Old Age Psychiatry Advanced Training Posts

Last updated December 2020

 

NO

SPECIALITY

TRUST / AREA

TRAINER

1

Old Age – Community & Inpatient (organic)

AWP - Bath

Dr Roz Ward

Rosalind.ward@nhs.net

2

Old Age – Community & Inpatient (organic)

AWP - Bath

Dr Alister Gomes-Pinto

Alister.gomespinto@nhs.net

3

Old Age – Inpatients

 

AWP - Bristol

Drs Jonathan Hewitt/Geoff van der Linden

Jonathan.hewitt@nhs.net Geoffrey.vanderlinden@nhs.net

4

Liaison Psychiatry

(Endorsement)

AWP - Bristol

Dr Anish Patel

anishpatel@nhs.net

5

Old Age –Community/Memory

AWP - North Somerset

Dr Niall Moore

niallmoore@nhs.net

6

Old Age – Community/Memory

AWP – North Somerset

Dr Alison Lerant

Alison.lerant@nhs.net

7

Old Age - Community

AWP - South Gloucestershire

Dr Sarah Price

Sarah.price12@nhs.net  

8

Old Age - Inpatient

AWP - Swindon

Dr Sabari Muthukrishnan

s.muthukrishnan1@nhs.net

9

Old Age - Community

GHC – Forest of Dean

Dr Martin Ansell

martin.ansell@ghc.nhs.uk

10

Old Age - Community

GHC - Stroud

Dr Joe Stratford

Joe.Stratford@ghc.nhs.uk

11

Old Age – Community

GHC - Cheltenham

Dr Tarun Kuruvilla

tarun.kuruvilla@ghc.nhs.uk

12

Old Age – Inpatient

GHC - Cheltenham

Dr Katie Kelly

katie.kelly@ghc.nhs.uk

13

Old Age - Community

GHC – Cheltenham, North Cots & Forest of Dean

Dr Nik Bhandari

nik.bhandari@ghc.nhs.uk

 

14

Old Age – Community

SomFT – Mendip and Soth Somerset

Dr Antony Christopher

Antony.Christopher@SomersetFT.nhs.uk

15

Old Age – Inpatient

SomFT - Taunton

Dr Stephen de Souza

Stephen.DeSouza@SomersetFT.nhs.uk

16

Old Age – IDSS - Community

SomFT – Yeovil & Taunton

Dr Rajewari Makena

Rajeswari.Makena@SomersetFT.nhs.uk

17

Old Age - Community

SomFT – Sedgemoor

Dr Tiff Earle

Tiff.earle@SomersetFT.nhs.uk

  

Detailed Descriptions

 

1          Old Age Psychiatry – Community and Inpatients (Organic)

            Trainer: Dr Roz 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)

            Trainer: 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. Aspen Ward, Callington Road Hospital, Bristol

            Trainers: Dr Jonathan Hewitt and Dr Geoff van der Linden

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 and a core psychiatry trainee 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) Southmead Hospital  

            Trainer: 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.

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 Tiff Earle in advance so that your application can be considered with that of the GA trainees.

Clinical work typically falls into three categories: Emergency Zone, In-patient and Outpatient. Non-clinical areas of development that will run in parallel 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.

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 behavioral 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 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. 

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 strong links with the Neuropsychiatry AND Care of the Elderly services on site that link in with the Liaison Psychiatry services with opportunities to undertake out-patient clinics and specific Neuro-Liaison special interest.

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 Care of the Elderly medical colleagues. Attendance with senior liaison clinicians to the Mental Health Operational group and STP level meetings will also assist developing higher management/leadership skills.

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

Research Interest: Mental Capacity Act, Medical Ethics and Law.  Member of the Bristol Clinical Ethics Advisory Group. Links with BRACE and NBT Cognitive disorders service

 

5          Old Age Psychiatry –community, memory and potential for inpatient, North Somerset. 

            Trainer: Dr Niall Moore

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

This is one of two Community Old Age Psychiatry posts 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 Psychiatry – Community, memory and potential for inpatient, North Somerset

            Trainer: Dr Alison Lerant

This is one of two Community Old Age Psychiatry posts 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 Lerant 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.  She 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 Lerant.

Dr Lerant used to be a GP in North Somerset and has extensive experience in management, physical medicine and psychiatry and is an enthusiastic teacher and mentor.  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) 

 

7          Old Age Psychiatry – community. South Gloucestershire

            Trainer: 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 academic programme and the timetable is flexible and negotiable.

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

 

8          Old Age Psychiatry – Inpatients (Swindon) 

            Trainer: Dr Sabari Muthukrishnan

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 (Forest of Dean) and Medical Management  

           Trainer: Dr Martin Ansell

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 people’s 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 both the Deputy Medical Director and Quality and Leadership Champion for the Trust and as such there will be ample opportunities 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 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. Stroud, Gloucestershire

            Trainer: Dr Joe Stratford

This post is based within the Stroud Older person’s Mental health Service.  It is a semi-rural area encompassing Stroud and its neighbouring villages.  The population it services is approximately 18,000 (over 65 years). 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 other LTFT consultant psychiatrists, and (usually) 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. Cheltenham

          Trainer: Dr Tarun Kuruvilla

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 Cheltenham (Charlton Lane)

            Trainer: Dr Katie Kelly

This post is based on Chestnut Ward at the Charlton Lane Hospital in Cheltenham.

The post offers experience in a wide range of inpatient assessment and management of both organic and functional illness. The trainer (Dr Kelly) divides her time between the ward and her role as Clinical Director for Older Adult Services across the county.

Chestnut Ward is one of three wards at Charlton Lane. Chestnut ward has 14 beds covering patients from age 65 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 – Cotswolds and Tewkesbury CMHT (Community)

            Trainer: Dr Nik Bhandari

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. There will also be opportunity for the trainee to join NIHR and commercial research trials.

The trainer is a full-time substantive consultant psychiatrist based at Avon House, Tewkesbury, and provides consultant input for the Cheltenham and Tewkesbury CMHT. He is also the Chief Investigator for an Alzheimer’s IMP trial, and Principal Investigator for another monoclonal antibody Dementia trial

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 has 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.

 

14        Old Age Psychiatry – Community and Day Hospital. West Mendip Somerset                                                    

            Trainer: Dr Antony Christopher

This post offers a broad experience in community old age psychiatry, including organic and functionally ill patients and those with early memory problems. The post is based in an overwhelmingly rural area of the Mendips and out into the Somerset levels. The patch includes the Cathedral City of Wells and the small country towns Shepton Mallet, Street and Glastonbury and the villages between these. There is a wide socio-economic spread – some villages are very affluent, whereas other areas are more deprived. The population of patients over 65 supported is approx. 15,000

The trainee would be part of an integrated multidisciplinary team covering The Mendips – although this is split into two geographical teams – one based in Frome, and the other at The Bridge on the Priory Health Site in Wells. The overall team leader covers both sites, and specialist psychology is also split between the two. Medical, nursing, OT, STAR (enabling) and admin staff work within the same team but will generally work at one site. The trainee would be based at The Bridge where they have access to their own office, with IT access and part 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 The Bridge, 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. There will also be liaison work into the local community hospitals and local nursing and residential homes. Patients requiring inpatient admission would be admitted to the specialist OPMH inpatient wards in Taunton.  Although the trainee would not normally continue with responsibility once admitted, training and experience with inpatients can be arranged if this is appropriate.

The Bridge also runs Day Hospital services ( for both organic and functional 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 Clinical Director for OPMH.

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. Taunton, Somerset 

            Trainer: Dr Stephen de Souza

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 to Wincanton in the East. The geographic spread of the patients offers unique challenges, as well as 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 Clerkship Lead in psychiatry for students from the University of Bristol on rotation in across Somerset. As such he has a particular interest in medical education and would be happy to support any trainee if they wish to develop this further. He is also involved in a number of medical education projects, and again interested higher trainees can be involved with these.

If the post holders’ interests lie elsewhere however, there are multiple opportunities with a range of clinical and nonclinical special interests available, including managerial opportunities. Dr De Souza is a former CD in the trust, holding an MSc in leadership and organisational development, completed during his own higher training. He is happy to support trainee to pursue interests in leadership and management through this post. There is the chance to work with a highly regarded CAT service delivered locally and as well the Somerset intensive dementia support service. There is an emerging neuro-stimulation service, and the trust will support higher trainees interested being involved with this service as part of their clinical special interest.

 

On Call 1 in 15 (until Midnight)

 

16        Old Age Psychiatry (Intensive Dementia Support Service – IDSS), Yeovil & Taunton

            Trainer: Dr Raji Makena

This advanced training post is primarily across Somerset with bases in Pyrland House, Taunton and Magnolia House, Yeovil for community work within the Intensive Dementia Support Service IDSS.

The advanced trainee will be involved in 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

MDT meetings are held weekly on Monday morning in Yeovil and Tuesday morning in Taunton with twice daily handover meetings on both sites

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

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.

ST4-6 trainees will participate in the rota with a frequency of 1:15 (until midnight).

The population served is approximately 28000.  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.

Secretarial support is available via Dr Makena’s secretary for all aspects of the trainee’s work.

The higher trainee would have a permanent base between Pyrland House in Taunton and 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.

                                                                                                                                                                                                                                                                     

17      Old Age Psychiatry – Community. Bridgewater and Burnham on Sea (Sedgemoor). 

          Trainer: Dr Tiff Earle

This advanced training post is primarily based in the Mulberry Centre (Burnham on Sea) and encompasses functional and organic psychiatry for those aged over 65. The 2 teams are the CMHT and the memory assessment service, with opportunities for experience across both fields.

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 Community Hospitals. There is a particular emphasis on development in neuropsychiatry, frailty and comorbid physical health issues (including delirium) in addition to the core competencies of the old age psychiatrist

The team work closely within a primary care network, and there are daily meetings with GPs, geriatricians, District Nurses, social services and neighbourhood agents. We also work alongside the newly created transformation teams, whose aim is to ‘fill the gap’ between primary and secondary mental health care.

In addition, we work closely with the LARCH team – care home in reach, to advise and desk top review patients with dementia in care homes in the patch.

Dr Earle is especially passionate about leadership development (Having had medical management roles and an MBA qualification); a proven track record in service development and QI and a broad range of experience in teaching and training beyond mental health services. The trainee would be encouraged to participate in all of these areas.

Clinical Special Interest opportunities within the locality are many and varied and would include: Leadership development with a consultant, having experience of management roles and an MBA; neuromodulation service (ECT and rTMS); newly developed memory assessment hub; LARCH care home in reach team; Intensive Dementia Support Service; Liaison Psychiatry.

Other opportunities with the acute trust side could be explored, such as: Geriatric Medicine, Neurology; Parkinson’s disease clinic and Neuroradiology experience, to name but a few.

OPMH CMHT meetings are held weekly on Monday 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 CPNs, Psychologists, Community OTs, Support, Time and Recovery Workers (Community Support workers)

Clinic slots are flexible and will cover both CMHT and MAS, in Bridgewater and Burnham.

Supervision will be provided weekly for an hour on Wednesdays

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

The total population of Sedgemoor is 122,000, concentrated in the towns of Burnham on Sea and Bridgewater, with a large surrounding rural area. The area has mixed socio-economic characteristics, providing a variety of clinical and social problems.  The elderly population is around 20 000, with a number of care homes on the patch.

There is a 0.8 WTE consultant based in Bridgewater, as well as a 0.6 WTE MAS staff grade, and secretarial support is provided by the medical secretary attached to either Mulberry Centre or Glanville house

The higher trainee would have a permanent base at the Mulberry Centre, Burnham on Sea, with office space for use up to 5 days per week and with access to their own Trust laptop computer and mobile phone

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.

Research Interest: Neuromodulation (including ECHO Esketamine study); Leadership; Physicians Associate development

On Call rota: 1 in 15 (until Midnight)