Specialty Doctor in CAMHS
Specialty Doctor in Child & Adolescent Mental Health (CAMHS).
This is a newly created post to work on a new 13 bedded CAMHS Inpatient service. To include 9 General Adolescent beds and 4 Psychiatric Intensive Care beds.
We are seeking to appoint a Specialty Doctor to join our new CAMHS Inpatient team. You will be passionate about empowering young people and will work with them to co-design an inpatient service that responds to their needs and works collaboratively with their local community services.
The new service will open in September 2019 and will host 9 General Adolescent beds (including a High Dependency Area) and 4 Psychiatric Intensive Care beds and will deliver a progressive and innovative service model from a newly built state of the art building.
A clinical model which will be centred on the delivery of:
- A robust approach to assessment, formulation and the planning of treatment approaches which provide developmentally appropriate care attuned to the complex mental health needs of young people. The service will be provided in a high quality, safe environment which can manage and support both high levels of clinical risk and high levels of vulnerability. There will be a strong emphasis on evidence based treatment delivered by a comprehensive Multi-Disciplinary Team with a core team of expert psychiatry, psychology, therapists, education and nursing staff.
The unit will deliver an excellent standard of inpatient care working in partnership with the local community as well as being part of a wider network of agencies supporting the mental health and emotional wellbeing needs of young people and families. The service will step away from a system defined in terms of the services the organization provides (Tiered model) towards one that sees service provision as a whole system approach with the focus being on the desire to build upon individual and community strengths wherever possible and ensures that young people and their families are active decision makers in the process of choosing the right treatment approach.
The role of the Specialty Doctor will be to support the Consultant Psychiatrist/s to provide dedicated, high quality medical care and treatment for young people and their families presenting with a range of mental health issues and developmental trauma. The successful applicant will be supported by a clinical leadership team including a Consultant Psychologist and Clinical Lead.
The post holder will be interested in developing and delivering innovative interventions will have excellent skills in engaging with young people and will enjoy working as part of a MDT. Suitable candidates will have a good level of clinical skills in assessment and intervention, offering a ‘needs led’ service, utilizing shared decision making and drawing flexibly on a range of models, theories and approaches in their work with the support of the supervising Consultant.
Applicants should have the necessary experience in CAMHS and possess full registration with the GMC and Section 12(2) approval. As well as being able to assess and manage psychiatric emergencies and act independently applicants should also be skilled in the diagnosis and management of complex mental illness and in the management of complex mental health needs.
The unit will deliver an excellent standard of inpatient care (QNIC Compliant), working in partnership with the local community as well as being part of a wider network of agencies supporting the mental health and emotional wellbeing needs of young people and families within the four defined localities.
Hull and East Riding Community CAMHS teams operate using the principles of the Thrive framework and are part of a small National Community of Practice delivering this integrated, person centred and needs led approach (Thrive is an NHS Innovation Accelerator). We are also an established CYP Improving Access to Psychological Therapies (IAPT) site which empowers young people to take control of their care, establish their treatment goals and take all opportunities to improve their health. Taken together, these two approaches clearly evidence the value based, contemporary approach we take in working with young people and it is this ethos and philosophy we will bring to the new in patient service.
Hull and East Riding CAMHS Crisis team offer 24 hour assessment and intensive home support. The inpatient team will create a network of crisis support, working with all the CAMHS Crisis teams, in the geographical area, to create the least restrictive plans of care that manage risk and support the needs of the young people and reduce the need for a hospital admission. The service will build upon existing relationships with the North Lincolnshire and North East Lincolnshire CAMHS providers and will work alongside the community teams to provide care and treatment in the least restrictive setting for the least amount of time.
In the current geographical areas the community providers all deliver a service that step away from a system defined in terms of the services the organisation provides (Tiered model) towards one that sees service provision as a whole system approach with the focus being on the desire to build upon individual and community strengths wherever possible and ensures that young people and their families are active decision makers in the process of choosing the right approach.
The inpatient clinical model will build upon that thinking, working in partnership with the current community resource, offering a safe and containing environment to the most vulnerable young people, adding to the existing clinical formulation not rewriting it. This will allow established therapeutic relationships to continue which will achieve better and timelier outcomes for the young person.
Working collaboratively with the community services to develop comprehensive needs led packages of care, will allow the inpatient service to better predict the needs of young people and therefore will allow the service to plan the most efficient use of the inpatient provision. This will offer a change to how inpatient units are traditionally viewed, the service will advocate shared decision making and the idea of “step in and step out” rather than “step up and step down” this will help to change the perception of the service and encourage agencies to be truly invested in the whole care package and retain their ongoing responsibilities.
Referral to the inpatient service will come from the CAMHS community team and will be made in accordance with the NHS England national Guidance on the Referral and Access Assessment process for children and Young people into inpatient units. As part of the referral process an assessment review will take place jointly conducted by the community team and the inpatient team. The assessment reviews will take place either on the unit or in the community (Home, Place of Safety or Designated Health based Assessment area within local acute hospital). The assessment will clearly identify presenting issues, risk and expected outcomes and will include the start of a discharge plan of care. The inpatient team will work closely with the community systems to identify young people who may require support from the inpatient team.
The inpatient team will use a shared decision making approach, empowering the young person to take a lead role in their own care and to set clear and achievable goals building on their knowledge of what works for them. As a CYP-IAPT organisation the service will use a range of tools at regular intervals to review progress and to help set new goals.
With high levels of staff training and supervision, the service will ensure that the care planning offers the highest standard of evidence based intervention, in accordance with NICE Guidance. Not all interventions will be offered directly by the inpatient team, some will be provided by clinician’s in reaching from the community team. Interventions will include Cognitive Behavioural Therapy (CBT); Cognitive Analytical Therapy (CAT); Brief Dynamic interventions; Eye Movement Desensitisation reprocessing (EMDR) and group psychological therapies such as Mindfulness, Dialectical behavioural therapy (DBT), Mentalization-based therapy (MBT) and interpersonal relationships.
To further support young person’s complex needs and co-morbidity e.g. Eating Disorders and Neuro-Developmental disorders we have developed collaborative network with the other CAMHS inpatient providers in the Yorkshire and Humber region. The network will enable opportunities to share learning, examples of good practice and clinical expertise to meet the wide range of mental health needs.
HTFT provide Specialist Eating Disorder services to Hull and East Riding, the inpatient service will use that expertise to work with all community CAMHS providers to develop pathways that ensure transitions in and out of the service are seamless and that care planning is of the highest standard and reflects the most up to date research e.g. the Junior Marzipan guidance. The service will build on existing links with Paediatric services within the acute hospitals.
The new service will be part of the QNIC and the NAPICU organisations and will operate within their guidance.
In line with “Future in Mind” and to ensure successful transitions for young people and their families the inpatient service will build on existing, strong, relationships with CCG’s, Local Authorities and providers of children’s services to create shared understanding of the service model and how the Unit will enhance support for complex needs.
The service will operate as an addition to specialist support already in place for a young person and their family. Inpatient staff will work alongside community teams to add to the existing clinical formulation, providing enhanced levels of safety and containment; aiming at the shortest and least restrictive approach.
The inpatient service will work in partnership with the young person and community services to develop a shared understanding of need.
The traditional view of “step up/step down “to inpatient services will be replaced with “step in and step out”. Ensuring that community services work in partnership with YP’s and Inpatient staff to develop shared understanding of needs and to work towards agreed outcomes. This will enable a high level of community services engagement keeping the young person connected to who and what is important for their recovery; building resilience to prevent future admissions.
Early discharge planning will enable services to complete necessary assessments e.g. Completing Social Care Early Help Assessments by discharge to will ensure support is available at point of discharge preventing possible re-admission.
The inpatient service will be led by the Senior Leadership Team, which comprise of the Consultant Psychiatrist, Consultant Psychologist (Approved Clinician), Clinical Lead and the Ward Manager.
The Senior Leadership Team will be recruited in advance of the launch of the new service; this will allow them to be instrumental in the development of the service clinical model, lead in the recruitment of the rest of the Multi-disciplinary Team and Core Nursing Team and engage with key stakeholders, developing the pathways that will meet the needs of young people and will support their transitions in and out of the service.
The inpatient team will work as one; all clinicians will be trained to a high standard and be able to work within a General, PICU or High Dependency environment ensuring all staff will be able to support young people across the service and ensure efficient use of staffing resource.
Consultant Psychiatrist 1.60
Consultant Psychologist- Approved Clinician 1.0
Clinical Lead- Advanced Nurse Prescriber 1.00
Ward Manager (non-clinical) 1.00
Clinical Leads- Nursing 9.38
Staff nurses 11.72
Clinical Support Workers 23.44
Therapist- Band 7 1.00
Specialty Doctor (This post) 1.00
Social Worker 0.50
Occupational Therapy 0.60
Family Therapist 0.60
OT Assistant, Associate practitioner 3.52
Speech and Language Therapist 0.20
Paediatric Physiotherapist 0.20
Teacher Hull CC
Teaching Assistant Hull CC
Medical Secretary 1.00
Admin Assistant/Receptionist 2.00
Catering Staff (Split posts) 1.00
Cleaner (Split posts) 1.00
Caretaker-Across whole Campus site. 1.00
Expected number of referrals:
As a newly commissioned service, extensive mapping was completed by NHS England to understand the current bed occupancy rates for the 4 named geographical areas due to be supported by the new service (Hull, East Riding, North Lincolnshire and North East Lincolnshire). This informed the commissioning of the 13 beds - 9 General Adolescent and 4 Psychiatric Intensive care beds. The service will operate at 85% capacity which will allow the service to flex to meet the needs of the young people in the most appropriate environment.