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Job Title: Consultant Psychiatrist, Merton Home Treatment Team Responsible to: Associate Medical Director for Sutton & Merton Services Base: Springfield Hospital, 61 Glenburnie Road, London sw17 7DJ


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Job Description




Job Title: Consultant Psychiatrist, Merton Home Treatment Team
Responsible to: Associate Medical Director for Sutton & Merton Services
Base: Springfield Hospital, 61 Glenburnie Road, London SW17 7DJ

  1. Introduction

This is a full-time (10PA) Consultant post with clinical responsibilities in South West London and St George’s Mental Health NHS Trust Merton Home Treatment Team, based at Springfield Hospital. This is a new post arising out of a reconfiguration of adult services.



  1. The Trust



Background

South West London and St George’s Mental Health Trust was formed in 1998. Springfield Hospital in Tooting, the largest site from which the Trust operates, has provided mental health services since 1841.


The Trust was originally known as the Pathfinder NHS Trust in 1994 and provided services for Wandsworth and Merton. In subsequent years its strategy was to grow and to become the main statutory provider of mental health services for South West London.
The Trust took on Putney and Roehampton services in 1998, Sutton Mental Health Services from St Helier NHS Trust in 1999, and Kingston and Richmond services in 2001 as the former health authorities were disbanded and primary care trusts were established. Kingston and Richmond services were in financial deficit at the time, and there were serious concerns about the quality of older people’s services at Tolworth Hospital. The different histories of services in different boroughs have been reflected in service models, cultures and partnership arrangements.

Population
The Trust now serves a very diverse population of 1 million people in South West London, with a range of BME communities and socio economic groups. In general the population of SW London is more affluent than other sectors of London and many people in the boroughs served by the Trust are highly educated and assertive in demanding the services they want. We also know that there are also pockets of deprivation across south west London and service provision is therefore carefully attuned to the requirements of the population as a whole.
Vision
The Trust is clear about its purpose, vision and values and has been positively transforming its services and its relationship with stakeholders in recent years.
The Trust’s vision is “A future in which people with mental health problems have the same opportunity as other citizens to participate in and contribute to our communities.”
For more information on the Trust please view http://www.swlstg-tr.nhs.uk
Range of Services

South West London & St George’s Mental Health NHS Trust operates over 150 services from 96 locations in Kingston, Merton, Richmond, Sutton and Wandsworth providing:



    • Community mental health services for working age and older adults

    • Inpatient beds for the same client group

    • Day Hospitals and day services in some Boroughs

    • Psychiatric Intensive Care Units

    • Psychological Therapies in Primary Care

    • Child and Adolescent mental health services (tier 3 and 4)

    • Specialist community and inpatient services for people with both a Learning Disability and a mental health problem

    • Specialist community and inpatient addiction services

    • Partially integrated social care services under separate agreements with the five Borough councils

    • Specialist services which are provided to a wider number of PCTs:

    • Forensic services

    • Services for Deaf adults and children, both as inpatients and in the community

    • Eating Disorder services for both adults and Children / adolescents

    • Inpatient and community personality and adjustment disorder services

    • Mental Health services in Wandsworth Prison

    • Perinatal services

    • Mental Health inpatient services for people with a learning disability

    • Neuropsychiatry

    • Post Traumatic Stress disorder services


Future objectives
The Trust is here to serve people with mental health problems in ways which respond to their requirements and preferences while remaining aspirational and offering them the opportunity to live their lives to the full. The Trust achieves this by listening to service users and carers through extensive surveying and dialogue, and through an ongoing commitment to closer collaboration with partner agencies. The Trust is on an important journey from the isolated and discrete mental health services of the past to the new integrated service models of the future; combining mainstream services with deep rooted community life.
Whilst the Trust provides a range of excellent specialist services on a regional and national basis, success in the future will depend on the quality and effectiveness of its services, including specialist services for local people in SW London, whatever their age or circumstances. This is the focus of the Trust’s business.
For more information on Trust objectives please view: http://www.swlstg-tr.nhs.uk/about/aims_objectives.asp

Management of the Trust

The Trust is led by a Trust Board, which consists of the following people:


Mr John Rafferty Chairman

Professor Roger Horton Non Executive Director

Ms Elizabeth Owen Non Executive Director

Ms Susan Dark Non Executive Director

Mr Iain McCusker Non Executive Director

Ms Judy Wilson Chief Executive

Mr Mike Naylor Director of Finance

Ms Kim Goddard Director of Nursing & Operations

Dr Ben Nereli Medical Director

Mr Ian Fleming Director of Human Resources

Ms Maresa Ness Director of Service Improvement & Organisational Development

Mr Peter Cardell Director of Corporate Planning



Management posts within each Borough:

Mr Stuart Thomson Wandsworth Service Director

Ms Sue Denby Kingston & Richmond Service Director

Mr Mark Clenaghan Merton & Sutton Service Director

Ms Dawn Chamberlain Specialist Services Directorate

Associate Medical Directors (AMDs)


Dr Mark Potter Wandsworth & Specialist Services AMD

Dr Rosemary Ball Kingston & Richmond AMD

Dr Mari Harty Forensic AMD

Dr Diana Cassell CAMHS AMD

Dr Paul Dewsnap Merton & Sutton AMD

Dr Debbie Stinson Old Age & Learning Disabilities AMD


Professional Heads:
Dr Chris Gilleard Head of Psychology

Ms Kim Goddard Director of Nursing

Ms. Mary Morley Head of Occupational Therapy

Mr John Woolven Head of Pharmacy


Clinical leads:

Dr Jale Punter Named Doctor Child Protection

Vacant CAMHs

Dr Helen Miller Deaf Services

Vacant Addictions

Dr Stephen Miller Personality Disorders

Vacant Learning Disabilities

Dr Debbie Stinson/

Dr Sarah Turner/ Old Age

Ms Mary Mellor Associate Director of Nursing

Vacant Liaison Psychiatry

Vacant Eating Disorders


3. Sutton and Merton

The management structures within South West London and St George’s Mental Health NHS Trust was previously devolved to the five Boroughs within the Trust have recently been reviewed and combined in the neighbouring outer London boroughs of Sutton and Merton, which relate to a single Primary Care Trust. In addition to management of their local services though, the Sutton & Merton Directorate is currently responsible for the management of a number of specialist services operating throughout the Trust, which includes the Psychotherapy Service and Community Alcohol Team based at Springfield Hospital.


Sutton and Merton are neighbouring outer London Boroughs of similar size, with populations estimated to be approximately 180 000 in Sutton and 190 000 in Merton. Both are relatively prosperous by national standards. The Indices of Deprivation Survey 2007 ranked Sutton and 234th and Merton 222nd most deprived of the 354 boroughs in England. This relative prosperity masks areas of significant deprivation in both boroughs. Some 15% of the population of Sutton and 28% of the population are from Black and Minority Ethnic Groups.
3.1 The Consultants for the Sutton services are:
Adult:
Dr Stuart Adams

Dr Mark Blackwell

Dr Nora Gribbin

Dr Alistair Forrest

Dr Deborah Stephenson
Liaison:
Dr Jim Bolton
Addictions:

Prof Mohamed Abou-Saleh


Old Age:
Dr Debbie Stinson (AMD for Older Peoples Services)

Dr Fiona Stormont



Psychotherapy:

Dr Anthony Ang

Dr Sean Fernandez

Learning Disabilities:
Dr Asim Naeem
3.2 The Consultants for the Merton services are:
Adult:
Dr Paul Brain

Dr Paul Dewsnap (AMD Sutton and Merton)

Dr Louise Guest

Dr Michael Yates

Dr Nicola Omu
Addictions:
Dr Emma Whicher
Old Age:
Dr Yasmin Daghistani

Dr Rajen Shah


Psychotherapy:
Dr Patricia Hughes

Dr Stephen Miller

Dr Sarah Robertson
Learning Disabilities:
Dr Jeremy Bird
4. The Service
The Merton Home Treatment Team (MHTT) is one of five similar borough-based multidisciplinary

Home Treatment Teams within the Trust which operates 24 hours a day, seven days a week

throughout the year to offer rapid assessment of referrals from Primary or other Secondary Care Services of people who might otherwise require hospital admission and provide intensive time limited interventions until such time as the crisis situation has resolved, up to a usual maximum of about six weeks duration. The Team occupies a pivotal position within the acute care pathway with an explicit role in gate-keeping all admissions to the Merton acute inpatient wards which are at Springfield Hospital and in facilitating early discharge from those wards to continue treatment in a less restrictive environment.
The service primarily targets individuals with severe and enduring mental health problems who would meet the threshold for secondary care, some of whom will already be receiving longer term care from the Early Intervention, CMHT or Assertive Outreach Services. In addition as an extension of its urgent assessment function the Home Treatment provides a short term crisis support service for persons with common mental health problems under circumstances where there are concerns about associated risk issues
The Merton Home Treatment Team is managed by a Locality Manager and Deputy Locality Manager who also have responsibilities for the Merton Assertive Outreach Service. There are 5.8 wte Band 6 nurses and four Band 3-4 Support Time and Recovery Workers who work shifts to provide 24 hour cover. There are two Social Workers, who work 9-5.

.

5. The Post


5.1 Accountability

The post will be managerial and professionally responsible to the Sutton and Merton Associate Medical Director, Dr Paul Dewsnap.


5.2 The Role
The employer South West London & St George’s Mental Health NHS Trust (“the Trust”) whose main base is Springfield University Hospital. The post holder may also be eligible for an Honorary Consultant contract with St George’s Hospital and, an Honorary Senior Lectureship at St George’s, University of London. The Consultant will be eligible to apply, subject to educational approval, to train a Higher Specialist Trainee after one year as a Consultant.
The clinical sessions are within the Merton Home Treatment Team providing an acute assessment and short term treatment service for adults otherwise at risk of hospital admission within the London Borough of Merton. The Team is based at Springfield Hospital though clinical duties are largely carried out in service users’ own homes.
The Consultant will assume medical responsibility for all patients under the team and have a particular responsibility for ensuring effective assessment, planning and delivery of care and in prioritization of resources in conjunction with the Locality (Team) Manager.
It is a whole time post. There are10 Programmed Activities (PAs). 7.5 PAs for Direct Clinical Care (DCC) and 2.5 PAs for Supporting Professional Activities (SPAs).

5.3 The Key Responsibilities of the Post are:



  • Full participation in the multi-disciplinary team providing mental health services.







  • Taking a key role in inpatient bed management through gate-keeping in collaboration with the Inpatient Consultant.




  • Providing cross-cover for the Inpatient Consultant where necessary.




  • Assuming Consultant responsibility for patients while they are under the HTT



  • Participating in care-pathways meetings with Inpatient and other Merton Community Consultants.




  • Being an ambassador for the HTT externally.




  • Being involved in service development and any joint planning for Adult mental health services.




  • Line management and clinical and educational supervision of junior medical staff.


5.4 Indicative Job Plan
There are 10 Programmed Activities (PA’s). 7.5 PAs for Direct Clinical Care (DCC) and 2.5 PAs for Supporting Professional Activities (SPAs).
The nature of the clinical work is such that it is reactive rather than timetabled, but a regular fixed commitment is the daily HTT clinical feedback review and zoning meetings.

AM PM

Monday


HTT clinical duties

Supervision


2 weekly Sutton & Merton Consultants’ Meeting

HTT Clinical Meeting





Tuesday

HTT clinical duties
Teaching

Monthly HTT Business Meeting

HTT Clinical Meeting





Wednesday

2 weekly Care Pathways Meeting

Monthly Adult Governance Meeting

Monthly Adult Business Meeting.

HTT Clinical Meeting


Thursday

HTT clinical duties

Academic Programme

HTT Clinical Meeting




Friday

HTT clinical duties

HTT Clinical Meeting

This timetable may be changed in consultation with the Associate Medical Director in accordance with the Job Plan and Trust Clinical Governance Procedures. It will be reviewed regularly and may be modified reflecting changing needs within the service.


The Consultant will take part in the Springfield Consultant on-call rota.
The consultant will also be expected to take on additional work with the Trust, taking part in various working groups and committees, usually at the request of either the Associate Medical Director or the Service Director for Sutton and Merton.
5.5 Supervision
The Consultant is responsible for supervising junior medical staff under his/her direction, and will commit one hour’s personal supervision weekly to each junior doctor in this respect.

A newly appointed Consultant will be eligible, after twelve months, to apply as an educational Supervisor for a Specialist Registrar.


5.6 Teaching
The Consultant will be expected to offer a teaching input to Specialist Registrars and Core Trainees and to medical undergraduates attached to the team.
5.7 Administration
The Post holder will be expected to attend Trust Medical staff Committee, which meets on a regular basis. Additionally he / she will be expected to accept where appropriate invitations to be a member of relevant committees where this is consistent with clinical commitments.
5.8 Clinical Governance
The Post holder will be expected to comply with the Trust and the Sutton and Merton Directorate Clinical Governance requirements and participate in related initiatives where appropriate. This will include participation in clinical audit and review of outcomes working towards achievement of national and local performance management targets, complying with risk management policies and participating in the appraisal process.

5.9 Appraisal

The Consultant will be expected to participate actively in annual appraisal with the Associate Medical Director



5.10 Continuing Professional Development

The Consultant will be expected to participate actively in CPD and maintain good standing with the Royal College for CPD. There are a number of local consultant CPD peer groups and educational events including the regular academic programmes.



5.11 Mentoring

All new Consultants will be offered mentoring. The Trust will provide a mentor if the Consultant wishes though some may wish to arrange external mentorship.


  1. St George’s, University of London

The Trust has a comprehensive training scheme for Core and Higher Specialist Trainees and enjoys a close relationship with St George’s, University of London, an independent School of the University of London.

SGUL, in association with St George’s Hospital, is one of five general combined undergraduate/postgraduate teaching complexes within the Faculty of Medicine, University of London. During the 1970s, long-term plans to relocate the Medical School and the Teaching Hospital in Tooting were put into effect. The new Medical School opened in October 1976 admitting pre-clinical students for the first time. The Medical course now has an entry of 190 undergraduate students per year, plus 70 graduate students on the Graduate Entry Programme. Since 1995, the range of courses offered has expanded to include Biomedical Sciences and, in conjunction with Kingston University, Nursing, Midwifery, Physiotherapy and Social Work. SGUL has a strong focus on research with world class teams particularly in Infectious Diseases and Epidemiology. In 2006, a new initiative, the South West London Academic Network, SWAN, was announced to further research and teaching collaborations with Kingston University and Royal Holloway, University of London.

    1. Division of Mental Health

The Division of Mental Health comprises major research groups in community psychiatry, eating disorders, forensic psychiatry and personality disorders, plus further groupings in child and adolescent psychiatry, the psychiatry of addictive behaviour and disability. There are further academic posts in the psychiatry of old age which are placed in the Division of Developmental Sciences. In all, psychiatry represents a major specialty within the School.



    1. Training

The Trust has a comprehensive training scheme for SHOs and SPRs, which includes placements in Broadmoor hospital and enjoys a close relationship with St George’s Hospital Medical School.


7. Conditions of Service

The post will be offered under the terms and conditions of service for Consultants [England] 2003.


7.1 Salary
The Consultant salary scale commences on £74,504 rising through pay thresholds to a maximum of £100,446. Part-time Consultants are paid pro rata, based on the number of agreed weekly Programmed Activities. The starting salary will be determined in accordance with the Medical & Dental Whitley Council Terms and Conditions for Consultants, Schedule 14. An on-call availability supplement will be payable at the rate of Category A (3%) in reflection of the low frequency rota.
The Trust is entitled at any time to deduct from the post-holder’s salary, or any other monies payable to the post-holder by the Trust, any overpayment of salary or wages, under-deduction of charges, over-payment of holiday entitlement or any other sum which the post-holder may owe to the Trust and, if this is insufficient, the Trust may require payment of the balance.
Appointees expressing an interest in a part time post to undertake private practice will normally be expected to hold a 6 programmed activity [PA] contract.
Any offer of appointment to the post will be subject to the receipt of three references which are satisfactory to the Trust, confirmation by the Occupational Health Department that the pre-employment health screening is acceptable and immunisation against infectious diseases as may be required.

7.2 Review of Job Description

This job description, together with the job plan, will be reviewed annually and agreed with the Chief Executive and Medical Director, as appropriate; to ensure that it continually reflects the areas of work, clinical responsibility of the post and purchaser requirements.


7.3 Confidentiality
All employees and honorary appointees are required to exercise discretion and maintain confidentiality at all times.
7.4 Conflict of Interest
All applicants to any post within the Trust are required to declare any involvement directly with any firm, company or organisation, which has a contract with the Trust. Failure to do so may result in an application being rejected or, if discovered after appointment that such information has been withheld, this may lead to dismissal.
7.5 Criminal Record
In view of the nature of the work this post is exempt from the provision of Section 4 (2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exemption order 1975). Applicants are, therefore, not entitled to withhold information about convictions including those which for other purposes are “spent” under the provisions of the Act. You are, therefore, required to declare any pending prosecutions or convictions you may have, even if they would otherwise be regarded as “spent” under this Action and any cautions. In the event of employment, failure to disclose such convictions could result in dismissal or disciplinary action by the Authority. Any information given will be completely confidential and will be considered only in relation to an application for positions to which the order applies.
The Trust aims to promote equality of opportunity for all with the right mix of talent, skills and potential and welcomes applications from diverse candidates. Criminal records will be taken into account for recruitment purposes only when the conviction is relevant. As the Trust meets the requirements in respect of exempted questions under the Rehabilitation of Offenders Act 1974, all applicants who are offered employment, will be subject to an ‘enhanced’ criminal record check from the Criminal Records Bureau before the appointment is confirmed. This will include details of cautions, reprimands or final warnings, as well as convictions. The post you are applying for will require such a check.
The disclosure of a criminal record, or other information, will not debar you from appointment unless the selection panel considers that the conviction renders you unsuitable for appointment. In making the decision the Trust will consider the nature of the offence, how long ago and what age you were when it was committed and any other factors which may be relevant, including appropriate considerations in relation to the Trust’s published Equal Opportunities Policy.
Failure to declare a conviction, caution or bind-over may, however, disqualify you from appointment, or result in summary dismissal/disciplinary action if the discrepancy comes to light. If you would like to discuss what effect any conviction you have might have on your application, in confidence, for advice, please contact a Senior Officer in the Human Resources Department.
7.6 Data Protection
In accordance with the Data Protection Act (1998), the Trust is authorised, if required to do so, to obtain, process and/or use information held on a computer in a fair and lawful way. The Trust is authorised to hold data only for the specific registered purpose and not to use or disclose it in anyway incompatible with such purpose. It is further authorised to disclose data only to authorised organisations as instructed.
7.7 Equal Opportunities
It is the aim of the Trust to ensure that no applicant or employee receives less favourable treatment on grounds of sex, race, colour, nationality, disability or sexuality and is not disadvantaged by conditions or requirements which cannot be shown to be justifiable. To this end, the Trust has an Equal Opportunities Policy and it is for each employee to contribute to its success.
7.8 Health and Safety
Employees must be aware of the responsibilities placed on them under the Health and Safety at Work Act (1974), to ensure that agreed safety procedures are carried out to maintain a safe environment for employees, patients and visitors. The Trust also operates a No Smoking Policy, which does not allow smoking at work other than in a designated area.

7.9 Personal Property
The Trust cannot accept liability for loss or damage to personal property on official premises by burglary, fire, theft or otherwise. Staff are advised to provide their own insurance cover.


8 Person Specification





Criteria

Essential

Desirable



Qualifications

  • Primary Medical degree.

  • Full GMC registration.

  • MRCPsych or equivalent.

  • Included on the GMCs Specialist Register or eligible for such inclusion.

  • Specialist Registrars within three months of completing their CCSTs.

  • Section 12 (2) approval of the Mental Health Act or be willing to apply for such approval once in post.




Knowledge: Critical Expertise in Specialty

  • Completed minimum of three years full time training in approved higher psychiatric training scheme.

  • A detailed knowledge of the Mental Health Act, the functions of the Mental Health Review Tribunals and Hospital Managers' Hearings






Ability to enhance specialty of mental health care provided

Management/Audit

  • Commitment to developing practice through clinical audit

  • Experience of service planning




Research and Publications

  • Evidence of participation in Research.


Completed a research project

Publication of research




Teaching

  • Experience of teaching undergraduate and postgraduate psychiatry






Personal Skills


  • Ability to provide strong clinical leadership.

  • Ability to communicate clearly and work

co-operatively in a multi- disciplinary

team


  • Ability to prioritize conflicting demands and flexibility to meet these demands.

  • Commitment to personal and service development.

  • Ability and manage and adapt to change

  • Willingness to supervise junior medical staff and staff from other disciplines.

  • Willingness to take on fair share of Trust-wide duties where necessary.






Personal

  • Able to participate in Consultants’ on-call rota.

  • Hold a driving licence and have access to a vehicle










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