HEKSS CHILD & ADOLESCENT PSYCHIATRY PROGRAMME - HST Trainee Job Description Job Title: HST TRAINEE Community Eating Disorders Child and National Post Number: Educational / Supervisor: Base: Hours of Work: Dr Shereen Haffejee, Consultant Psychiatrist Surrey Wide Eating Disorder Service for Children and Young People, Willow, St Ebba s South Entrance, Hook Road, Epsom KT19 8QJ 40 hours a week, Monday to Friday / on-call rota commitments Job Outline: Objectives of Placement: Education and Training: Research and Quality This is a post in a well-established and experienced Community Eating Disorders Team using NICE-concordant therapies to treat Children and Young People. You will work alongside an MDT, a Child Psychiatrist and an Adult Psychiatrist. There is an option to gain experience in other areas of CAMHS (neurodevelopmental disorders and LD) on request and depending on stage of training. Assess and Manage children and young people with Eating Disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, ARFID and Unspecified Eating Disorder Identify and treat co-morbid mental health problems Become familiar with the use of the Mental Health Act and Mental Capacity Act and how they apply to young people with Eating Disorders Individual supervision will be provided by the approved Supervisor who will provide clinical supervision for one hour every week. Ad hoc supervision about clinical matters will happen outside of this, for instance discussing a patient, but is not a substitute for protected teaching time. Experience in the assessment and clinical management of psychiatric emergencies is provided by on-call commitments. The Unit s teaching programme runs on Friday mornings and HSTs are encouraged to contribute by chairing trainee journal club and topic presentations and discussions thereafter. HSTs are encouraged to attend the Unit s Friday Academic Meeting between 09:15am to 1:30pm. with trainee case presentations and external speakers. HSTs are also encouraged to contribute to the induction of Foundation and GP doctors on rotation to Psychiatry, and assist with the training and development of Core trainees. Other teaching opportunities include participation in the wider HST training programme and team educational activities. HSTs are encouraged to attend the sector s Medical Advisory Committee (MAC) and management meetings. HSTs are invited to look at a variety of special interest options that are available. In order to achieve Psychotherapy competencies the HST will need to complete three SAPES during their training. One of these can be based on Balint group experience, the other two from conducting psychotherapeutic interventions relevant to their speciality. The HST should confirm that the interventions chosen meet the requirements for a SAPE by speaking to the Psychotherapy Tutor. HSTs are required to complete at least one audit in their area of practice and are encouraged to supervise trainees with audit. Study Leave is available within HEKSS Guidelines. Research opportunities are available under the supervision of the Trust s Medical Lead for Research and Development. Previous trainees have had the opportunity to
Improvement: Emergencies: publish their work in peer reviewed journals and present at national conferences. The junior doctor accepts that he / she will also perform duties in occasional emergencies and unforeseen circumstances at the request of the appropriate consultant in consultation, where practicable, with his colleagues, both senior and junior. Additional commitments are exceptions and juniors should not be required to undertake work of this kind for prolonged periods on a regular basis. The job description includes cover of normal annual and study leave of colleagues for whom the practitioner is expected to deputise during the normal run of his / her duties. INDICATIVE TIMETABLE Monday Tuesday Wednesday Thursday Friday a.m. p.m. Assessment Clinic reviews and administration as required Reviews and Administration as required Supervision Reviews and administration Parents Group or Consultants Meeting or reviews and administration as required. Reviews and administration Assessment Clinic ACADEMIC MEETING PROGRAMME/Team Meeting Local Academic Program/ and Reviews and administration Reviews and administration Supervisors Roles and Responsibilities: A named clinical supervisor oversees the trainee s clinical work throughout a placement. He or she gives feedback during the placement and leads in providing a review of the trainee s performance which contributes to the educational supervisor's report on determining if the trainee progresses to the next stage of their training. A named educational supervisor is responsible for the overall supervision and management of a trainee s development during a placement or series of placements. He or she helps the trainee to plan their training, achieve agreed learning outcomes and brings together all relevant evidence to determine if the trainee progresses to the next stage of their training. Although these two roles are distinct they may be the same person, Core Trainees and HSTs usually have an educational supervisor who is also the clinical supervisor. GP trainees and foundation trainees usually have a separate educational supervisor. Expectations for supervision: This job description briefly describes the training placement and outlines a timetable which includes an identified time for supervision. This should be one hour per week and is protected teaching time. This should be one-to-one with your supervisor but may be delivered in a group with other trainees that your supervisor is responsible for. Ad hoc supervision about clinical matters will happen outside of this, for instance discussing a patient, but is not a substitute for protected teaching time. Please contact your locality tutor if supervision is not happening as per the guidelines above. HST Child & Psychiatry Curriculum 2015 - Placement Matrix The following table provides an indication as to what extent the HST syllabus areas may be met during a specific placement.
Key: None of the syllabus areas should be expected to be met in this placement To some extent/limited opportunity (please note that this may be positive or negative e.g. positive in that you may be able to experience this outcome) To a great extent/ample opportunities Good Medical Practice Domain ILO1 : Professionalism for Child and Psychiatrist ILO2: Establishing and maintaining therapeutic relationships with children, adolescents and families ILO3: Safeguarding Children ILO4: Undertake clinical assessment of children and young people with mental health problems across the age range Intended Learning outcomes Specific opportunities Expect to achieve 1.1 Practices Child & Psychiatry in a professional and ethical manner 1.2 Child and Family centred practice: The needs of the child are central to the child psychiatrist s practice, taking into account and balancing their views and those of their carers 1.3 Understands the impact of stigma and other barriers to accessing mental health services 1.4 The child and adolescent Psychiatrist works with colleagues in the multidisciplinary team and between agencies to achieve the best outcome possible for their patients 2.1 Builds trust and respect 2.2 Advise on young people s confidentiality, competence (capacity) to make treatment decisions, and consent and refuse treatment 3.1 Detects alterations in children s development that might suggest the child has been maltreated or neglected 3.2 Works with the family and professional network to clarify and manage safeguarding 4.1 History taking and interviewing using developmental approach:- From parents From child under 5 From primary school age child From young people in adolescence 4.2 Physical examination of children across the age range 4.3 Use of appropriate rating scales / questionnaires/ instruments 4.4 Seeking information from available outside sources 4.5 Diagnosis formulation and feedback of assessment and management plan to parents and child or young person Mental Health Act assessments Assessments and outpatient clinics -Assessments in particular Mental Health Act assessments Liaison with Schools 4.6 Note-keeping and clinical
correspondence Mental Health Act assessments ILO5: Main Conditions (including Axis I diagnoses) in Childhood and Adolescence ILO6: Managing Emergencies ILO7: Paediatric Psychopharmac ology ILO8: Psychological Therapies in Child and Psychiatry ILO9: Inpatient and day-patient Child and Psychiatry ILO10: Management ILO for all ST4-6 CAP 5.1 Assesses and manage the main clinical conditions presenting in the under 5s 5.2 Assesses and manage the main clinical diagnoses presenting in the preadolescent, school aged child or continuing from under 5s 5.3 Assesses and manage the main clinical diagnoses in adolescence (commencing in adolescence or continuing from childhood) includes transition to Adult Mental Health Services 6.1 Assessment and management of psychiatric emergencies 6.2 Management of young people presenting with risk in an emergency 6.3 Use of relevant legal frameworks for children and adolescents presenting in an emergency 7.1 To recognise the indications for drug treatment in children and young people 7.2 Able to explain the risks and benefits and develop treatment recording keeping in the form of system one entries Letters/ Communications to GPs and other agencies Mental Health Act Assessments Urgent Assessments Mental Health Act Assessments Mental Health Act Assessments decisions collaboratively 7.3 Able to prescribe safely 8.1 Ability to assess suitability of children, adolescents and families for psychological therapy 8.2 Ability to refer appropriately and monitor progress of child and adolescent patients in therapy 8.3 Ability to deliver therapy to child and adolescent patients and families 9.1 Manages children/young people with severe/complex mental health problems in inpatient or day-patient setting 9.2 Provides day to day medical leadership for an inpatient or daypatient multi- disciplinary team 9.3 Understands the legal frameworks in use in an inpatient or day- patient setting 9.4 Manages the physical wellbeing of children/ young people in an inpatient or day patient setting 10.1 Managing risk
trainees ILO11: Teaching, Supervision & lifelong learning skills ILO12: Research and scholarship 10.2 Evidence based Practice 10.3 Applying good practice standards 10.4 Involving service users Service Development Days 10.5 Audit Opportunity to complete an audit facilitated by supervisor 11.1 Is able to organise and deliver teaching sessions in a variety of formats 11.2 Can complete a structured assessment of another s performance and deliver constructive feedback 11.3 Can supervise another s clinical work 12.1 Able to find and analyse research carried out by others Academic program-local and CAMHS Opportunity to do this with CT2 Opportunity to do this with CT2 Opportunity to engage in journal club Research opportunities available through supervisor or research department 12.2 Can generate original research Attend Annual Trust Research Day Opportunity to engage in journal club Research opportunities available through supervisor or research department Attend Annual Trust Research Day 12.3 To disseminate findings Opportunity to engage in journal club Research opportunities available through supervisor or research department ILO13: Assessment and Treatment in Child and Neuropsychiatry ILO14: Psychiatric management of 13.1 To be able to assess and treat the psychiatric and behavioural consequences, associations, and learning complications of acquired brain injury and progressive neurological disorder 13.2 To be able to diagnose and treat neuropsychiatric disorders such as ADHD, Tic Disorders, Tourette Syndrome, and OCD 13.3 To be able to carry out an assessment of an individual with autism spectrum disorder 13.4 To be able to contribute to the management plan of an individual with autism spectrum disorder including use of psychotherapeutic and psychopharmacological interventions 13.5 To be able to contribute to the management of neuroepileptic conditions 14.1 To be able to undertake a developmental assessment of child to make a diagnosis of Attend Annual Trust Research Day Limited role in this post-likely recognition and referral to appropriate team Limited role in this post-likely recognition and referral to appropriate team Limited role in this post-likely recognition and referral to appropriate team
children and adolescents with learning disabilities ILO15: Intended Learning Objective: Paediatric Liaison ILO16: Medico- Legal Aspect of Child & Psychiatry ILO17: Substance misuse learning disability and assess associated comorbid conditions 14.2 To be able to take part in a multidisciplinary assessment of a child with learning disability and associated mental health disorder and to formulate, implement and coordinate a multidisciplinary assessment and treatment plan 14.3 To be able to liaise with colleagues and other child health professionals in associated agencies to provide advice about assessment, diagnosis and management of children with learning disability and associated mental health problems 14.4 To be able to advise the courts/legal process in relation to children with learning disability 15.1 To be able to advise on the presentation of psychiatric disorder in the context of physical illness 15.2 To be able to assess and manage cases of self-harm, delirium and other psychiatric emergencies that present in the A&E department or on the ward 15.3 To be able to assess and manage somatising disorders including impairing functional or unexplained medical symptoms 15.4 To be able to provide a liaison/consultation service to the paediatric team 16.1 Prepare reports for the family courts 16.2 Preparing reports for the criminal courts in child and adolescent mental health cases 16.3 Attend court and present evidence 17.1 Carries out screening for drug/alcohol misuse in young people presenting with other difficulties 17.2 Deploys a range of techniques explicitly directed at securing engagement in young people with substance use disorders. 17.3 Carries out detailed, developmentally-sensitive assessments of drug/alcohol use in young people to determine the presence or absence of substance misuse, and to assess its impact, and contributory factors 17.4 Takes part in multidisciplinary/ multi-agency assessments of children/adolescents with comorbidity (co- occurring substance misuse and a psychiatric disorder) in order to Sessions can be arranged with LD team if requested In CAMHS but sessions can be arranged with LD team if requested In specific circumstances only
ILO18: Transition to Adult Mental Health Care ILO19: Public Mental Health ILO20: Advanced Management and Leadership formulate, implement and coordinate a multi-agency intervention plan 17.5 Delivers integrated interventions for young people and their families with substance abuse or dependence to meet the young person s multiple needs 17.6 Contributes to the development of specialist psychiatric substance misuse services for children/adolescents 18.1 To assist young people with enduring mental health problems engage with adult mental health services Transition to Adult ED service CPAs 19.1 Knowledge of the findings of Training programme epidemiological research studies 19.2 Understanding of the Training programme interaction between wider social determinants and mental wellbeing 19.3 An awareness of the use of Training programme population screening 19.4 Promotes mental well- being Out patient Clinics and prevention of mental illness, including liaison with media 19.5 Understanding of the impact Out patient Clinics of stigma and other barriers to accessing mental health services Training programme 19.6 Understanding of the link Out patient Clinics between good emotional health and quality of life Training programme 19.7 Understands early Out patient Clinics intervention and economic evaluations Training programme 20.1 Business and Finance Shadow and attend relevant Trust meeting 20.2 Handling complaints Shadow and attend relevant Trust meeting 20.3 Analysing and Monitoring Shadow and attend relevant Trust meeting Outcomes 20.4 Leadership within an organisation Shadow and attend relevant Trust meeting