Job responsibilities
Job Summary and Purpose of service
The A2ED service complements the pre-existing Psychiatric Liaison service based at Derriford Hospital and First Response Services. A2ED takes direct referrals from other urgent care agencies such as 111, the ambulance service and police.
The service operates from 5pm-1am, usually on Tuesday, Wednesday and Saturday and Sunday each week, and on other days according to funding available. The service continues to develop and contribute to finding effective alternatives to emergency department attendance.
The A2ED provides a timely response to adults aged 18 and over who are in mental health crisis, enabling them to be seen swiftly in an alternative location to an Emergency Department (ED). The A2ED supports the flow of patients within the acute environment, including actively diverting people out of the ED for a mental health assessment when there is no need for physical health care. The aim is to provide a welcoming and calm environment enhanced by peer support workers
The successful post holder will be primarily clinical within this service although there may be a requirement to offer line management support to peer support workers and placement students.
The role will include a high level of autonomous working, with the successful post holder carrying out skilled mental health assessments and providing risk formulation and onward care plans for patients using the service. This will be in close collaboration with family, friends and carers.
You will be expected to be able to make clear clinical decisions based on the analysis of often complex presenting difficulties; this can include being the decision maker in terms of the onward care plan for patients experiencing crisis mental health needs.
You will be able to demonstrate a high level of communication skills in terms of use of verbal, electronic and written formats.
You will be required to engage with patients who can be challenging and/or acutely distressed.
Organisational Chart
Directorate Manager
Service Manager
A2ED Team Manager
This Post Peer Support WorkerSecurity staff
Students on placement/NHSP/Agency workers
Professional /Clinical Responsibilities
The Post-holder will:
The Post holder will check acute hospital systems such as Nervecentre for relevant potential referrals. Contact will be made with Ambulatory care/ED to consider if there are any patients who could be diverted to receive an assessment within A2ED. Further proactive contact will be made with First Response from Plymouth, Devon and Cornwall services, ambulance, police and 111.
Undertake holistic and comprehensive bio-psychosocial assessment of patients referred to the service.
Utilise a range of highly specialised clinical skills appropriate to the needs of individual patients and the clinical setting in which they are seen
Conduct risk assessments on all patients presenting to the service in line with up-to-date guidance and Livewell Southwest policy. The post holder will have highly developed risk assessment skills to manage complex presentations.
Advise referrers/family/patients, medical and other professional staff on the management of patients and contribute to care planning to meet identified needs.
Work closely with peer support workers and volunteers to enhance patient experience.
Evaluate effectiveness of care interventions with all disciplines of staff, adjusting care plans where necessary.
Provide a consultation-liaison service to clinicians and clinical teams referring to the A2ED. This will include giving specialist advice on care, treatment and patients management issues.
Work in collaboration with colleagues in the promotion of care delivery and strategic objectives and taking responsibility/lead for specific areas of working e.g. liaison with police, drugs and alcohol, safeguarding, neurodiversity
Refer and signpost people to appropriate mental health services as required both within and outside of the organisations area. Assist people to complete self referrals when this is in their best interests.
Work collaboratively with social care teams, and community mental health teams in devising appropriate discharge plans.
Deliver care that is evidenced based and reflecting current best practice.
Be accountable for own practice in accordance with NMC Code of Professional practice or HCPC relevant codes of practice.
Demonstrate sound understanding of the ethical and legal issues in caring for all older adults attending the hospital. This will include Mental Health Act (1983), Mental Capacity Act and Deprivation of Liberty Safeguarding (2005) issues as required.
Involve carers and families of people with mental health needs, providing support and advice as needed.
Work collaboratively with colleagues in the development of the A2ED Service.
Communication
The post-holder will :
Communicate effectively and sensitively with patients, families and carers. It is expected that staff will practice within the principles of the Triangle of Care.
Have highly developed interpersonal skills, self awareness, and empathy to engage with others and provide an effective outcome.
Work positively and sensitively with angry or hostile behaviours to enable therapeutic and productive outcome.
Demonstrate the ability to negotiate and problem solve in complex situations where agreement is required, or communicate clear decision making and rationale when agreement cannot be reached.
Provide comprehensive information based on assessment to inform the care, treatment or discharge planning process of patients within the acute general hospital.
Demonstrate the ability to develop and maintain good working relationships with colleagues within the A2ED Team and across other statutory and non-statutory organisations.
Maintain confidentiality of the patients as per policy whilst sharing information when appropriate to do so.
Keep accurate and contemporaneous electronic/written patient records and comply with professional and organisational record keeping policies.
Comply with local and national policies in relation to confidentiality and information sharing protocols.
Liaise with existing care networks regarding the status and progress of patients who are subject to the CMHF framework.
Demonstrate the ability to adapt communication to take account of others needs.
Maintain high standards of integrity when communicating with patients and others.
Demonstrate ability to use IT systems effectively including email and clinical systems used by the team.
Ensure that security staff have a relevant briefing about patient risk to enable safe execution of their role.
Represent the team by attendance at meetings as delegated by Team Manager.
Act as a role model for all staff.
Analytical and Judgmental skills
The post-holder will:
Demonstrate the ability to analyse often large amounts of complex information from a range of other services, assimilate these and their relevance to a persons mental health needs. Formulate a clinical opinion including an assessment of risk, and advise on an appropriate care plan.
Possess a good working knowledge of mental health legislation including Mental Health Act, Mental Capacity Act and Deprivation of Liberty safeguards and use this in relation to advising and planning care, independently or with other professionals.
Formulate a care pathway following assessment, with an appropriate onward referral to other NHS professionals, statutory and non-statutory services as necessary.
Planning and Organisational skills
The post-holder will:
Demonstrate the ability to manage conflicting demands on time and the ability to prioritise clinical work effectively
Demonstrate the ability to organise work schedules as well as re-prioritising work in light of changing demand.
Refer for the appropriate follow up of patients seen by the service.
Deliver formal and informal training sessions on behalf of the team to other professionals where needed.
MANAGEMENT
The post holder will:
Take responsibility for agreed clinical, managerial and strategic projects associated with the provision of the A2ED service. This will include planning, implementing, reviewing and revising these projects as necessary.
In the absence of the Manager, take responsibility for the coordination of all activities within the clinical area or equivalent sphere.
In the absence of the Manager, take responsibility for the management of the Team and patient care provided, to the agreed local and professional standards
Undertake line management supervision and appraisal of other staff within the team where appropriate.
EDUCATION
The post holder will:
Participate in the mentoring and education of a range of students on placement with the Team
Participate in the planning, development and delivery of educational programmes and training sessions for a range of clinical staff within the working and learning environments.
Provide clinical supervision to colleagues and students as required
Physical skills
The post-holder will:
Be able to demonstrate IT skills, including keyboard use.
Show the ability to concentrate for sustained periods of time and work effectively with potential frequent interruption in a busy environment.
Be required to have ability to travel to other clinical sites for attendance at meetings.
Be involved with patients who at times present with physical and verbal aggression due to ill health, distress and/or non concordance with care. Post-holder will need to be aware of how to respond appropriately and safely, with consideration to the safety of themselves and others.
Freedom to Act
The post-holder will:
When required to, work without supervision and make autonomous clinical formulation and decisions in relation to the care, treatment and safe discharge of patients with complex mental health needs.
Post-holder will receive regular management supervision and appraisal on an annual basis, or more as needed.
Please refer to the full JD & Spec - supporting document.
