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CORE PSYCHIATRIC TRAINING AT THE SEVERN DEANERY

The Severn Deanery is committed to providing high quality medical training across Avon, Gloucestershire, Somerset and Wiltshire. The Postgraduate Dean is Professor Davinder Sandhu. The Head of the Severn Graduate School of Psychiatry is Dr Brian Robinson. The Core Training Programme Director is Dr Linda Heaney. Psychiatric Training is managed by the Severn School of Psychiatry working in close partnership with the Royal College of Psychiatrists and 5 NHS Trusts across the Deanery area. All the posts within the Severn School of Psychiatry have been approved by PMETB. 

There are 64 training placements available for Trainees in the Core Psychiatric Training Programme, including 3 Academic Clinical Fellow posts. The scheme offers a wide variety of training posts and is designed to facilitate the transfer from Core to Advanced training. Each post lasts for six months.

 

For the first two years, trainees are placed in a ‘subrotation’ in a defined geographical area, with a Tutor allocated to each area. During these first two years, there is an emphasis on general adult and old age psychiatry including a broad range of community based psychiatry and developmental psychiatry. Each post lasts for six months.

 

The CT3 year is focused around specialist psychiatric training, including experience in Forensic Psychiatry, Learning Disability Psychiatry, Child & Adolescent Psychiatry, Addiction Psychiatry, Psychotherapy, Liaison Psychiatry, Rehabilitation Psychiatry and Neuropsychiatry. During their final Core Training year, trainees are also expected to spend one session per week in a ‘special interest’ session, in order to broaden their experience of the specialities.

  

All Trainees receive one hour of protected supervision with their Educational Supervisor. There is a weekly academic meeting in all centres across the Core Training Programme. All Core Trainees have access to psychotherapy training, including attendance at a Balint Group. . All Core Trainees are expected to attend an approved MRCPsych Course. All Trainees’ timetables are designed to allow them guaranteed access to the MRCPsych Courses and study leave support and expenses are available. There is training available in the OSCE component of the MRCPsych membership exam. In each post Trainees are encouraged to take part in multi-disciplinary clinical audit and will receive support from their Educational Supervisor to do so. The Core Trainees are expected to develop their own skills as medical teachers and the local academic programmes will allow them opportunities to develop these skills with support.

CONTACT DETAILS FOR CORE TRAINING PROGRAMME DIRECTOR

Dr Linda Heaney
Linda.heaney@awp.nhs.uk

 

 

 
 
 
 
 


APPRAISAL PROCESSES

All trainees will be appraised throughout their core training. A full guide to these processes is available in the attached document:



CORE PSYCHIATRY TRAINING COURSE

All trainees are expected to attend a Core Psychiatry Training course, which is run by the School of Psychiatry. This takes place on Thursdays and is held at the Deanery buildings. The course closely follows the Curriculum, and is designed primarily to give trainees a solid grounding in psychiatry, as well as helping to prepare for MRCPsych exams. The Course Co-ordinator is Dr Sian Hughes.


Please follow link:

http://psychiatry.severndeanery.org/core_specialist_training/core_psychiatry_training_course

 
 
 
 
 

A GUIDE TO CORE TRAINING

A powerpoint presentation created  for 26th August 2009 (the School Welcome Day) to summarise an overview of the training programme in Severn and the training experienices required over the three years for completion of training. This includes a brief guide to posts and rotations, psychotherapy experience, work based assesments and ARCP. For further information on ARCP see the ARCP page with a comprehensive powerpoint presentation:

 


A NATIONAL GUIDE TO TRAINING

 
Please find below the OP69 Document (Published Jan 2010):-

It provides guidence on the standards for psychiatric training that the Royal College of Psychiatrists recommends, and so the guide may be used to support the Quality Assurance of psychiatric training. It is not intended to cover every detail and aspect of training but it sets out standards as they apply across all psychiatric training.  This guide has been written to provide an overview of postgraduate training in psychiatry.

The guide is intended to outline the process of training for a doctor in training in psychiatry and so assist them in meeting the requirements of the Curriculum. This replaces OP65.

Download:

 
 
 
 
 

CORE PSYCHIATRY TRAINING

CORE PSYCHIATRIC TRAINING IN SOMERSET

Somerset Partnership NHS & Social Care Trust provides social and health care for the rural county population requiring secondary psychiatric services. These services are concentrated in the 4 main centres of population, i.e., Wells, Bridgwater, Yeovil and Taunton. The majority of services are provided by generic Child & Adolescent, Adult or Elderly Community Teams. There are also specialist teams including Enhanced Community Support, Eating Disorders, Early Intervention in Psychosis and Forensic, some of which are provided on a County-wide basis.   The buildings are generally modern, pleasant and purpose-built. 

Relationships between senior and junior medical staff are generally excellent. Throughout the County we have 2 F2 Doctors, 5 VTS Trainees and 9 Core Trainees. Currently there are also 4 or 5 Advanced Trainees.

General adult posts will vary in the proportion of time spent on the wards and with specialist teams, allowing more senior trainees to work increasingly independently.

Psychological therapies are well developed in the Trust and trainees will attend regular Balint group and have supervision in long and short cases in the main modules. There are 2 specialist addiction Consultants who will be able to provide training, probably on a sessional basis. 

Currently for on-call purposes the County is divided into West and East. Both rotas are approximately 1:10 and cover inpatients in the Trust’s units and also carry out assessments at the two General Hospitals (Musgrove Park in Taunton and Yeovil District Hospital in Yeovil).

Postgraduate Medical Education is provided on Monday mornings in various locations throughout the County.   This is an opportunity to hear expert speakers and also for Trainees to present cases or other matters of interest. Smaller Journal Clubs meet on a more local basis.  

In summary, Somerset can provide a wide experience of psychiatry and a pleasant environment in which to begin a psychiatric career.

The Junior Doctors Handbook (created by Core Trainee Dr Gareth Jarvis) is available below:

Somerset Junior Doctors Handbook

 

CORE PSYCHIATRIC TRAINING IN GLOUCESTERSHIRE

Core Training in Gloucestershire is provided by 2gether Partnership Trust., which provides mental health services for the 600,000 residents of Gloucestershire.

The Trust hosts 12 Core Trainees placements. The Trust also hosts 3 General Practice Vocational Training Scheme (GPVTS) trainees and 3 Foundation Year 2 (F2) trainees. Gloucestershire also has between 8 and 12 Specialist Registrars attached from the Deanery Advanced Professional Rotation in all specialties.

The Trust is divided into five clinical directorates: General Psychiatry, Old Age Psychiatry, Addiction Psychiatry, Child and Adolescent Psychiatry, and Learning Disability Psychiatry. Working Age Adults services are divided into three large localities: Gloucester and the Forest of Dean; Cheltenham, Tewkesbury and North Cotswolds; and Cirencester/Stroud. Older Age Psychiatry, Learning Disability and Child and Adolescent Psychiatry work in smaller multi-disciplinary community mental health teams. 

Working Age Services in Gloucestershire 

The inpatient unit for Working Age Adults is Wotton Lawn, in Gloucester, a modern purpose built unit with 72 beds. This includes a six bedded PICU and a ten bedded low secure unit (Montpellier Unit). There are four open wards, each of which relates to a specific locality. The community psychiatric services have been reorganised into 3 large localities with a variety of functional teams. Each locality has one Crisis Response Home Treatment Team (CRHTT), one Primary Care Assessment and Treatment Team (PCAT) and two Recovery Teams.

The Crisis Response Home Treatment Consultants also operate as the inpatient consultants and all inpatients apart from the patients of the Rehabilitation Service are managed by the CRHT consultants and teams. The Greyfriars Psychiatric Intensive Care Unit is based on this site. There is also a low secure ward on this site (Montpellier Unit) which is modern and purpose built.

Old Age Services in Gloucestershire

There are two wards on the Charlton Lane Centre site – a modern purpose built psychiatric unit. There are also three community inpatient units for older age patients in Stroud (Weavers Croft), Gloucester City (Holly House) and the Forest of Dean (Colliers Court). 

Specialist Substance Misuse Services in Gloucestershire 

The inpatient unit for Specialist Substance Misuse Services is also based at Charlton Lane Centre on Sezincote Ward.


CORE PSYCHIATRIC TRAINING IN BRISTOL

1. BLACKBERRY HILL HOSPITAL, BRISTOL

 Blackberry Hill Hospital is situated North East of Bristol, about five miles from the City Centre and about fifteen minutes drive away. It is within a mile of Frenchay Hospital which provides clinical support services and a range of medical and surgical specialties including neurosurgery, and a University Department for the Care of the Elderly. Current psychiatric services on the Blackberry Hill site includes Bristol Addictions Centre, Fromeside Clinic (Medium Secure Unit), Wickham House (High Dependency Rehabilitation Service), Elisabeth Casson House (Female PICU).. The ARC (Rehabilitation Day Service), Art Therapy, Psychology and Psychotherapy Departments are also based at Blackberry Hill Hospital. The Burden Centre is based at Frenchay Hospital. It is specialist neuro-psychiatry unit with expertise in the management of organic/neuropsychiatric conditions.

 

2. BRISTOL ROYAL INFIRMARY

This is a large District General Hospital in the centre of Bristol city. There is a well developed Psychiatric Liaison Service at the Bristol Royal Infirmary. There are two Consultant Psychiatrists and a multidisciplinary Team working with all specialties in the hospital, including the busy A&E department. There is a CT2/3 Liason post and CT2/3 on call rotas (1 in 7) for those working in some of the Bristol subspecialities.

 

3. CALLINGTON ROAD HOSPITAL, SOUTH BRISTOL

This is a new mental health hospital in Brislington, South Bristol, with a range of inpatient, high dependency, rehabilitation and therapies for adults and older adults. There are 65 beds in total. The general adult and older adult inpatient beds for the south and central sectors of Bristol are now located in this hospital. The hospital is placed at the centre of the community that it serves, and has close links with its community teams. The older adult service development on the site is specifically designed around the new elements of older adult care with ease of access for the inpatient units and close communication with specialty support services such as Occupational Therapy, Physiotherapy and Community Liaison. Specialist Rehabilitation In-patient Services are provided at 4 units across the city with 2 of these units at Callington Road Hospital. There are 4 Recovery Teams in South and Central Bristol and 2 Assertive Outreach Teams based in community centres. There are two Assessment and Intervention Teams also based in community centres. There is a centre for alcohol misuse at the Robert Smith Unit.

 

4. COSSHAM HOSPITAL, SOUTH GLOUCESTERSHIRE (BRISTOL ROTATION)

Cossham Hospital is located 2 miles from Blackberry Hill Hospital and provides a community base for an Adult Community Mental Health Team and the Psychiatry of Old Age Community Team, together with a multi-speciality out-patient service. There is also a local hospital Day Hospital for elderly people with mental illness.

 

5. SOUTHMEAD HOSPITAL, BRISTOL NORTH.
The Mental Health Unit at Southmead was opened in December 1992. At Southmead, there are now 66 general adult admission beds. The main out-patient clinic is at Gloucester House which is adjacent and also houses the twenty-four place Day Hospital. The population served by Southmead is divided for General Adult Psychiatry into several sectors across North Bristol and South Gloucestershire. Each area has working within it, a number of Community Mental Health Teams which aim to facilitate multi-disciplinary working. The coordinated approach requires that the medical staff are involved in Community Mental Health along with the other disciplines of Nursing, Occupational Therapy, Psychology, Social Work and Art Therapy. Community Psychiatry is being encouraged, but with close links to the strong hospital base. The Rehabilitation Service comprises a Community Rehabilitation inpatient unit (Blaise View) on the old Brentry Hospital site and a Community Rehabilitation Team, which supports patients with severe long term mental health problems in the community. There is a partnership with a local Community Housing Trust, which provides accommodation in five staffed houses in the community and also a 10 bedded rehabilitation hostel. There is also an Assertive Outreach Team based on the Brentry site. The Eating Disorder unit and the Mother and Baby unit are both based at the Southmead Hospital site.

The Department of Psychiatry of Old Age provides an active community-orientated service and all professional staff are encouraged to work as part of a multidisciplinary team, both in domiciliary assessments and support to families. There are close links with Housing, Social Services and Voluntary Agencies. The department has pioneered the development of Local Day Care for elderly people with psychiatric problems. There are six social support day centres and two day centres funded by the Trefgarne initiative to start with, Southmead having been designated a Demonstration District in the Psychiatry of Old Age. In-patient facilities are provided at the purpose built assessment unit (Avonmead) at Southmead Hospital, which provides 30 acute assessment beds in close proximity to a 25 place Day Hospital (Dorian Day Hospital). There are close links with the Department of Geriatric Medicine and General Psychiatry. In addition, there is a small Day Hospital and 12 in-patient beds at Thornbury Hospital. Out-patient clinics for the elderly are held at Gloucester House and Thornbury Health Centre.

CORE PSYCHIATRIC TRAINING IN DEVIZES, WILTSHIRE


GREEN LANE HOSPITAL

 

Green Lane Hospital was opened in 1995 and provides a modern, spacious, and light in-patient unit with individual rooms and private facilities for patients. The hospital is set in pleasant grounds on the outskirts of Devizes. The population served by the hospital, and extensive community services, is 310,000 - living in market towns and surrounding villages. There are three wards each with 21 beds. Imber and Avebury ward accommodate adult patients of working age whilst Silbury takes mainly elderly patients with functional illness. Also on the hospital campus there is a large administrative building which provides office space for doctors, managers and the local community mental health teams. There is also a doctors’ mess here.
Newly formed specialist Crisis and Home Treatment and Assertive Community Treatment teams have bases at the hospital site as does a specialist Drug and Alcohol team. Devizes shares a weekly academic programme with Bath during term time. Meetings alternate between the two sites. Community mental health teams are well established, multi-professional, and have integration of health and social services staffing. The teams have bases in, or close to, the market towns they serve. Services for the elderly have additional beds in hospital units in Trowbridge and Chippenham.


CORE PSYCHIATRIC TRAINING IN SWINDON, WILTSHIRE

Four General Adult Teams exist in Swindon and one in Kennet (the latter not being part of the training scheme). The four teams in Swindon have access to 36 beds at Sandalwood Court and the support services in Swindon. It is supported by the Rehabilitation In-patient Services (12 beds). A new Low Secure Forensic/Psychiatric Intensive Care Unit of 12 beds opened in April 2001. There are well developed Psychotherapy Services.

The Old Age Psychiatry Service in Swindon is currently managed jointly with Social Services. It manages over 1000 patients in the community, most in their own homes and works closely with residential care facilities. It has four wards on two sites – at the Victoria Hospital and Savernake Hospital, Marlborough. Two of these are for assessment (one functional and one dementia) and the other two respite and assessment. The Victoria Hospital also houses the Kingshill Dementia Research Unit which is an international renowned facility and offers many research opportunities. The Old Age service deals with all patients with dementia, irrespective of age and also has set up a Huntingdon’s Chorea and other neuro-degenerative disorder services with Clinical Psychologists.

 

 

CORE PSYCHIATRIC TRAINING IN WESTON-SUPERMARE

WESTON GENERAL HOSPITAL

Weston General Hospital was opened in 1986 on a green field site on the edge of Weston Super Mare between junction 21 and 22 on the M5. Psychiatric Inpatient Facilities are based in the Long Fox Unit, Weston General Hospital. There are community team bases in North Somerset and an 8 bedded Rehabilitation Unit in Locking. There is a postgraduate department and facilities within the Long Fox Unit. The unit has 50 beds which are divided between the acute needs of the elderly and adult patients. There is a busy A&E Department in Weston General Hospital and Liaison referrals are assessed from the General Wards.

 

 

CORE PSYCHIATRIC TRAINING IN BATH

BATH ROYAL UNITED HOSPITAL (Hillview)

In-Patient Services for adult patients with mental health problems in Bath and North East Somerset are located at Hillview Lodge in Bath. This is a modern purpose-built Psychiatric Unit which has the benefit for training of being based within the Royal United Hospital, the district general hospital serving Bath and the surrounding area. It has two wards, one with 23 beds, and the other with 6 high-dependency places; these also providing for patients over the age of 65 years with functional illness.  There are two Community Mental Health Teams serving adults of working age in Bath and North East Somerset, and these are multi-disciplinary and sectorised according to general practice populations. The Bath Team is based on the Royal United Hospital campus and the North East Somerset Team at Paulton Hospital just south of Bath. In addition, there are 3 specialist teams based at Hillview Lodge. The first is a dedicated Assertive Outreach Team which combines a Recovery Care Option and an Assertive Community Treatment Option looking at rehabilitation and difficult-to-engage patients. The second is the Crisis Resolution and Home Treatment Team which prevents admisssion and facilitates early discharge. The third is the Early Intervention Team which works with younger patients with a first episode of psychosis. Being within the district general hospital allows excellent opportunity for liaison psychiatry, with one of the consultants having responsibility for this.

 

There are two Community Mental Health Teams serving older adults in Bath and North East Somerset, the Bath Team being based on the Royal United Hospital campus and the North East Somerset Team at Midsomer Norton just south of Bath. A 20-bedded ward for patients with dementia is at St Martin’s Hospital, and there is a newly-created multi-disciplinary Therapies Team across the patch.

Child and Family Services are also based at Royal United Hospital, amd the AWP Research and Development Team is based at Hillview Lodge which can provide help and advice with research.


DEVELOPMENTAL SUB-SPECIATILY CORE TRAINING POSTS

1. LEARNING DISABILITY(LD)

 
There are 6 placements in Learning Disability across the Deanery area. The old Learning Disability Hospitals in the area have now been closed. Specialist Health Services are therefore community-based and are delivered through areas, which are conterminous with Council and Social Services boundaries. There are well established multi- disciplinary community learning disability teams (CLDT’s) in each sector. Most of the staff working in the CLDTs are now employed by their local Primary Care Trust. Community services have the back up of NHS facilities: Lansdowne House, Kingswood, Bristol (12 beds), Badgers Close, Longwell Green (Autism Unit), Robins Close, Brentry, Intensive Care Units (three 5 bedded houses), Constable and Peel Houses (Rehabilitation), and two modern purpose built community units in Gloucestershire, Westridge Assessment Unit in Stroud, and Hollybrook Rehabilitation / Challenging Behaviour Unit in Gloucester.

Clients are able to use services across boundaries where appropriate. Due to its size and reputation and approach to therapy, the service has been able to recruit a wide range of clinicians, and has an active and large team of Occupational Therapists, as well as a smaller group of Art and Music therapists. The services of Dance therapists, Drama therapists, Aromatherapists, and others are also used where it is felt appropriate. Many of the Community Teams can also call on the services of a Challenging Behaviour Support Team who provide intense inputs into the community with particular clients. A recently developed outreach team is now available to work with clients with learning disabilities and mental health problems.

In all posts, Trainees will be involved with outpatients through CLDT’s and there will be much opportunity for close working with other members of the multi disciplinary team which is coordinated through team meetings. There is close liaison and partnership working with residential homes, day centres and schools. They will also be involved with the care of inpatients in assessment and treatment unit, and possibly those in the longer stay community units.

 

 

2. CHILD AND ADOLESCENT (CAMHS)

There are 7 Child and Adolescent placements across the Deanery. Avon and Wiltshire. Placements are in community Child and Adolescent Mental Health Service (CAMHS) teams [Tier 3]. Community services are supported by more intensive specialist day or inpatient provision [Tier 4]: Riverside Adolescent Unit (UBHT, NBT, AWP); Children and Young People’s Service Day Unit (Bath); Marlborough Adolescent Unit (Swindon). Community team boundaries are coterminous with Primary Care Trusts’ localities and currently are not entirely coterminous with local authority boundaries, although plans are under way for this. 

Tier 3 CAMHS teams are multidisciplinary (MDTs) comprising of a range of professionals with specialist training/experience in child development [Tier 2], working independently at Tier 2 or together at Tier 3. MDTs comprise Child and Adolescent Psychiatrists, Clinical Psychologists, Community Psychiatric Nurses, Family Therapists, Individual Psychotherapists and a range of other creative therapists (Art/Drama). More recent developments are Primary Mental Health Specialist posts with responsibilities for a particular age range (infant; primary age; adolescent) and for consultation / liaison / support / teaching / training to Tier 1 professionals. Tier 1 professionals are all those people whose daily job routinely brings them into contact with children, eg: GPs, Paediatricians, Educational Psychologists, Teachers, Social Workers.

CAMHS have built up close working links with Community Child Health colleagues and routinely discuss / share care for complex, challenging children and young people with multiple diagnoses. CAMHS also work closely with schools and Social Services, discussing / observing / advising and working with children and families across a range of settings.

Trainees will be able to gain experience initially shadowing and subsequently working conjointly with those professionals comprising the multidisciplinary team. Assessments of children in school and at home will be an expected part of a trainee’s experience. There will be opportunities to gain specialist therapies experience via: attendance at Family Therapy Clinic; Individual Psychotherapy supervision; involvement in specialist group work. There will also be opportunities to shadow more experienced team members in consultation to a range of Tier 1 professionals.


 
 
 
Last updated at 10:11, 02 September 2010