Consultant Psychiatrist - Forensic Psychiatry | Barnet, Enfield & Haringey Mental Health NHS Trust

The North London Forensic Service has an exciting position available for an enthusiastic and motivated consultant forensic psychiatrist to jointly provide Consultant leadership to Derwent Ward, a low secure admissions ward on the Chase Farm Hospital site, and to HMP Wormwood Scrubs, a local Category B prison in inner West London.

The successful applicant will join a wider group of consultant forensic psychiatrists within the North London Forensic Service, a large and successful forensic psychiatric service in North London. Its secure care services have been rated as outstanding by the CQC. Derwent Ward is a 12-bedded male low secure admissions ward and HMP Wormwood Scrubs is a local prison, with an inpatient Healthcare and Mental Health In-Reach Team. The successful applicant will have responsibility for providing consultant leadership (with the other consultants on each team) to the two teams, and in delivering high-quality inpatient care and care to prisoners.

§ To provide clinical leadership to ensure the delivery of high-quality patient care to the men resident in HMP Wormwood Scrubs

§ To contribute to the maintenance and development of Offender Care services (working closely with primary care, the prison and probation services) within the Trust to the highest standard.

§ To provide assessments, treatments, and interventions as part of Mental Health In-Reach Team and to the patient admitted to healthcare at HMP Wormwood Scrubs.

§ To provide holistic care taking into account of the patient population's complex health and social care needs

§ To provide psychiatric assessment and treatment of forensic psychiatric inpatients.

§ To take on the role of Responsible Clinician for detained patients.

§ To produce reports for CQC Tribunals, Hospital Managers hearings and Criminal Justice System were required.

§ To take the lead on prescribing and risk assessments.

Barnet, Enfield and Haringey Mental Health NHS Trust is responsible for providing mental health services for people of all ages across the London Boroughs of Barnet, Enfield and Haringey, as well as providing some specialist services across the whole of North London and beyond. Since January 2011, the Trust also provides adult and children's community health services in Enfield, following the transfer of Enfield Community Services from NHS Enfield.

Formed in 2001 through the merger of its predecessor organizations, Barnet, Enfield and Haringey Mental Health NHS Trust (BEH-MHT) continues to innovate and develop at a fast pace. We are a large mental health trust in London with an annual budget of £337 million and employing more than 3,300 staff. In 2020-21 the trust cared for more than 126,176 people; approximately 2,800 patients on our wards and over 128,388 service users in the community.

We provide a wide range of local and more specialist mental health services, including helping people with serious mental illness (SMI), personality disorders, drug and alcohol recovery, children's mental health issues, dementia, eating disorders, learning disabilities, ADHD and suicide prevention. The Trust has an overall Care Quality Commission (CQC) rating as 'Good' from 2019 and retained the 'good' rating in 2022. It also runs the North London Forensic Service (NLFS), which the CQC has rated as Outstanding.

The Consultant Forensic Psychiatrist role is split between: HMP Wormwood Scrubs, a local remand prison (5 PAs) and Derwent Ward, a low secure admissions ward (5 PAs).

HMP Wormwood Scrubs is a local Category B prison in inner West London which holds up to 1279 adult males in the early stages of custody, remanded from local Magistrates and Crown Courts. Working alongside two LTFT Consultant Forensic Psychiatrists based at the prison, the postholder will provide leadership to the Mental Health In-reach Team and for prisoners admitted to Healthcare.

The Mental Health In-Reach Team (MHIRT) receives circa 80 referrals each week, which are initially screened (triaged) by nursing staff and holds a caseload of approximately 80 cases at any one time, primarily managed by CPNs. There are about 50-60 patients subject to multi-professional/agency working under the auspices of the Care Programme Approach (incorporating section 117 Aftercare) at any one time. The post holder should expect to be responsible for a caseload of up to 15 cases, and personally case-manage approximately 8 patients (patients assessed in clinic that did not meet criteria for in-reach caseload). The post holder would be expected to receive, on average, 2 new assessments and 5 follow up reviews per week.

During the course of assessing and managing prisoners with mental health problems the MHIRT will liaise with Community Mental Health Teams to facilitate ongoing treatment for prisoners and provide aftercare via the CPA process. Prisoners with mental health problems that meet the criteria for transfer to hospital under the Mental Health Act will be referred to hospitals of appropriate security depending on their catchment area.

The post holder will be expected to provide consultant psychiatric leadership (alongside two LTFT consultant colleagues) and input into the mental health care of men resident on the Healthcare Unit (H3), currently 12 beds for mental health patients and 5 beds for physical healthcare in HMP Wormwood Scrubs. This includes chairing weekly ward rounds, with each consultant responsible for prisoners they admit to healthcare. The proportion of beds can vary, but over the course of the year tends to even out. Referrals to the Inpatient Unit will only be accepted from clinicians (psychiatrists and the MHIRT) following assessment. Patients may be referred from different areas including reception, ordinary location, segregation, FNC and other prisons.

Duties on Derwent ward will include medical management of up to 6 male inpatients (half of the 12 bedded ward); Derwent Ward is a low secure admission ward, which primarily admits patients from prison, often under sections 48/49 of the Mental Health Act 1938 for further assessment and treatment. There may be some patients who are transferred from general adult services, usually PICU and urgent community recalls may be admitted. Patients on Derwent Ward may be discharged directly to the community, where they are supported by the NLFS FOS and SCFT. Patients requiring longer admissions may transfer to one of the low secure rehabilitation wards or in some circumstances step up to medium security. A few patients may be remitted to prison.

On Derwent Ward duties include chairing ward round and CPAs; preparing reports for the courts, managers' hearings, tribunals and the Ministry of Justice, giving evidence at tribunals and managers' hearings; managing medication regimes and assessing capacity to consent to treatment; liaising with SOADs; supervising the ward's core trainee in their management of the patients; undertaking seclusion reviews; liaising with other services including high and low secure units, prisons, physical health providers and the Ministry of Justice about the patient's care.

Additionally, the post holder will be expected to undertake assessments of patients referred to the NLFS for risk assessment and consideration of admission to low or medium secure services. These referrals come from a variety of settings including prisons, high security step downs, general adult PICU, general adult wards and community teams, with the referrals being shared equitably over the year between NLFS Consultants body. In recent years as the Consultant group has expanded the number of referrals seen by individual Consultants has decreased, with the expectation now being that the successful candidate will see approximately 10 referrals per year.

The post holder will be expected to support the Trust's Clinical Governance Framework for monitoring and improving standards of care through taking part in activities for improving quality, identifying and managing risks within the service, as well as maintaining his or her own continuing professional development.