Job Description

Duties and Responsibilities Communication and Working Relationship Skills Contribute to the teams engagement with a wide range of stakeholders including staff, service users, their carers and other statutory and voluntary sector agencies. Impart highly complex and sensitive information to: Patients and families/carers re assessment, care planning, treatment and review Multi disciplinary teams to ensure the provision of consistent well coordinated care Primary care teams regarding client care External agencies also involved in the provision of care e.g.: voluntary and private sector, police, social services, housing, employment etc Service user/carer groups Liaise with a wide range of other professionals and agencies. Contribute to the safe and effective day to day operations of the service including the handling of clinical enquires. Provide and receive information some of which may be contentious, sensitive and highly complex to and from individuals and their families/carers, where there may be barriers to understanding.

Provide a high standards of written and verbal communication that is clear and in line with professional documentation standards. Participate in and chair clinical meetings, this will include CPA and non-CPA reviews, professional meetings, and clinical risk meetings. Demonstrate the ability to communicate in a way that is empathic and reassuring whilst employing negotiating techniques to gain co-operation from highly complex individuals. Communicate information in a way that makes it relevant and understandable for service users and carers, working in line with practice standards and operational policies.

Facilitate fair access to social care services and promote social inclusion regardless of age, ethnicity, gender, sexual orientation or disability. To maintain effective verbal and written communication with the clinical team and to keep staff informed of changes to prescribing intervention or treatment provided to service-users. To work in partnership with medical staff and service-users in the development and implementation of clinical management plans related to an individuals treatment and prescribing needs. To establish and maintain good liaison with GP practices and other services in the area, including sharing prescribing information and rationale.

To liaise and work jointly with partnership agencies, service user and carer groups, with both the statutory and non-statutory sectors as appropriate. To develop joint working relationships with other services where needed. Analytical and Judgemental Skills Undertake and continuously re-evaluate complex bio-psycho-social assessments and develop a working formulation and diagnosis which will lead to the development of personalised care packages in line with evidence based and payment by results. Undertake recovery focussed care planning with individuals, their carers and their families which ensure that personalised recovery goals are identified and met.

Undertake complex risk assessments and develop a formulation of risk which will lead to the development of risk management plans which have taken into consideration a range of possible options. Ensure the continuous re-evaluation of individuals needs and clinical risk situations and use clinical judgement to formulate the most appropriate clinical plan. Planning and Organisational Skills Organise and facilitate complex meetings, these will include: CPA and non-CPA professional and risk meetings. Responsible for managing their own workload to ensure the needs to the individuals who use our services are met taking the wider needs of the team into consideration.

Ensure that interventions are planned in an integrated and co-ordinated manner particularly where dependent on other external agencies. Plan and organise individuals packages of care and ensure that reviews are held within the required time frames, for example Section 117, Funding Panels and CPA. Plan own workload and the workload of junior colleagues to ensure that care is provided in the most high quality and cost efficient manner, prioritise and make adjustments as appropriate. To be aware of the current legislation and prescribing developments that may impact on the delivery of services to service users.

Have a good knowledge, and apply current Trust Policies and associated Standard Operating Procedures Ensure that interventions are planned in an integrated and co-ordinated manner particularly where dependent on other external agencies.Responsibility for Patient/Client Care, Treatment and Therapy Ensure that caseload is well managed and that care and treatment is provided in line with practice standards and recovery co-ordination (CPA and non-CPA ). Develop and deliver care packages including assessing, planning, intervention and evaluation. Ensure that all interventions have clear outcomes and that these are taken into consideration when sourcing the resources to best meet the individuals needs. This will include enabling individuals to take up Direct Payments and offering the person as much choice and control of resources as appropriate.

Ensure that all social care packages are reviewed within the relevant timescales and focus on integration within existing community resources where possible. Deliver services using a recovery and strengths approach where the needs of the individual and their carers are held as central and their involvement is proactively encouraged. Deliver care in line with evidence based practice and employ engagement and therapeutic skills that are appropriate to the clinical situation presented. Responsibility for triaging individuals and signposting to the most appropriate services.

Provide specialist advice to referrers/other multi-disciplinary staff in relation to the care of individuals. Enable communication and engagement of individuals and their carers to ensure that they have a voice about the services they receive and how these are developed. This may include engagement of advocacy services. Ensure that appropriate action is taken to safeguarding adults and children.

This will include providing and receiving highly complex and sensitive information in relation to safeguarding adult and children work, co-ordinating and chairing safeguarding meetings and implementing relevant care plans. Ensure that assessment and treatment plans are holistic, outcome focused and take into account the physical health and social needs of the individual, including input of significant others. Ensure the monitoring and review of mental health medication taking into consideration interactions with physical health needs. Ensuring timely and accurate documentation of all clinical activity in line with professional guidance and best practice.

Practice in a way that actively minimises dependency and promotes recovery. Comply with the relevant Professional body Code of Conduct/ Royal Pharmaceutical Society Code of Ethics, relevant legislation, procedures and policies. To attend and contribute effectively to relevant professional forums. Responsibility for Policy and Service Development Implementation Participate in programmes of audit and research within the team as agreed by the Directorate and implement the findings.

Contribute to clinical governance arrangements in order to ensure the quality of the service provided, this will include ensuring performance targets are met to provide high quality care. Involvement in the development of local systems and process that ensure the implementation of Trust policies. Facilitate the multi-disciplinary teams knowledge of mental health and rehabilitation. Take appropriate action to encourage the professional development and positive therapeutic commitments on the part of health/social services and other agencies towards service users.

Responsibility for Finance, Equipment and Other Resources Prepare and oversee care panel applications ensuring that wider financial implications are taken into consideration. Ensure care is provided in the most cost-effective and high quality manner and identify unmet needs. Responsible for the safe use of any equipment. Responsibility for handling of monies and individuals valuables.

To contribute to financial governance through knowledge and appropriate resource management of allocated prescribing budget for service, in collaboration with clinical lead and medical colleagues. Responsibility for Human Resources, e.g. Supervision, Training, HR Advice and Management Provision of day to day and clinical supervision as allocated by line manager (this will include participation in the PDR process). Demonstrate and role model excellent clinical leadership skills.

Supervise the caseload and care provision of junior colleagues. Mentor students in line with professional requirements. Ensure that core training is maintained and that the training and development opportunities in line with the Directorates Workforce Plan are participated in to meet professional requirements. Ensure participation in the teams compliance with CQC standards through the participation in provider compliance assessment tools.

To provide advice and training to the team on issues related to mental health and rehabilitation. Responsibility for Information Resources and Administrative Duties Ensure information resources are used to maintain a knowledge of Trust, Directorate and Team priorities and safety initiatives. Maintain up to date clinical record in a timely and accurate manner. Ensure information is shared with key stakeholders and other agencies in a secure manner Ensure up to date relevant information is available to the team in relation to your registered speciality (mental health nursing, social work, occupational therapy) Work within operational policies and service specifications.

Work cooperatively with staff colleagues ensuring a no hands off approach Undertake any other reasonable management request.

Job Description

The Liaison Psychiatry Service provides a 24 hour, 7 day a week in and out of hours comprehensive service to patients, clinicians and carers at the local District General Hospital (DGH). This includes specialist mental health assessment and intervention to people of all ages from the age of 18 who present or, are admitted to the DGH. We provide a specialist consultation-liaison service to referring clinicians and clinical teams, assisting them in decision making in difficult and complex cases, and providing both formal and informal education to qualified and unqualified staff, and offer a broad range of specialist psychosocial treatments for individual inpatients. Staff within the service are also representing the Devon Partnership Trust in the general hospital setting and will play a vital role in communicating and maintaining a good working relationship between the two organisations.

Through consultation, assessment and interventions, the Liaison Psychiatry Service aims to – Arrive at a formulation which will identify the correct care pathway and ensure this is implemented Improve the quality of mental health care for all patients Improve quality of life for both patients and carers Identify and manage risk Reduce the length of stay in the general hospital Prevent hospital admissions Reduce the number of incidents and complaints Measure improvements of health outcomes Determine service needs A key aim of the service is to contribute to the acute care pathway, ensuring that those persons who present to the DGH receive a timely specialist mental health assessment by a specialist mental health worker. A significant proportion of these presentations will be those who present with acts of self harm and suicidal behaviours. In Exeter, our service incorporates the following areas: Acute Care Pathway (ACP)Ensuring a timely response to people who attend the Emergency Department and facilitating discharge from the Acute Medical Unit and other wards. InpatientAssessing and reviewing patients who are kept on caseload for a period of monitoring whilst they remain in-patients in the RDUH Eastern wards.

This will include dementia, delirium, depression, eating disorders, psychosis, medication management & support for patient and ward in challenging situations, on-going risk assessment and monitoring. Integrated Psychological Medicine Service (IPMS)Ensuring pathways are in place to allow access to the right treatment at the right time for those who present with both complex physical and psychological needs. There are high rates of mental health problems among people with long-term medical conditions and people with severe mental illness have a reduced life expectancy which can be due to physical health issues. Duties and Responsibilities Communication and Working Relationship Skills Contribute to the team and engage with a wide range of stakeholders including staff, service users, their carers and other statutory and voluntary sector agencies.

Impart complex and sensitive information to: Patients and families/carers re assessment, care planning, treatment and review Multi disciplinary teams to ensure the provision of consistent well coordinated care Primary care teams regarding client care External agencies also involved in the provision of care eg: voluntary and private sector, police, social services, housing, employment etc Services user and carer groups Liaise with a wide range of other professions and agencies. Contribute to the safe and effective day to day operations of the services including the handling of clinical enquiries. Present information, some of which may be contentious, to patients and their families and carers. Planning and Organisational Skills Attend management and professional meetings as directed by their line manager and professional lead.

Responsible for planning and co-ordinating own day to day work load in collaboration with the needs of the service users and the wider needs of the service. This requires excellent prioritisation skills. Plan and organise case conferences liaising with other agencies as required to meet the needs of their clients. Ensure that interventions are planned in an integrated and co-ordinated manner particularly where dependent on other external agencies.

Analytical and Judgemental Skills Undertake bio-psycho-social assessments, developing a working formulation and diagnosis which will identify onward care pathways. As part of the bio-psycho-social assessment completion of risk assessment and formulation will determine risk management plans. Further assessments/reviews may be required and adjustments made to care pathways where appropriate. Understands and recognises own limitations and seeks supervision when necessary.

Responsibility for Research and Development Participate in research and development in line with service delivery & development. Freedom to Act Work without direct supervision and take accountability for your own actions. When tasks are delegated, ensure that the person you have delegated these tasks to is appropriately skilled to undertake the tasks. Work within the operational policies and service specifications of the team.

Responsibility for Patient/Client Care, Treatment and Therapy Responsible for developing care whilst service users are in the DGH. This will include assessing, planning, intervention and evaluation. Ensuring active involvement of service users and their carers. Triage/prioritise referrals by assessing and advising on eligibility criteria.

Provide specialist advice to referrers/other multi-disciplinary staff in relation to the care of the patient. Participate in safeguarding adults and children. Act in an advisory and collaborative role in interpretation of clinical, professional and technical policies relating to adult mental health. Appraise current practices and standards in light of new research findings and introduce evidence based techniques as appropriate.

Responsibility for Policy and Service Development Implementation Participate in programmes of audit and research within the team and implement the findings. Contribute to professional clinical governance arrangements in order to ensure the quality of the service provided. Participate in the development of Mental Health Services. Work collaboratively on the formulation of, and review of policies, standards, guidelines and procedures within DPT and the DGH.

Attend and participate in relevant groups to include policy implementation, networking , peer review to promote benchmarking and sharing of best practices. Responsibility for Finance, Equipment and Other Resources Responsible for care of own equipment. Responsibility for Human Resources, e.g. Supervision, Training, HR Advice and Management Supervision of junior qualified and non-qualified staff.

Provide clinical supervision. Co-ordinate the activity of the team and facilitate handover meetings. Provide mentorship to students allocated to the team. Take a clinical lead in the absence of the team leader / practice lead.

Participate in clinical & managerial supervision as well as annual PDR. Participate in team staff support. Support staff within the DGH to holistically manage people presenting with complex mental health issues and offer appropriate therapeutic interventions. To actively participate in producing and delivering training packages to our colleagues in the DGH and acting as a point of reference as required.

Keep up to date with all Core and Essential Training requirements. Responsibility for Information Resources and Administrative Duties Maintain up to date clinical records in a timely and accurate manner in line with standard operating procedures. Any Other Specific Tasks Required The postholder works towards complying with the core competencies for mental health liaison practitioners as described in the Competency Framework for Liaison Mental Health Nursing. Professional Duties Practice in a way that actively minimises dependency and promotes recovery.

Communicate information in a way that makes it relevant and understandable for service users and carers, working to the principles of the functions policy implementation guidelines and practice in line with the standards and values set out in them. Work co-operatively with staff colleagues within the Acute Hospital, other parts of the mental health services, primary care & other statutory and non-statutory organisations. Ensure a duty of care to your patients and clients, who are entitled to receive safe and competent care. The Service User wishes, feelings, values and beliefs should be taken into consideration as well as the views of the people close to them.

Take personal accountability for your own practice. This means that you are answerable for your actions and omissions, regardless of advice or directions from another professional in accordance with the NMC Professional Code of Conduct.

Job Description

To work as part of a large multi disciplinary team who’s remit involves Crisis and Home Treatment interventions to support people to remain at home during a mental health crisis, as well as facilitate appropriate stepdown from acute psychiatric admission. Please see attached Job Description for full details.

Job Description

The post holder will deliver high quality comprehensive mental health services. The role involves managing a defined caseload with a focus on providing expert assessment and treatment for people with complex mental health difficulties and their carers. This will include recovery co-ordination (design and co-ordination of treatment packages that are personalised and evaluated in line with payment by results). To provide statutory Adult Social Care, Care Management functions (assessment, care planning and reviewing).

The liaison with a wide range of statutory and non-statutory agencies is central to this role. The post holder will contribute to the clinical leadership of the team, providing supervision for other members and participating in team and service development, and evaluation.