Job Description and Learning Agreement

1) GENERAL INFORMATION

This part of the work schedule describes your post and training opportunities
and constitutes the job description and learning
2) JOB SUMMARY
This is a Specialist Trainee post in Old Age Psychiatry (ST4-6) based at:
 Liaison Psychiatry Departments at Royal Free Hospital.
 Older Adults Acute Care Pathway based within the Services for Ageing
and Mental Health (SAMH) Home Treatment Team (HTT) and RFH
TREAT service which is part of the Care of the Elderly Service at the RFH
2.1) The Trust
Camden & Islington NHS Foundation Trust was established on 1 st April 2008.
Previously (since 1st April 2002) it had been one of the first Mental Health and
Social Care Trusts in the country. The Trust is responsible for the provision of
in-patient and community mental health services within the London Boroughs
of Camden and Islington. This includes general adult mental health services
(including rehabilitation, EIS, AOT services), services for ageing and mental
health, people with learning disabilities and substance misuse services.
2.2) The Service

In the Liaison service at Royal Free hospital, there is an old age psychiatry
and general adult consultant session and liaison nurses contribute to this
service
The HTT is a multidisciplinary service working with patients over 75 or
dementia at any age, to prevent in-patient admission and facilitate discharge
from hospital. TREAT (triage rapid elderly assessment team) is a consultant
led front door service to promote and facilitate safe discharge from the
emergency department for complex and frail older patients.It is anticipated
that 2 sessions will be spent with HTT and 2 sessions with TREAT providing
senior psychiatric input and liaison to the HTT.
.
2.3) Professional relationships
Dr Matthew Hagger is the Old Age Psychiatry Consultant and Dr Nora
Turjanski is the general adult consultant. There is a full time CT, F1 doctor,
liaison nurses and specialty doctor. Dr Hagger will also provide consultant
supervision for the work in TREAT.
Dr Lucy Wright is the consultant in the Home Treatment Team. This is a
multidisciplinary team that works across both boroughs. You will have
secretarial support and office space with access to internet.
2.4) Clinical Supervision

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The Dr Hagger is your Named Clinical Supervisor with whom you will have a
weekly clinical supervision meeting. WPBAs will be done as part of clinical
supervision.
2.5) After-hours duty rotas
You will join the after hours full shift duty rota. This rota is 1 in 24 resident. It
covers Royal Free, UCLH and Whittington Hospitals as well as the mental
health beds. There are three, full shift, Core Trainee after hours rotas
covering either the Whittington, UCH or Royal Free Hospital A&Es and
associated services. There is support from the on call Consultants. There is
also support from the Liaison team and the Crisis Teams. You will be part of
the trust wide day time S12 rota

Typical weekly programme

NB, this programme is indicative only. It will vary in the light of your learning
needs and the needs of the clinical service.
Monday Tuesday Wednesday Thursday Friday
StR teaching
1xmonth
Liaison RFH

9am Handover
Special interest meeting HTT
Morning TREAT TREAT
/ research 10am
supervision
with Dr Hagger

Special interest
Afternoon RFH LIAISON HTT RFH liaison Liaison RFH
/ research

3) MAIN DUTIES AND RESPONSIBILITIES

The duties of the post, performance criteria and the learning opportunities
available are set out following the structure of the Psychiatry Specialty
Curriculum (as approved by PMETB, 2006), which in turn, is based on the
headings of the GMC’s Good Medical Practice.
3.1) Providing a good standard of practice and care
3.1.1 Undertake clinical assessment of patients with mental health problems
In HTT you will undertake new patient assessments and formulate
management plans. You will review patients as needed, often with team
members, and update their management plans. You will attend MDT
meetings. In liaison you will assess patients in A&E and on medical and
surgical wards. You will attend the morning handover meeting. You will
familiarise yourself with the Mental Health Act and Mental Capacity Act and
work within this legislation. You will adhere to Trust Policies. You will maintain
accurate, legible, contemporaneous and useful clinical records for all patients
in whose care you are involved. (ILO1, ILO2, ILO3, ILO4, ILO5, ILO6, ILO13,
ILO18)
3.1.2 Manage chronic illness

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A significant number of patients will be suffering from dementia and other long
term conditions and you will gain experience of managing them. (ILO7)
3.2) Decisions about access to care
3.2.1 Use the results of the clinical assessment to ensure effective patient
management
Under the supervision of a clinical supervisor, you will prescribe
pharmacological and psychosocial treatments for the patients that you are
working with. You will refer them promptly to other professionals, services and
organisations as required. (ILO2, ILO3)
3.3) Treatment in emergencies
3.3.1 Manage emergencies
During the course of your placement you will work in conjunction with fellow
members of the multidisciplinary team to manage emergencies which may
arise. Such management may involve an assessment as to whether physical
intervention is required in which case liaising with colleagues at A&E, Crisis
and Liaison Psychiatry teams may be necessary and arranging a bed either
within the acute general wards or a community alternative to in-patient bed.
You will be involved in Mental Health Act assessments.
You will see patients who require urgent psychiatric assessment when you do
after-hours duties, both in the A&E and the psychiatric wards. You will provide
supervision and advice to the junior doctor on call. You will be part of the trust
S12 daytime rota (ILO1, ILO2, ILO3, ILO4)
Maintaining good medical practice
3.4.1 Maintain and use systems to update knowledge and its application to
any aspect of your professional practice
During the placement you will follow the Psychiatry Specialty Curriculum and
maintain an up-to-date learning portfolio that you will bring to meetings with
the trainer when asked to do so. As a minimum, this will be at the beginning,
mid-term and the end of the placement.

You will participate in the Academic Programme at St Pancras Hospital

chairing a journal club
You will attend the higher trainee scheme monthly teaching
You will complete mandatory training.
You have a study leave allocation and should discuss relevant conferences
and courses with your supervisors in good time. (ILO8, ILO9)

Maintaining performance
3.5.1 Monitor and maintain professional performance
You will participate fully in the workplace-based assessment programme of
the Psychiatry Specialty Training Curriculum and will use the feedback that
you receive from this process to inform your critical self-awareness. You will
discuss every item of assessment with your trainer.
You have the opportunity to undertake one audit or quality improvement
project during the 12 months supervision. (ILO10, ILO11, ILO12)

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Teaching and training, appraising and assessing
3.6.1 Plan, deliver, and evaluate teaching & learning in a variety of
environments
You will participate in the teaching of medical students attached to the unit.
This will include assisting the ‘bedside’ teaching of junior and senior students
by helping identify and consent suitable patients for the students to see and
by helping the students develop their clinical skills by giving them
opportunities to present and discuss the patients they have seen. You will
facilitate medical students learning by taking them on home visits (with the
patient’s permission) and discussing the assessment with them. You will
provide teaching sessions to the students attached to the firm.
You may also have the opportunity to be involved in lecturing to clinical
medical students.
You will facilitate a medical student simulation teaching session. (ILO17)
3.6.2 Assess, appraise and evaluate learning and learners
You will evaluate your own learning and progress, using self-assessment
forms that you may retain in your learning portfolio. You will participate in the
assessment of others, including clinical medical students and colleagues
using multi-source feedback tools. (ILO12, ILO14)
3.1) Relationships with patients
3.7.1 Conduct professional patient relationships
Whenever possible, you will obtain informed consent from patients for whom
you provide treatment. You will observe patient confidentiality at all times.
When guided by your clinical supervisors, you should share information
appropriately with colleagues. Whenever possible, and especially towards the
end of the placement, you will inform your patients of the ending of your
relationship with them in a timely manner. (ILO19)
3.2) Dealing with problems in professional practice
3.8.1 Conduct or performance of colleagues
If you become aware of problems with the conduct or performance of a
colleague, you must bring this to the attention of a senior colleague.(ILO19)
3.8.2 Complaints and formal inquiries
You must always cooperate fully with any complaints procedure or formal
inquiry. (ILO19)
3.8.3 Providing assistance at inquiries and inquests
You must always cooperate fully with any formal inquiry or inquest into a
patient’s death. (ILO19)
3.8.4 Indemnity insurance
Early in the placement, you must discuss the provisions of the NHS indemnity
insurance with your Supervisor. (ILO19)
3.9) Working with colleagues

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3.9.1 Continuously promote value based non prejudicial practice
You must maintain a legal, ethical and fair approach toward working with
colleagues and respect diversity. (ILO14)
3.9.2 Work effectively as a member and a leader of multidisciplinary team
3.9.3 Demonstrate appropriate leadership
During this placement you will be a full member of the multidisciplinary teams
(MDT) and will attend their respective meetings. (ILO14, ILO15)
3.9.4 Communicate effectively with other healthcare professionals
You will keep clear, accurate and contemporaneous clinical records. You will
send regular written reports on patients to general practitioners and other
professionals involved in patient care. (ILO6, ILO13)
3.9.5 Appropriately assume, delegate and devolve responsibility for clinical
management where necessary, involving other MDT members.
3.9.6 Access advice, assistance and second opinion when delegating and
making referrals
Your Clinical Supervisor and other members of the multidisciplinary team will
give you guidance as to the level of responsibility you should assume in
individual clinical situations. If you are unsure, you must always obtain advice
and assistance. (ILO16, ILO19)
3.10) Maintaining probity
3.10.1 Ensure that reports, evidence and documents you have a responsibility
for are complete, honest and accurate.
You will write your patient assessments in a standard departmental manner.
You will make the necessary communications to colleagues within the acute
settings and external agencies, including GPs when appropriate and
necessary. (ILO6, ILO13)
3.10.2 Properly manage financial and commercial dealings
You must report receiving any gift from patients with your Supervisor and you
must not solicit any fee or payment from a patient or third party unless your
Supervisor has sanctioned this. You will not meet with any representatives of
the pharmaceutical industry during work time, unless this is at a postgraduate
meeting that has been organised within ABPI Guidelines. (ILO19)
3.10.3 Avoid conflicts of interest and advise others on preventing and dealing
with conflicts of interest
Inform your Supervisor of any real or potential conflict of interest you may
have. (ILO19)

3.11) Health
3.11.1 Ensure that your health and the health of others does not put patients
at risk
You must always obtain advice and treatment for mental and physical health
problems and must ensure that your health does not put patients at risk. You
must comply with the Trust’s Occupational Health policy. (ILO19)