Specialty Doctor - Psychiatry - Manchester

Job responsibilities

Role purpose

The post is for 5.0 PAs and is based in The Christie cancer centre. The postholder would join a small multidisciplinary team comprising two part-time consultant psychiatrists in psycho-oncology (0.55 WTE each), 3 WTE psychological nurse specialists, 2.8 WTE counselling/psychotherapy staff, 0.4 WTE psychologist and two sessions per month psychosexual consultant. These team members provide a clinical psychiatric and psychological service to cancer patients and their families at NICE levels 3 and 4. They work in close collaboration with specialist nurses and other health professionals providing care at NICE levels 1-3 in the Trust.

The post has 5 Programmed Activities (each PA is 4 hours). A broad design of 4.0 direct clinical care (DCC) PAs, including clinical management and administration, and 1.0 supporting professional activities (SPA) is envisaged. There is no on call requirement. The SPAs could cover management, research, CPD and audit, mental health education and training or a special interest activity.

It is expected that the clinical PAs will consist of two fixed sessions for inpatient liaison assessments, one session for priority out-patient/day-patient referrals, and one session for MDT and ad hoc inpatient cover. The exact days and time of these sessions can be negotiated but availability on Wednesday mornings will be required.

As an indicator of workload, the psycho-oncology service as a whole accepts approximately 35 in-patient referrals per month and 6 priority out-patient/day-patient referrals per month. The postholder would be expected to see up to two priority patients per week, sometimes jointly with another member of the MDT, (or up to 2 routine outpatients if there is no priority patient to be seen) and approximately 4-5 in-patient reviews per week. There is some capacity to develop an additional small out-patient caseload of about two patients per week.

The post holder will be professionally responsible to the Medical Director, and clinically accountable to the Divisional Director of Support Services.

DUTIES AND RESPONSBILITES

Clinical sessions (4.0 PAs)

• The post holder will manage his/her share of the clinical workload and be responsible for onward referrals and clinical care.
• He/she would work in collaboration with the consultant psychiatrists and provide advice and clinical guidance to the full team.
• 2.0 fixed sessions are provided for the assessment of newly referred in-patients.
• 1.0 fixed session is provided for priority out-patient/day-patient referrals.
• 1.0 flexible session for MDT meetings, business meetings, and ad hoc in-patient reviews.
• Clinical administration and service management will include team meetings and MDT meetings, and supervision. The post holder would also participate in a number of additional strategy and governance groups and service development initiatives, if desired.
• In-patient referrals include adult (16 years and over) cancer patients who are registered as patients at the Trust. There is no upper age limit. Referrals are mainly received from within cancer teams at the Trust; these arise from a range of medical and surgical oncology consultants and their medical and nursing teams within the Trust, and some outlying cancer services in the Network. Specialist oncology nurses and Macmillan nurses also refer directly to the service. Referrals from the Cancer Network are currently restricted to patients who are already registered at the Trust for treatment or follow-up.
• Routine new patient appointments should be provided within 8 weeks of referral, wherever possible. Priority patients should be seen within 2 weeks. In-patient reviews are seen within 48 hours. Interim management advice would be given where appropriate. Patients considered to be at risk would be seen urgently or arrangements made for referral to appropriate local mental health services.
• There is considerable opportunity for using brief psychotherapies in in-patients and out-patients such as counselling and eye movement desensitisation and reprocessing, and medium-term individual therapy training could also be undertaken according to the post-holders expertise and interests

In patient referrals include patients with complex physical and psychological problems, the assessment of psychiatric disorder risk assessment, the management of acute and chronic confusional states, and the assessment of capacity where the usual oncology team is uncertain. Some patients are seen in the terminal phase of illness. The postholder will need to use the Mental Health Act very occasionally (approximately twice per year), and be familiar with prescribing and monitoring rapid tranquilisation for acute confusion (again, rarely required).

Hospital Liaison

Working relationships with the oncology teams, the supportive care team (for the management of both palliative and living with and beyond patients), allied health professionals, and specialist nurses are already well established in The Christie.

Responsibilities and Continuity of Care

• Onward referrals to local services due to risk of self harm would be made if care provision was not possible on site.
• There is currently no on-call requirement for this post. Emergency cover for the Christie is provided out of hours, at week-ends and on public holidays by the on-call psychiatry registrars at Wythenshawe Hospital. The post holder is not required to contribute to the Wythenshawe on-call rotas.
• Wherever possible, the two Trust psychiatry consultants would attempt to provide cover for each other during annual leave as appropriate.
• From time to time the consultant will supervise a psychiatry trainee wishing to spend one session per week with the Psycho-Oncology Service as a liaison psychiatry special interest attachment. There is also usually an F2 doctor attached to the team and clinical supervision of that doctor by the postholder would be expected.
• The post holder will assist in managing Good Medical Practice by engaging in continuing professional development and encouraging others to do so.
• NICE Guidelines and current Trust management guidelines will be used to develop psychological care pathways, referral guidelines and guidelines for antidepressant prescribing.

Qualifications

Essential

• Full GMC registration
• 4 years post FY2 as a minimum

Desirable

• Postgraduate degree
• MRCPsych or equivalent
• A minimum of 3 years of postgraduate training in psychiatry

Knowledge

Essential

• Eligible for Mental health Act Section 12(2) approval
• Diagnosis and treatment of mental illness in the general hospital setting or equivalent
• Knowledge and experience of facilitating complex assessment under Mental Capacity Act in the general hospital setting or equivalent

Desirable

• Completed Section 12 Approval Course
• Skills and experience in an oncology setting
• Experience in working with older persons

Skills

Essential

• Ability to work as a team worker with professional colleagues, both doctors, nurses and other health professionals
• Ability to offer leadership to MDTs

Desirable

• Skills in psychodynamic psychotherapy or other psychological therapies
• Interest and/or skills in specialist areas relevant to cancer and palliative care

Teaching

Essential

• Experience of teaching medical and other staff
• Ability to assist with in-service training

Desirable

• Interest in teaching postgraduate staff
• Ability to help develop and implement educational initiatives in psychological care

Reaserch

Essential

• Ability to undertake audit and/or research

Desirable

• Published research

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).