

Dr Claudia Calciu

Gloucester Assertive Outreach Team is one of three Assertive Outreach Teams across the County of Gloucestershire.  There are two other Consultant led teams based in Cheltenham and Stroud.  The team has an enhanced skill mix of Band 6 clinicians with an activity coordinator, support works and dedicated clinical psychologist.

The team operates a 7 days service with extended hours.  Out of hours is provided by CRHT and Local Authority/non-statutory day services.  The aim of the AOT is to provide assertive clinical engagement for patients with serious and enduring mental health problems in Cluster 17 and 16.  To promote recovery and social inclusion (education, recreation, vocation & employment).  To provide specific interventions (e.g. psychological interventions, medication management, family work, etc).  To liaise and plan locality caseload mix, ongoing care with colleagues from Recovery, GRIP and inpatient teams.  To provide care management, undertake statutory duties under the Mental Health Act 1983/2007 and to assess and support carers.

As Dr Calciu is involved in research and audit projects, this placement is offering the post holder the opportunity to take part in such projects. Also, as one of the consultants within the team is the Medical Director, opportunities for enhancing knowledge on management and leadership could be pursued. The post holder will also have more opportunities to enhance their knowledge of the Mental Health Act usage due to the characteristics of the Assertive Outreach Team patient group, who often require the management of their care under a Community Treatment Order.

53

Rehabilitation

Somerset

Dr John Barnes

The trainee will be able to obtain training and experience in rehabilitation psychiatry.

This includes:

• Assessment of referrals to the low secure service including male patients most frequently with psychosis referred from Somerset’s acute services and from the South West Providers Collaborative, which the ward is part of.     Formulation of treatment plans prior to admission including the needs for rehabilitation in conditions of low security   Often in referrals there is a pattern of frequent readmissions and gradually escalating risk in the context of poor social functioning.  Other referrals have better functioning but greater forensic risk requiring assessment and amelioration of multiple contributing factors.     
• Delivery of treatment plans as formulated following discussion with the Multi Disciplinary Team thorough ongoing assessment, maximising benefits of engagement with treatment including meaningful occupation, psychosocial treatments and medication.    Provision of a broad range of pharmacological treatments in major mental illness including treatment resistant schizophrenia.  Provide support, advice and supervision to the Multi Disciplinary Teams.
• Management experience through working in a well functioning, multi disciplinary team, that works collaboratively with local community services and general psychiatric CMHT’s.
• Audit of clinical practice and research opportunity within the Clinical Governance framework.
• Knowledge of rehabilitation specialty service research and professional issues through opportunity to attend quarterly SW regional rehabilitation consultant peer meetings and annual Royal College Residential Rehabilitation faculty National conference held in November, which are held virtually during the pandemic.

Research and teaching are encouraged with medical student teaching occurring regularly in the service. The outlined timetable can be adjusted to suit individual trainee’s needs. Support will be available in conducting a research project in the field of psychiatric rehabilitation with a view to submission as oral or poster presentation at the Rehabilitation Faculty Conference and in submission to the Douglas Bennett research prize awarded by the Rehabilitation Faculty for trainee’s working in psychiatric rehabilitation:

ihttp://www.rcpsych.ac.uk/workinpsychiatry/faculties/rehabilitationandsocial/aboutus/prizesandbursaries

54

Forensic - GHC

Gloucester

Oana Cioanasu

The post is based on the Montpellier Unit in Gloucester. This is a 12 bedded low secure unit and the hub for the forensic directorate of Gloucestershire.

All the patients will be detained under a section of the MHA 1983/2007, with the vast majority detained under a ‘forensic section’. There is usually a mix of transferred prisoners, patients who have received a hospital disposal in Court and patients who have been transferred from medium and high secure settings as part of their pathway progression.

The vast majority of patients will have a diagnosis of severe mental illness, usually co-morbid with personality disorders and substance misuse. On occasion, some of the patients will have an additional diagnosis of ASD/LD.

The forensic team is responsible for the assessment and management of all the inpatients, and the monitoring of some patients currently receiving treatment in out of area settings who may be suitable for step down to conditions of low security. The unit works closely with the newly established Specialized Forensic Community Team.

A significant role of the team is conducting gatekeeping assessments for the South West Provider Collaborative, for Gloucestershire patients but also for patients who may be considered appropriate for admission to the Montpellier Unit, who are registered with a CCG outside of Gloucestershire.

The team has close working relationships with numerous agencies, including: the criminal justice system, mainstream mental health services, social care and the voluntary sector. Some of the team members have strategic roles in the South West provider collaborative.

The ward is fully multidisciplinary with a specialty doctor attached to the unit. There is also a core trainee post attached to the unit. The higher trainee will work directly with the supervising Consultant and the multidisciplinary team to offer assessment and treatment for the patients admitted to the unit.

The post holder will also have the opportunity to participate in gatekeeping assessments under the supervision of the Consultant and gain specific forensic expertise, such as MAPPA/VLO referrals, CJLS contact, and MoJ leave applications. There will be opportunities for giving evidence in Managers Hearings and Mental Health Tribunals. Through its unique position within the SW provider collaborative, the Montpellier Unit training post offers the opportunity for the trainee to gain a wider understanding of operational and strategic systems.

Formal teaching opportunities include attendance at the weekly academic meetings which includes case presentations, journal club and internal/external speakers.