Old Age Psychiatry Advanced Training Posts

Last updated July 2020

  

NO

SPECIALITY

TRUST / AREA

TRAINER

1

Old Age – community and inpatient (organic)

AWP - Bath

 

Dr Rosalind Ward

2

Old Age – Community and Inpatient (organic)

AWP - Bath

 

Dr Alister Gomes-Pinto

3

Old Age – inpatients

AWP - Bristol

Dr Jonathan Hewitt/Geoff van der Linden

4

Liaison - Psychiatry (Endorsement)

AWP - Bristol



Dr Anish Patel

5

Old Age – Community/Memory

AWP - North Somerset

Dr Niall Moore

6

Old Age - Inpatient

AWP – Weston Super Mare

Dr Elizabeth Bennett

7

Old Age - Community

AWP - South Gloucestershire

Dr Sarah Price

8

Old Age – Inpatient

AWP - Swindon

Dr Sabari Muthukrishnan

9

Old Age - Community

GHC – Forest of Dean

Dr Martin Ansell

10

Old Age - Community

GHC - Stroud

Dr Joe Stratford

11

Old Age – Community

GHC - Cheltenham

Dr Tarun Kuruvilla

12

Old Age – Inpatient

GHC - Cheltenham

Dr Katie Kelly

13

Old Age – Community

GHC – Cheltenham, North Cots & Forest of Dean

Dr Nik Bhandari

14

Old Age – Community

SomPar - Chard

Dr Antony Christopher

15

Old Age –  Inpatient

SomPar - Taunton

Dr Stephen de Souza

16

Old Age - Community

SomPar - Yeovil

Dr Rajewari Makena

17

Old Age - Community

SomPar - Taunton

Dr Stefan Kolowski

 

 

Detailed Descriptions

 

1          Old Age Psychiatry – Community and Inpatients (Organic)

            Dr Rosalind Ward – Bath & Midsomer Norton

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

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

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

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

Research Interest:   Dementia Diagnosis and Research; BPSD; Medical Education.

 

 

2          Old Age Psychiatry – Community and Inpatients (Organic)

            Dr Alister Gomes-Pinto - Bath

This post is based at NHS House, Bath and the post-holder will work primarily with Dr Alister Gomes-Pinto who will be the Educational and Clinical supervisor. Outpatient clinics are based at Bath NHS House on the RUH site. The trainee will carry out assessments of newly referred patients with supervision from the consultants in the clinic setting, in the community, inpatient, and also in the liaison setting at the RUH. This will include communicating and liaising with GPs, RUH hospital staff, and care coordinators, and with other members of the liaison and multidisciplinary Complex Intervention and treatment team (CITT), and the Therapies team. There are opportunities to attend various meetings in a variety of settings (Best Interest, Professionals).

They will attend multidisciplinary Liaison meetings and also the CITT team and business meetings. In the outpatient clinic, they will be expected to follow up a cohort of patients, providing assessment and treatment (including liaising with family and carers) under supervision. This post will involve working and communicating closely with the community team to ensure a comprehensive care planning process. If there are older adult inpatients on Sycamore ward, the trainee will be expected to see all new admissions and complete a thorough history and examination, including physical examination, and will be responsible for regularly updating the patient’s treatment plan during their stay. If there are no inpatients, they will be engaged in hospital liaison work on ward 4/RUH instead. There may be opportunities to participate in Mental Health Act procedures eg Mental Health Act Assessments, Manager’s Hearings and Tribunals.

The trainee will have the option of completing a year doing both functional/organic, community/inpatient work; or if preferred, splitting these into six month community/inpatient placements. We have successfully hosted trainees in both the community setting and in the inpatient setting under Dr Ward and Dr Pinto’s care. Special interest sessions could include working alongside PCLS; within internal medicine; Crisis work; the RICE memory clinic; neuropsychiatry at the Rosa Burden centre in Bristol as examples.

Supervision: Weekly individual educational, clinical and personal supervision with Dr Pinto, including  specific supervision of on call work.  Separate clinical supervision for Liaison work by Dr Jelley, and cross cover from Dr Ward in Dr Pinto’s absence. There is a weekly meeting with supervision for liaison assessments. Trainees may be invited to attend the Balint Group where one is available locally, and will have access to psychotherapy supervision including CBT and psychodynamic psychotherapy.

On Call 1:15. This will be non-resident. The on call usually incorporates SHO supervision for Sycamore Ward, Hillview Lodge (general adult inpatient unit with some functional elderly beds); and Ward 4, St Martin’s Hospital (dementia inpatient unit). The trainee will be on call with a consultant out of hours, and regularly with a SHO who will be first on call on the junior psychiatric rota (as registrars are supernumerary this will occur when they are allocated posts typically within BANES).

Admin and logistical support: the post holder will have access to facilities in the doctors’ office at NHS House where there is a dedicated (protected) desk with lockable drawer, upgraded computer and phone, and there will be administrative support for all aspects of the trainee’s post (a dedicated and friendly band 4 secretary).

A phone will be provided as well as a laptop for flexible and home access when on call. Kitchen and parking facilities are also available. The RUH canteen, library, general hospital and education centre are all less than a 10 minute walk away. Other psychiatric teams (Recovery, Early Intervention, Crisis, AMHP, Adult Inpatient, PCLS, Care Home Liaison, Hospital Liaison) including HR are all based out of NHS House or on site.

NHS House has recently been revamped to accommodate the Trust headquarters. Hot desking facilities are also available in the doctors’ office at Hillview Lodge.

Audit/ Quality improvement: The trainee will be expected to be involved in Quality improvement programmes and will receive support to complete a quality improvement project during the post.

Research: There are opportunities for research training and support on site. The Research Institute for the Care of Older People (RICE clinic) are always keen for trainees to become involved in ongoing projects and in fact have participated in the SpRRIC (SpR Research Involvement Course) formerly hosted by Dr Ben Wood.

Teaching: There will be opportunities to develop teaching skills and to deliver teaching both formal and informal in a range of settings including teaching medical students and Foundation doctors.

A weekly hospital-based academic meeting is held, including a case conference and a seminar/speaker at the Postgraduate Medical Centre in Bath, and Green Lane Hospital. A weekly journal club is based at Hillview Lodge. There is an excellent library at the Education Centre of Bath Academy and Dr Pinto is a library member having accessed various journals and articles online there.

On Call 1:15

 

 

3          Old Age Psychiatry - Inpatients

            Dr Jonathan Hewitt and Dr Geoff van der Linden Aspen Ward - Callington Road Hospital, Bristol

Drs Jonathan Hewitt and Geoff van der Linden will be paired as a job share to be the consultants of Aspen Ward, working half the week each.

The trainee will be a supernumerary member of the inpatient Mental Health Team based at Callington Road Hospital, Bristol.  The inpatient ward for older adults is Aspen, based within the Coppice unit. Aspen is a 24 bedded unit for functionally mentally ill people.

The available opportunities include the assessment and treatment of psychiatric and medical conditions which frequently coexist in this patient population.  In addition, the trainee can chair MDT meetings, ward rounds and Best Interests meetings. He/she will be encouraged to fulfil whatever duties are likely to be of educational value to him/her.

The trainee will also have the opportunity to gain other experiences if required, including older adult liaison to the District General Hospitals, community work within one of the four community teams admitting to these wards, memory clinics and the teaching of both medical and non-medical staff.

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

There are ample opportunities to develop teaching skills – training medical students (attached to the consultant), the local Core Psychiatry Training course, and carers support groups. In addition the ward has a two foundation year junior doctors attached to it, and there will be the opportunity to participate in WPBA for the junior trainees.

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

Research Interest: ECT

 

 

4          Liaison Psychiatry (Mixed Old Age and General Adult Liaison - Endorsement post)  

            Dr Anish Patel - Southmead Hospital

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

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

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

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

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

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

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

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

 

 

5          Old Age - community, memory and potential for inpatient

            Dr Niall Moore - North Somerset

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

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

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

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

There are opportunities to become involved in clinical research based at Windmill House.

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

 

 

6          Old Age Inpatients – The Long Fox Unit

            Dr Elizabeth Bennett - Weston-Super-Mare

The total population of North Somerset is 208,000 (2014), concentrated in the town of Weston-super-Mare, and its immediate outlying villages (105,000 population). The remainder of the population is dispersed within the smaller towns of Clevedon, Portishead, Nailsea and Backwell, and a large rural area, which stretches towards the Mendip Hills. North Somerset is a retirement area, and the towns of Weston-Super-Mare and Clevedon offer up to 2,000 private residential home beds. One in five people are over the age of 65 years and one in three of these live alone. Parts of Weston-Super-Mare are in the most deprived quartile in the country. It is also a developing area, with increases in the population scheduled including new ‘garden villages’. The area has mixed socio-economic characteristics, providing a variety of clinical and social problems. 

There are 2 older adult inpatient wards; Dune ward is a 14 bedded organic ward for both men and women and is the only ward for people with organic illnesses needing specialist assessment in BNSSG. We work closely with the North Somerset Dementia Enhanced Support Team (DEST), Dementia Wellbeing Service and South Glos teams. Cove ward is a 10 bedded mixed gender ward for people with functional illnesses. North Somerset Intensive Support team are the gate keepers for the beds locally. Each ward has a ward manager and there is one Consultant (Dr Bennett) covering both. Dr Bennett is supported by one FY2, one GPST1 and a FY1 doctor (on 2 month placement).A Staff Grade post is being advertised.

THE POST

Advanced trainees will be encouraged to develop their full potential and be stretched in directions of their choosing. The post, which will be supervised by Dr Elizabeth Bennett, offers the trainee excellent experience in the assessment and management of behavioural and psychological symptoms of dementia, in an inpatient setting, with a particular focus on recognising the importance of physical issues, comorbidities and delirium. Capacity assessments are a regular part of the work and the advanced trainee will be actively involved in assessments and supporting the junior staff and ward teams in this regard. There will be the opportunity to work with the DEST team who regularly attend ward reviews both in post but also as a possible special interest. The advanced trainee will have the opportunity to experience the different care pathways available to individuals.

Cove ward provides rich and varied experience in the care of older adults with functional illnesses including bipolar disorder, depression and psychotic illnesses. Experience in decision making around balancing risk for elderly depressed patients who have greater physical health needs but for whom the environment is not ligature free will be gained, including participation in professionals and risk management meetings.  Our patients travel to Callington Road Hospital for ECT. Ward rounds are held over 2 days with an appointment system open to family and care coordinators to attend. Again there is the opportunity to experience the different care pathways available to individuals from North Somerset and other parts of the Trust.

Both wards offer the opportunity to be involved in use of the Mental Health Act including section assessments and tribunals (on average at least one a month).

There is a healthy multidisciplinary approach to work with a weekly MDT meeting chaired by therapy staff (OT, psychology, art and music therapy, pharmacy) setting and reviewing GAS goals for patients as well as regular formulation meetings facilitated by psychology colleagues. The medical team work closely with the ward managers of Dune and Cove, using the meridian discharge tool and attending twice weekly ‘board rounds’ with the local CITT. There will also be the opportunity to attend care pathways with the ward managers.

Dr Bennett also offers in house teaching to the ward teams when possible, teaching to medical students and is Postgraduate Tutor. The academic meeting, which is open to all professions, takes place on Monday lunchtime and the advanced trainee will have the opportunity to attend and contribute. The trainee will also be able to attend the monthly Consultants’ meeting and senior meetings at Windmill House, the community base for older adult services.

Clinical Special Interest opportunities within the locality are many and varied and would include: Residential Home Liaison with DEST, Community Old Age psychiatry, Memory service, Family therapy work, Neuropsychology expertise development, Primary Care Liaison, Recovery; ECT, Management and Leadership and personality disorder service experience.

Opportunities out with the Trust might include Alcohol and Substance Misuse, Geriatric Medicine, Parkinson’s disease clinic and Neuroradiology experience, to name but a few.

The trainee will be based at Long Fox Unit, Weston Super Mare. The trainee will have dedicated office space, PC, mobile phone and secretarial support for all aspects of trainees work including on call. There is also hot-desking & free parking at the Long Fox Unit. The service is based on the same site as the general hospital and restaurant facilities are available within a 2 minute walk.

There will be one hour of dedicated supervision time per week with the educational supervisor (Dr Bennett), in addition to ad hoc supervision throughout the week.

The trainee will participate in a non-resident senior on call rota with Consultant supervision with 1:15 frequency (West Super Senior On-call rota).

 

Other Training opportunities

 

Teaching opportunities:

  • In house teaching to Cove and Dune ward staff including dementias, delirium and severe and enduring mental illness in the elderly population.
  • Other opportunities include teaching of junior medical staff, Foundation programme teaching at Weston General Hospital, medical students and voluntary/independent sector staff .

 

Research and Audit opportunities:

  • Dr Ramesh Marudanayagam is locality research lead and we have good links with the Trust Research and Development department – trainees will be encouraged and fully supported in any research projects.

 

 

7          Old Age Psychiatry – Community - South Gloucestershire

            Dr Sarah Price 

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

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

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

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

 

 

 

8          Old Age Psychiatry – Inpatients 

            Dr Sabari Muthukrishnan - Swindon

Inpatient advanced training in functional and dementia assessment wards in Victoria Centre, Swindon. Functional ward – Hodson has 12 beds and it is mixed gender ward. Dementia ward- Liddington has 14 beds and is also a mixed gender ward.

Opportunities: Chairing care programme approach, professional, multidisciplinary, multiagency, interdisciplinary, & Best Interests meetings. Involvement in Mental Health Review Tribunals & Managers Hearings. Managing a case load in both functional and dementia assessment wards and taking a lead in the multidisciplinary ward rounds.

Research: Sub Investigator or Principal Investigator in Kingshill Research Centre under the supervision of the Consultant who is the PI for three to six dementia studies. Kingshill Research Centre is situated within the Victoria Centre. The Consultant has published his Chief Investigator project in Cardiff in International Journal and can help the trainee in research writing up.

Old Age Forensic Experience: The Consultant has bespoke experience in old age forensic psychiatry and provides expert opinion for medico legal cases in Crown Courts and Parole Boards. The trainee will have an opportunity to observe and develop an interest in this niche area of expertise. The Consultant has a PG certificate in Medical Law and Ethics from De Montfort University

Leadership: The Consultant has been a Clinical Director in Cardiff for 2.5 years and can guide the advanced trainee in acquiring leadership skills and Quality Improvement Projects

Audit: Audit lead is based in Victoria Centre and will have an opportunity to participate in new audits or help in ongoing audits.

Teaching: There will be ample opportunity to teach and supervise a core psychiatry trainee (CT1), GP trainees and Foundation Trainees. The two wards are supported by 2 GP trainees, 1 Core Psychiatry trainee, 1 FY1 and 1 FY2.There will be opportunity to support medical students and also informal teaching sessions for MDT in the ward.

Psychotherapy: The Consultant will be keen to support psychotherapy supervision for the advanced trainee by liaising with senior psychologists in the locality and Psychotherapist’s within AWP.

Additional Clinical Opportunities:

1.       Memory Clinic

2.       Mental Health Liaison service in Great Western Hospital (adjacent to the Victoria Centre), Swindon

3.       Care Home Liaison work and the team is based in Victoria Centre

4.       Complex Intervention and Treatment team and Primary Care Liaison services

 

On Call – Swindon/Wiltshire Rota

 

 

9        Old Age Psychiatry – Community 

            Dr Martin Ansell - Forest of Dean

This is primarily a Community Old Age Psychiatry post based at Colliers Court in Cinderford. The patch covers both rural Communities of the Forest of Dean and the Market Towns of Coleford, Lydney and Newent. There is a diverse population with a number of retirees from the Midlands and local Foresters. Since being the site of Edward 1s crossbow bolt factory in the 12th Century the area has had a unique juxtaposition of an industrial heritage in a rural environment. There will be opportunity to undertake outpatient clinics and home visits for both functional and organic conditions and to be part of the stand-alone Memory Assessment Service which specialises in early dementia diagnosis.

The post holder will become an active member of the CMHT and will be able to take part in and chair referral and business meetings, CPA meetings and Best Interest meetings with staff, carers and partner agencies. There will be opportunities for hospital liaison work in our 2 community hospitals working with the specialist older peoples liaison nurse. There are a number of local care homes who we assist in the management of psychiatric illness in their residents alongside our care home support team.

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

Dr Ansell is currently Quality and Leadership Champion for the Trust and as such there will be opportunities for the trainee to gain experience of medical management including an understanding of the principles of clinical governance, budget setting, business planning and developing business cases.

The Locality has a population of 18,000 over 65s.  The Trainee will join a team which consists of a consultant old age psychiatrist, a specialty psychiatrist and periodically a part time VTS GP trainee. The CMHT has community nursing staff, OTs, physiotherapists, and psychologists.  We also regularly take Medical Students from Bristol University and nursing students from UWE. There is ample scope for teaching. As well as providing teaching for the Medical Student and junior medical staff.   The CMHT is always eager for enlightenment and the team provides regular educational sessions for the local GP practices.

On call: 1 in 20

Research Interest:   Mental Capacity Act; Medical Management, Service Development

 

 

10        Old Age Psychiatry – Community

            Dr Joe Stratford - Stroud & Berkeley Vale 

This post is based within the Stroud Older person’s Mental health Service.  It is a semi-rural area encompassing Stroud, Berkeley Vale (Dursley, Cam, Berkeley etc) and the neighbouring villages.  The population it services is approximately 26,000(over 65 yrs).The team operates along traditional CMHT lines rather than being split into functional units. Staff include nurses, occupational therapists, psychologists, physiotherapists and a social worker as well as 2 consultant psychiatrists, and a Core Psychiatry trainee.

The post is primarily community-based since the inpatient beds at Weavers Croft relocated to Cheltenham and Gloucester in December 2007. However, there is ample opportunity to be involved in the inpatient units and this would be encouraged. The postholder would be expected to assess new and existing patients in community, outpatient and general hospital settings, suffering from a variety of both functional and organic mental health conditions. She/he would also be expected to liaise closely with members of the team, carers, statutory agencies and other healthcare professionals as well as providing a degree of clinical support to junior staff.

There is good liaison with our neurological and radiological colleagues locally, and a cutting-edge neuroradiology service which has just been awarded the first UK license for running amyloid scans outside London.  If desired, special interest sessions can be arranged accordingly.  There is also now daily consultant old age psychiatrist membership of the general hospital liaison team and established liaison links with geriatrician colleagues within the general hospital, enabling focussed experience there, as well.

There is an excellent local academic weekly programme run in Gloucester which the ST4-6 will be encouraged to attend as well as providing support to CT1-3 colleagues with their presentations. There is also regular teaching and examination training provided by the ST4-6’s for those junior colleagues attempting MRCPsych exams. Medical students are also attached to the old age psychiatry teams and so there is the opportunity to help with their training. There are plenty of opportunities for special interest sessions and a popular theme tends to be linking in with the local Care of the Elderly teams for a variety of learning experiences (eg ward rounds, specialist clinics etc).

On Call Rota: 1 in 20

 

 

11        Old Age Psychiatry – Memory service/Research

            Dr Tarun Kuruvilla-  Cheltenham     

This is primarily a memory service post within Gloucestershire Health & Care NHS Foundation Trust (GHC), based at Charlton Lane Centre, Cheltenham.

The trainee will primarily work with the highly acclaimed Memory Assessment Service (MAS) for Cheltenham & the North Cotswolds. The team comprises of memory nurses, a young-onset dementia nurse, clinical psychologists, occupational therapists, SALT, a speciality doctor & trainees.

The trainee will get experience in carrying out initial memory assessments; chairing the MAS MDT meeting; training in neuropsychological assessments; interpreting structural & functional scans; formulating & giving diagnosis of dementia; and commencing treatment in a memory clinic setting. On Call 1 in 20.

Dr Kuruvilla is a NIHR funded researcher; joint clinical lead for Division 4 (DeNDRoN, mental health, ageing & neurology) of the West of England Clinical Research Network; and Clinical Director for Dementia Research at GHC. The trainee will be encouraged to actively participate as a sub-investigator in the various NIHR portfolio adopted dementia research studies that the Trust is carrying out at its purpose-built clinical trials facility (The Fritchie Centre) allowing the trainee to get valuable research competencies. There will also be opportunities for home-grown projects potentially leading to publications and conference presentations.

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

Dr Kuruvilla has an interest in neuroimaging which the trainee will be encouraged to take up as a special interest, getting experience in interpreting CT, MRI, FDG-PET and Amyloid PET scans. Shadowing radiologists / radiographers at the nearby, highly acclaimed, Cobalt imaging charity, will be a unique learning opportunity especially for the PET scans, which are not routinely available in most parts of the country.

Other clinical special interest sessions offered are geriatric medicine including Parkinson’s disease and falls clinics; neurology clinics; and palliative care.

We get fourth year medical students from University of Bristol, GP trainees from the Severn Deanery GP School and advanced trainees from different specialities from Severn and Oxford Deaneries for special interest / research sessions. The trainee will attend the weekly postgraduate academic programme in Gloucester and the monthly old age psychiatry meetings at Charlton lane centre.

There are several management projects which the trainee can participate in such as the young-onset dementia STP working group; the functional neuroimaging for dementia service, organising conferences etc.

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

 

 

12        Old Age Psychiatry - Inpatients

            Dr Katie Kelly - Charlton Lane - Cheltenham

This post offers a traditional model of Old Age Psychiatry – covering both community and inpatient work and offering a range of experience across both domains.  The community team is based at modern offices at Avon House, Tewkesbury whilst the inpatient unit is based at the new purpose designed facility at Charlton Lane Hospital, Cheltenham.

The post offers experience in a wide range of mental health services for older people, including inpatient assessment and management of both organic and functional illness, community assessments, work within a community mental health team and outpatient clinic assessments and management. The trainer Dr Kelly divides her time approximately equally between the CMHT and the ward but the balance of time spent in each by the trainee can be adjusted according to training needs.

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

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

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

On-Call:  1:20.

Research Interest: Palliative care

 

 

13        Old Age Psychiatry – Memory Assessment Service (Community) 

            Dr Nik Bhandari - Cotswolds & Tewsbury, CMHT & Forest

The post is based in the community and offers a broad range of experience in the assessment and management of organic and functional mental health disorders in older adults.

The trainer is a full time substantive consultant psychiatrist based at Avon House, Tewkesbury, and provides consultant input for the Cheltenham and Tewkesbury CMHT and Forest of Dean MAS team. The catchment is predominantly rural and suburban and includes the scenic AONB of Cotswolds with market towns of Burton-on-the-Water, Moreton-in-Marsh and Stow-on-the-Wold. The CMHT and MAS teams have staff members from various disciplines including nurses, occupational therapists, psychologists, physiotherapists and speech and language therapists, with a strong focus on multi-disciplinary approach in developing patient care plans.

The trainee will have a dedicated desk, lockable drawer, phone, computer facilities and full secretarial support at Avon House, Tewkesbury. As part of their training, the trainee will have out-patient clinics, domiciliary visits to patients’ homes, will work with Care Home Support Team and Community Dementia Nurses for assessment and management of patients in community. The trainee will have the opportunity to work with specialist old age liaison team at North Cotswolds and Tewkesbury community hospitals. The CMHT works closely with Crisis Team for functional patients and there will be opportunities for the trainee to gain experience in managing emergencies and use of MHA, where appropriate.

The trainee will be encouraged to take on management roles within the team, such as chairing MDT meetings, CPA reviews and best interest meetings. The trainee will also be liaising with GPs and professionals from other organisations such as locality Social Workers, and staff from third sector organisations such as Alzheimer’s society and Age UK. There will be opportunity to undertake inpatient work if required (with clinical supervision provided by the inpatient consultants at Charlton Lane Hospital).

There are opportunities for teaching junior doctors and medical students who are attached for blocks of time. Also, as part of the Managing Memory Together, the trainee will be encouraged to do teaching sessions for dementia patients and carers. The trainee will also be offered support to participate in audits and Quality Improvement Projects. On Call is 1 in 20.

Dr Bhandari is ‘Research Champion’ for GHC Trust and is currently Principal Investigator for a commercial drug study. He and his research team recently completed an IV infusion monoclonal antibody trial for prodromal and Mild Alzheimer’s patients. The trainee will be encouraged to participate in research trials and could take on the role of Sub-investigator for commercial and NIHR portfolio studies. There will also be opportunities for working with the trainer on systematic reviews, potentially leading to publications and conference presentations.

The trainer has special interest in neuropsychiatry. There will be opportunities to work with geriatric medicine colleagues (as part of the Parkinson’s Hub clinic). Also, clinical special interest sessions in neurology, palliative care and neuroradiology can be arranged. There is a  weekly postgraduate teaching programme in held at Gloucester, and the monthly Old Age Psychiatry academic session is at Cheltenham.

Research Interest: Frontotemporal Dementia

 

 

14        Old Age Psychiatry – Community & Day Hospital

            Dr Antony Christopher - Somerset

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

The trainee would be part of an integrated multidisciplinary team covering South Somerset – although this is split into two geographical teams – one based in Yeovil, and the other at Bracken House in Chard. The overall team leader covers both sites, and specialist psychology is also split between the two. Medical, nursing, OT, STAR (enabling) and admin staff are dedicated to each site. The trainee would be based at Bracken House where they have access to their own office, with IT access and full time admin support, which would cover support for all aspects of the trainee’s work, including on-call.

The work is outpatient based with clinics running both in Bracken House, and also being accommodated in the patient’s own GP surgeries. Many patients require to be visited at home, and access to independent transport will be essential. Patient’s requiring inpatient admission would either be admitted to Yeovil (organic) or Taunton (functional).  Although the trainee would not normally continue with responsibility once admitted, training and experience with inpatients can be arranged if this is appropriate.

Bracken House also runs a 12- place Day Hospital ( mostly for organic patients) which has its own dedicated nursing staff team. The trainee would be welcome and encouraged to gain experience in this area of work.Dr Christopher has special interests in both education and management, and is the Associate Medical Director for OPMH and LD services across the trust.

There are many opportunities for enthusiastic trainees to participate in management activities as a special interest either for ongoing operational or more project based work. There are also many opportunities to be involved with education as the trust has both core and higher trainees, and also undergraduate students. The trust runs an active PGME and audit programme which the trainee would be able to become involved with.

Research Interest: Management.

On-Call:   1:15 (until midnight)

 

 

15        Old Age Psychiatry – Inpatients 

            Dr Stephen de Souza - Taunton, Somerset

This an inpatient post based at Pyrland Ward, Taunton.  The post offers those undertaking their first or second higher training job an excellent grounding in old age psychiatry and in particular provides an excellent start to higher training. For those with more experience the post can be adapted to reflect this seniority, by offering more responsibility as required, supported by close consultant supervision.

Pyrland ward is a 28 bedded unit, 14 are for those over 65 with functional illness, and 14 for those with organic illness. The organic beds are prominently used to care for patients with behaviour that challenges in dementia.

Pyrland ward offers a countywide service, treating patients from Minehead in the West, Wincanton in the East. The geographic spread of the patients offers unique challenges, as welas opportunities to use innovative solutions to ensure continuity of care.

The ward is currently working towards accreditation as an AIMS-OP site, and higher trainees interested in service development can be involved in this work.

Dr De Souza is currently the clinical director for older Persons Mental Health within Somerset Partnership. Trainees interested in management can be supported to work with Dr De Souza in his CD role

Dr De Souza has a particular interest in medical education and would be happy to support any trainee if they wish to develop this further. He is currently the Undergraduate Unit Coordinator for the University of Bristol’s psychiatry students on rotation in Somerset.

If the potholders’ interests lie elsewhere however, there are multiple opportunities in a range of clinical and nonclinical special interests available, including a highly regarded CAT service delivered locally and which the trainee would be supported to attend.

On Call 1 in 15 (until Midnight)

 

 

16        Old Age Psychiatry – Community

            Dr Raji Makena - Yeovil, Somerset

This advanced training post is primarily based in Magnolia House, Yeovil, for community work within the Community Mental Health Team, the Memory Assessment Service and also working with the newly established Intensive Dementia Support Service IDSS.

The advanced trainee will be involved in clinic appointments on site as well as joint and individual visits to patients’ homes, Care homes and Nursing homes and to the local DGH and local Community Hospitals.

The Intensive Dementia Support service was created following the closure of Magnolia ward and provides support for patients in crisis. The aim is to prevent admission with early and intensive support. It is a nurse led service with medical support provided for advice and visits. The team consists of CPN’s, Occupational therapist, Community Support Workers CSW’s, Admin and Team Manager

OPMH CMHT meetings are held weekly on Wednesday morning and there will be opportunity for joint visits with team members as well as individual assessments allocated when new referrals are discussed

The team includes Psychologists, Community OTs, Support, Time and Recovery Workers (Community Support workers) and Community nurses.

Regular weekly clinics take place in Magnolia House and at times at Wincanton community Hospital. This includes Memory clinic assessments and follow ups.

Supervision will be provided weekly for an hour.

Regular attendance at local PGME on Wednesday mornings and Audit meetings will be strongly encouraged

There will be some night and weekend on call requirements as part of the county wide senior on call rota. However, given the potential travelling distances involved for ST4-6 trainees based in the Somerset area the first on call commitment will be limited to daytime and evenings only. ST4-6's will be first on call for telephone calls and referrals up until midnight.  After midnight the second doctor on the rota will become “first on call” for telephone calls and referrals.

The population served is approximately 28,000. Dr Makena also has 2 Programmed Activities dedicated to her role as a medical manager and will be able to provide insights into this work for the higher trainee.

Apart from the consultant there are also 2 full time Staff grades and a part time Consultant Psychiatrist in the team. Secretarial support is available via Dr Makena’s secretary for all aspects of the trainees work.

The higher trainee would have a permanent base at Magnolia House in Yeovil with office space for use up to 5 days per week and with access to their own Trust laptop computer and mobile phone

On Call rota: 1 in 15 (until Midnight)

                                                                                                                                                                                                                                                                                 

17      Old Age Psychiatry – Community

            Dr Stefan Kolowski - Taunton, Somerset

This post offers a broad experience in community old age psychiatry, including organic and functionally ill patients and those with early memory problems.  The post is based in Taunton and surrounding areas namely the village of Creech St Michael.  The catchment area is approximately 110,000 with 19,000 being over the age of 65 years.  Taunton is an historic market County town famous for cricket and cider.  There are no major areas of socially economic deprivation.  The trainee would be part of an integrated multidisciplinary team based at Foundation House in Taunton, which also accommodates the general adult community teams, Community CAMHS and the National Deaf Service.  Other trainees are based at Foundation House and the Wellsprings Hospital Site where Foundation House is located, including core and advanced trainees in psychiatry, GP trainees, Foundation Year 1 and 2 doctors and Medical Students on attachment.

The advanced trainee would gain experience in the assessment and treatment of psychiatric morbidity in the over 65s, including a separate Memory Assessment Service.  The postholder would do two clinics a week, an emergency clinic on a Friday and up to 4 to 5 home visits per week.  There are 5 residential homes, two with EMI nursing and one specialised residential home.  There is a separate liaison service for the over 65s at Musgrove Park Hospital 2 miles away with Dr Nick Warner and Dr Sian Hughes, which could be considered as a possible special interest.  It is a compact small area which could be covered on a bike, allowing commuting on the train.  Foundation House is a 7 minute walk from the train station.

The integrated team of 15 based at Foundation House includes: 1 Psychologist, 1 OT Manager, 1 Core Trainee, Nurses, Support Workers, Admin Staff (Secretary).  Not all team members are full time.  Dr Kolowski has an office above Pyrland Ward with the other OPMH Consultants.  There is a doctors room next to Dr Kolowski’s office shared with the CT1, there are 3 desks and 2 desk top computers available.  A lockable cabinet and laptop can be provided, with admin support from Dr Kolowski’s secretary (for this post and out of hours work). A mobile phone is also provided.                                                                  

Teaching experience is available at the local PGME meeting where the advanced trainees co-ordinate Peer Led training.  There are medical students on attachment and the medical student unit co-ordinator/psychiatry tutor Dr De Souza is based on Pyrland Ward next to your shared office.  He would welcome support teaching the medical students on attachment.  Management experience can be gained shadowing Dr Lucy Knight, Medical Director who is seconded with the integration project with Musgrove Park Hospital.  Shadowing is also possible with Dr Antony Christopher OPMH Consultant and Clinical Director, currently deputy Medical Director for OPMH and CAMHS.  Lucy and Antony would be happy to support any trainee if they wished to develop their management experience further. If the postholder’s interests lie elsewhere, there are multiple opportunities in a range of clinical and non-clinical special interests available, including a highly regarded CAT service delivered locally.

On Call Rota: 1 in 15 (until Midnight)