Consultant Psychiatrist in Forensic Psychiatry

Job overview

This vacancy is for a Consultant Forensic Psychiatrist based with the specialist forensic community service at Hollins Park, Warrington.

The service provides inpatient forensic stepdown and community follow up to patients on the secure pathway. The post has been developed following an increase in female patients on the community caseload and the development of the Tennyson Unit into a dedicated inpatient female forensic stepdown service.

The postholder will lead the service provision for female patients across these services.

The post holder will have RC responsibility for the female forensic step-down unit (Tennyson) and community patients managed by the Specialist Community Forensic Team (SCFT).  They will lead the well-established MDT which works across both the inpatient and outpatient caseloads.  There is excellent support from a full-time specialty doctor and dedicated medical secretary.

The post holder will also lead on undertaking assessments for female patients referred to the service and will continue to develop links with secure services, the local authority and community services to further enhance the secure pathway provision for female patients.

Main duties of the job

The post holder with have statutory responsibilities as an RC.  All inpatients are detained under the MHA and the majority are detained under Section 37/41 of the Act.  In the community, patients are typically subject to a Conditional Discharge or a Community Treatment Order (CTO).

The post holder will lead the inpatient MDT and CPA meetings. Outpatient medical and CPA reviews will also be scheduled.  The post holder will contribute to the weekly SCFT MDT meeting and referrals and allocations meeting held jointly for forensic stepdown services and SCFT.  The postholder will provide medical oversight to the inreach caseload. The patients the SCFT are working with to support their discharge from hospital

Pre-tribunal, renewal of detention, pre-managers hearings, discharge planning and pre-discharge meetings and handover of care meetings will also be scheduled as required.  The post holder will also liaise closely with other agencies including the Ministry of Justice and MAPPA and complete statutory reports.

The general weekly timetable will involve attendance at ward round meetings, CPA reviews, SCFT caseload review meetings, allocations meetings to review new referrals, professionals’ meetings and assessments.  HCR20 / other risk management meetings, attendance at Tribunals, managers hearings and handover of care meetings will also be scheduled.

Detailed job description and main responsibilities

The inpatient forensic mental health service at the Hollins Park site, Winwick, Warrington has a 15 bedded male low secure unit (Marlowe unit), a 10 bedded male step-down service (Auden unit), a 16 bedded female low secure unit (Chesterton unit) and an 8 bedded female step-down service (Tennyson unit).  The low secure inpatient services are part of a wider network of low secure care across the Northwest region.  The male and female forensic step-down services support patients with more complex needs to gradually transition from secure inpatient settings into the community.

The Specialist Community Forensic Team (SCFT) is also based at the Hollins Park site and provides specialist forensic follow up and care coordination to patients who require intensive monitoring and support in the community following discharge from the secure pathway.  The team also manages the outpatients who reside at the Crosby Women’s Service, an enhanced 24 hour supported accommodation for women who have typically spent many years in inpatient secure services.  The SCFT works closely with the inpatient units to support discharge into the community and with local mental health teams to support patients to transition out of forensic services.

The AED and acute general hospital services are located at Warrington & Halton Hospital and Whiston Hospital. The Trust has a fully established Liaison Psychiatry team at both acute trusts, that can help the wards in managing patients transferred to the acute hospital.

There is a secure division physical health service that oversees physical health care provision to the inpatients.  This includes a weekly GP session and phlebotomy services.

The post holder will have both an inpatient and outpatient caseload.  The model of care on the Tennyson Unit allows the posts holder and wider MDT to have worked closely with patients as an inpatient before their discharge into the community under the SCFT.  The post holder will have RC responsibility for 8 inpatients on the Tennyson Unit, 6 outpatients at Stanley Road and 10 (+/-2) outpatients residing in the community.  Outpatients are typically reviewed in their own homes with CPA meetings taking place

The SCFT also carries a caseload of around 50 patients who the team are working with to support their discharge from hospital.  These are RAG rated depending on when discharge is planned and level of involvement (inreach working) with our team.  These patients are located in secure services across the Merseyside and Cheshire area.  The team will commence working with them 6-12 months ahead of discharge and have an active role in discharge planning discharge. The post holder will support the inreach working with the female patients who make up around 10% of the inreach caseload however such cases do tend to be more complex in nature requiring higher levels of assessment and input.

There is an average of approximately 1-2 referrals to the stepdown services and SCFT per week and 1 admission across the male and female step-down units every 2 months.  The postholder will be allocated new referrals for female patients for assessment.  There is an independent admission panel who oversee admissions to the stepdown beds and the postholder may be required to attend to discuss such cases.

In the community the postholder will work with patients to support them to move on to local mental health services when they no longer require intensive forensic follow up.  We have developed good links with the local CMHTs in Merseyside and Cheshire and put in place arrangements to work together jointly to gradually transition patients on from our service.  Decisions to move patients on are reviewed and agreed by the wider team.

The post holder will have statutory responsibilities as Responsible Clinician with regard to the Mental Health Act, reporting to the Ministry of Justice and implementing MAPPA arrangements.  The post-holder will be expected to work collaboratively with the MDT, commissioners, and other stakeholders.

There is also the opportunity to discuss complex cases and share learning across the catchment area with regular peer review meetings.

It is envisaged that the post holder will work 10 programmed activities over 5 days. Following appointment there will be a meeting at no later than three months with the clinical manager to review and revise the job plan and objectives of the post holder. The overall split of the programmed activities is 7.5 to be devoted to direct clinical care and 2.5 to supporting professional activities (as per the Royal College of Psychiatrists recommendation). The timetable is indicative only. A formal job plan will be agreed between the post holder and associate medical director or clinical manager three months after commencing the post and at least annually thereafter.  Applications for less than full time working are welcomed, and the job plan will reflect this.

There is a 1:16 forensic on-call rota which covers Ashworth Hospital (HSS), Rowan View (MSU), Aspen Wood (Learning Disability LSU), Auden Unit, Tennyson Unit and the SCFT.  Consultants are on-call out of hours for a week at time.  An on-call supplement of 1 % is applicable to this rota. (Category B low frequency).

There are forensic ST and CT on-call rotas covering across all the services.

Please see the full job description for further details.