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Thames Valley Office

HEALTH EDUCATION ENGLAND - THAMES VALLEY

ADVANCED TRAINING SCHEME FOR DUAL CERTIFICATION IN CHILD & ADOLESCENT

FORENSIC PSYCHIATRY

About Health Education England - Thames Valley

Health Education England - Thames Valley (HEETV) covers Berkshire, Buckinghamshire and Oxfordshire. Our vision is to ensure the delivery of effective workforce planning and excellent education and training to develop a highly capable, flexible and motivated workforce that delivers improvements in health for the population of Thames Valley. HEE Thames Valley is responsible for the training of around 2000 Foundation and Specialty trainees.

Health Education England - Thames Valley is a relatively small organisation with a defined geographical area which serves as a single unit of application. In the majority of cases candidates will be asked to preference their choice of location for the first year. Future placements will usually be based on individual training and educational needs. Please note that applications are to the Health Education England - Thames Valley as a whole. This may mean that you may be allocated to any geographic location within HEETV depending on training needs.

Contents: / page
Section 1 / Overview of Dual Programme and Integrated Year / 1
Section 2 / Advanced Training Scheme in Child & Adolescent Psychiatry / 2
Section 3 / Advanced Training Scheme in Forensic Psychiatry / 8
Section 4 / Specialty Placements for the Integrated Year / 11

1. OVERVIEW OF DUAL PROGRAMME AND INTEGRATED YEAR

ESSENTIAL INFORMATION

Job title / Specialty Registrar ST4 – 8
Specialty / Child & Adolescent Forensic Psychiatry
Location / Health Education England - Thames Valley
Employer / Oxford Health NHS FoundationTrust
Annual leave entitlement / At Pts 0-2 of MN25:5 weeks
At Pt 3 and above:6 weeks
Standard hours / 40
On-call duties / Vary with placement

The five-year programme, which has educational approval from the Higher Specialty Training Committee of the Royal College of Psychiatrists and from the Postgraduate Dean, will lead to the award of two Certificates of Completion of Training (CCTs) subject to regular and satisfactory assessments. The dual training programme is now well established and the two previous trainees have taken up consultant posts in child and adolescent forensic psychiatry.

The training is divided into two consecutive years on the Advanced Training Scheme in Forensic Psychiatry, two consecutive years on the Advanced Training Scheme in Child & Adolescent Psychiatry, and an integrated final year that combines both Child & Adolescent and Forensic Psychiatry. Both Advanced Training Schemes have full educational approval in their own right. Trainees will be based in Oxford for the duration of the programme, but may work in Milton Keynes, Berkshire or Buckinghamshire.

There is a range of placements available to trainees in both Child & Adolescent Psychiatry and Forensic Psychiatry. There is a requirement that a trainee will work with an approved trainer on an adolescent forensic medium-secure unit (MSU); this is undertaken as part of the final Integrated Year.

Job descriptions of the integrated year and of the two training schemes are provided on the following pages.

2. ADVANCED TRAINING SCHEME IN

CHILD & ADOLESCENT PSYCHIATRY

GENERAL ORIENTATION TO THE SCHEME

There are eight full-time specialty trainee placements in the Health Education Thames ValleyAdvanced Training Scheme, based in Oxfordshire, Berkshire and Milton Keynes. This provides a balanced and comprehensive training fully approved by the Royal College of Psychiatrists.

Full-time single-specialty trainees have three one-year placements out of the eight available within HEETV programme. Less than full-time training is also available in the specialty, in which case the programme will last five years divided into four attachments of fifteen months each. All StRs are subject to annual assessments under the ARCP process.

There are excellent opportunities for involvement in teaching and research, including supervision of research in trainees' own special interests. The University Department of General Psychiatry is based at the Warneford Hospital with Professor John Geddes as its head. There is a University Section of Child Psychiatry also based at the Warneford Hospital, the section is led by Professor Alan Stein.

The variety of experience available in each placement is set out in detail below.

DETAILS OF INDIVIDUAL PLACEMENTS

OXFORD HEALTH NHS FOUNDATION TRUST

OXFORD CITY TIER 3 CAMHS (1 placement)

Consultants: Dr Anne Stewart, Dr Simone Forlee and Dr Marian Perkins

The Oxford City CAMHS team is a busy service with an experienced multidisciplinary team. The team provides the possibility of a broad experience of generic child and adolescent work as well as the possibility of some general hospital liaison and specialty experience in working with young people with eating disorders.

TIER 4 NEUROPSYCHIATRY OUTPATIENT SERVICE (1 placement)

Consultant: Dr Marian Perkins

The neuropsychiatry team is a specialist Tier 4 community service providing assessments and interventions for young people with complex neuropsychiatric presentations. The service currently provides for Oxfordshire bit its remit is likely to cover Buckinghamshire as well in the near future.

HIGHFIELD FAMILY AND ADOLESCENT UNIT (INPATIENT SERVICE (1 placement)

Consultant: Dr Tony James

Highfield Family and Adolescent Unit, situated in the grounds of Warneford Hospital, is an established unit providing the base for the Regional Psychiatric Adolescent Service; a completely new purpose-built unit is currently under construction. The multidisciplinary team provides a comprehensive experience in the assessment and treatment of a wide range of clinical disorders in adolescents and their families. The age range of the adolescent patients is from thirteen to eighteen years. There is scope for both brief and long-term treatment utilising the full range of treatment techniques. The specialty trainee will be able to obtain supervised experience in family therapy, individual and group psychotherapy, and in cognitive behavioural techniques and psychopharmacology. A school forms an integral part of the unit and the teachers work closely with the therapeutic team. The service has very well established links with agencies in the community.

The specialty trainee will have ready access to the academic training programme and to lectures and conferences in the University Department of Psychiatry and Section of Child Psychiatry. There are teaching commitments to undergraduates and postgraduates, and also opportunities for lecturing outside the unit.

BANBURYTIER 3 CAMHS(1 placement)

Consultants: Dr Rosie Shepperd, Dr Evie Manganari

The Banbury specialist CAMHS serves a population of 170,000. The purpose-built facility has numerous clinical rooms, a family therapy viewing room as well as rooms for sole use of clinicians, including an STR.

The children and adolescents seen represent a wide range of simple and complex cases, providing excellent training for competency assessments, differential and co-morbid diagnoses and differentiation, and patient-specific treatment programmes.

There is a very wide range of trainee experience in this placement such as individual and joint assessments with other professionals including a psychologist, social workers, CPNs and occupational therapists. A particular feature of the placement is the paediatric liaison provided to the Horton Hospital, both to the A&E ward and the assessment of self-harm.

The team in Banbury offers a range of multidisciplinary therapeutic skills for children and adolescents.

ABINGDON TIER 3 CAMHS (1 placement)

Consultants: Dr Emma Fergusson, Dr Tanya McGregor Dr Isabel Paz,

The South Oxfordshire Specialist CAMHS service is located in Abingdon. The team provides services to Abingdon, with outreach clinics in Didcot, Henley, Wantage, Thame and Berinsfield. The population served is currently 240,000 and hence affords excellent experience in a community-based team. Children and adolescents from 0-18 with a wide range of psychological difficulties are seen.

Specific features of the placement include a broad catchment area of a mixed urban and rural nature, interactions with other agencies and the possibility of inter-agency working, as well as excellent opportunities for liaison and consultation with schools, social services, educational psychology, health visitors and GPs. This reflects the emphasis of this team on multi-agency, multi-professional approach to assessing and treating children and adolescents with psychiatric difficulties.

Consultant Staff Based in Oxfordshire

Dr Rob Chapman is a Consultant in Child & Adolescent Psychiatry running a community team based in Witney, West Oxfordshire.
Dr Evie Manganari, Dr Rosie Shepperd and Dr Innibong Okonna (locum) are Consultant Child & Adolescent Psychiatrists based in Banbury, North Oxfordshire. Dr Shepperd is Clinical Director of Oxford Health Children and Families Division.
Dr Nick Hindley is Consultant in Child & Adolescent Forensic Psychiatry at Boundary Brook House, Oxford. He is clinical lead for the Thames Valley Child & Adolescent Forensic Mental Health Service TV FCAMHS) which provides a regional community forensic service to Oxfordshire, Buckinghamshire, Berkshire and Milton Keynes. He also provides input into the Child and Adolescent Harmful Behaviour Service (CAHBS; a service providing assessment and intervention for young people with sexually harmful behaviour) and the Family assessment and Safeguarding Service (FASS; a service providing court reports and thearapeutic interventions in families where child maltreatment has occurred.
Dr Ollie White, Consultant in Child & Adolescent Forensic Psychiatry is in a joint post providing input both to TV FCAMHS and Bluebird House (National NHS Adolescent Forensic In-patient Unit, Southampton)
Dr Tony James is Consultant and Honorary Clinical Lecturer in Adolescent Psychiatry at the Highfield Family and Adolescent Unit. Dr James has a wide range of clinical and research interests.
Dr Marian Perkins is Consultant in Child Neuropsychiatry at the Park Hospital with a special interest in epilepsy and in paediatric liaison. She leads a multidisciplinary team for management of children with complex epilepsy and associated psychiatric problems as well as a tertiary service for children with neuropsychiatric disorders such as autistic spectrum disorder, hyperkinetic syndrome, complex tic disorders, etc.
Dr Rosie Shepperd is Consultant in Child & Adolescent Psychiatry for Abingdon and Thame, South Oxfordshire. She works with a small multidisciplinary team and liaises closely with GPs, health visitors, social services and education, to assess and treat children from 0 to 18 years, with their families or carers.
Dr Anne Stewart and Dr Simone Forlee are Consultants in Child and Adolescent Psychiatry at the Oxford City CAMHS Team. Dr Stewart has close working links with the Department of Psychological Medicine and the Adolescent Unit in the John Radcliffe Hospital; her main clinical and research interest is in eating disorders.
Dr Emma Fergusson, Dr Tanya McGregor, Dr Isabel Paz, Dr Elizabeth Tovey are Consultants in Child and Adolescent Psychiatry at South Oxfordshire CAMHS.
Dr Fergusson is Programme Director for the Advanced programme.
ACADEMIC STAFF:
Professor Alan Stein, Dr Mina Fazel

BERKSHIRE NHS FOUNDATION TRUST

BERKSHIRE ADOLESCENT UNIT BASED AT WOKINGHAM HOSPITAL (1 placement)

Consultants: Dr M Allsopp, Dr Nicky Affonso

The Berkshire Adolescent Unit is sited in the ground of Wokingham Community Hospital and provides psychiatric services for young people and their families from Berkshire and surrounding districts. The service offers eight in-patient beds and an extensive day-patient programme. The Unit often closes at weekends but has the facility to remain open on a regular basis to respond to the needs of emergency or high-dependency patients. There are specialist out-patient clinics for patients presenting with eating disorders, obsessive compulsive disorder and first episode psychosis.

The specialty trainee will work as part of a multidisciplinary team comprising nursing, psychology, occupational therapy, family therapy, art therapy, dietetics and teaching staff as well as Dr Allsopp, Dr Affonso, and a Core trainee on a six-month attachment from the Oxford Rotational Training Scheme.

READING TIER 3 CAMHS AND PAEDIATRIC LIAISON SERVICE (1 placement)

Consultants: Dr Janet Bucher, Dr Andrew West, Dr Carsten Vogt

This placement is split between Paediatric liaison and Community CAMHS and is based at Craven Road. The Paediatric Psychology and Liaison Service (PPALS) comprises the registrar, consultant and a psychologist. There are fortnightly team meetings, monthly joint clinics, regular academic meetings with the paediatricians in addition to referrals from the paediatricians both on a routine and an emergency basis.

The community CAMHS aspect involves assessment and management of complex conditions and extensive working with members of the multidisciplinary team as well as liaison with external agencies. The registrar is welcome to attend and participate in the weekly referrals-triage meeting There exists a rota system for managing emergencies in the community, during the working hours. The weekly team meeting provides a platform for presentation and discussion of complex cases, audits etc.

There are also opportunities to participate in specialist ADHD, neuropsychiatry and ASD/SoCom (social & communication disorder) clinics. Psychotherapy supervision is available.

Consultant Staff Based in Berkshire

Dr Mark Allsopp and Dr Nicky Affonso are Consultant Child and Adolescent Psychiatrists responsible for the Berkshire Adolescent Service at Wokingham Hospital. His research interests include obsessive compulsive disorder in children and adolescents, eating disorders and the provision of early psychosis services.
Dr Janet Bucher, Dr Carsten Vogt and Dr Andrew West Reading CAMHS. Dr Bucher’s special interests are under-five clinics, parent-training courses, and ADHD. Dr West has a special interest in paediatric liaison based at the Royal Berkshire Hospital, Reading. Dr Vogt has a special interest in ADHD.
Dr Raj Gouda and Dr Elsa Godinho are Consultant Child and Adolescent Psychiatrists at Newbury CAMHS
Dr Cornelius Ani is Consultant Child and Adolescent Psychiatrist at Bracknell CAMHS
Dr Guy Northover is Consultant Child and Adolescent Psychiatrist at Maidenhead CAMHS
Dr David McDonald and Dr Anna Viviani are Consultant Child and Adolescent Psychiatrists at Slough CAMHS
Dr Tamsin Marshall and Dr Jyoti Vandana are Consultant Child and Adolescent Psychiatrists at Wokingham CAMHS

MILTON KEYNES PRIMARY CARE NHS TRUST

MILTON KEYNES CAMHS (1 placement)

Consultants: Dr Renu Daryanani; Dr K Hadi, Dr Haido Vlachos

The Department of Child and Adolescent Psychiatry is located on the first floor of Eaglestone Health Centre in the grounds of Milton Keynes General Hospital. The catchment area for the services tap off Milton Keynes and the department is the only tier 3 service in Milton Keynes. The population is 230,000 with an age structure weighted towards the younger group. The specialist CAMHS service sits within the Children’s Directorate of Milton Keynes Community Health Service. There are close links with the Paediatric Department and opportunities for paediatric liaison, attendance at the Child Development Centre and other paediatric clinics. There are also close links with the Adult Psychiatry Department and the Adult Eating Disorders services.

There are strong contacts with social services department, education department and the youth offenders team. There is consultation with social services and support for foster carers.

The department offers a family therapy suite and art therapy room and although there are no in-patient beds, it is possible to admit young people to paediatric wards. There is a strong emphasis on the large multidisciplinary team and the experience that that affords.

GENERAL INFORMATION – CHILD & ADOLESCENT SCHEME

STUDY, RESEARCH AND OTHER TRAINING

Evidence of research is required throughout the period of Advanced training, and supervision is arranged through the University Department of Psychiatry in Oxford. There are excellent library facilities in Oxford and at Prospect Park Hospital, Reading. The resources of the University libraries are also available.

Case conferences, and formal academic programmes are held weekly in both Oxford and Reading. StRs are expected to attend the series of reading seminars which cover the topic areas of the discipline over a three-year period. These seminars are run weekly in term time and are co-ordinated by the Tutors to the scheme. There are additional seminars which address other aspects of Advanced training. The University Department of Psychiatry provides lectures and seminars on a wide variety of topics.

There is weekly supervision in Oxford for individual child psychotherapy, and all trainees are able to attend this group when they have a child or adolescent in psychodynamic therapy. There is also a Tavistock Centre run course in Oxford for infant observation.

MANAGEMENT EXPERIENCE

There are opportunities for StRs to gain experience in the administrative and managerial aspects of the various clinical units, and to be involved in a number of departmental meetings, including medical committees for psychiatry and child health, and a range of joint planning and liaison bodies. Trainees are encouraged to attend management training courses and to take an active part in the various managerial structures within the health service.

TEACHING

Each clinical psychiatric firm in HEETV has a Core trainee on a six-month attachment. The Advanced trainees are expected to play an important part in their clinical supervision and in the weekly academic programmes. There are opportunities for being involved in teaching on the Oxford Postgraduate Psychiatry Course day release course in Oxford, and for teaching medical students during their paediatric and psychiatric attachments.

StRs are encouraged to participate in the teaching and training of other disciplines.

ON-CALL

At present StRs will take part in the Child & Adolescent on-call rota in all placements throughout the two CAMHS years of training. In Oxford Health FoundationTrust the on-call duty includes cover for Oxfordshire and Buckinghamshire including The Highfield Adolescent Unit. In Berkshire,StRs are expected to be rapidly available to assess emergency referrals and provide cover for the in-patient adolescent unit during their on-call duties.

3. ADVANCED TRAINING SCHEME IN FORENSIC PSYCHIATRY

INTRODUCTION

The Advanced Training Scheme in Forensic Psychiatry is based at the Oxford Clinic Medium Secure Unit, Littlemore Mental Health Centre, Oxford, and Marlborough House Medium Secure Unit, Milton Keynes. StRs in Child & Adolescent Forensic Psychiatry will spend two years in Forensic Psychiatry (changeover date usually being in April) working for one year each with two of the consultant trainers. In addition to the full-time StRs in forensic psychiatry the peer group may at any time include flexible trainees, general psychiatry StRs on a year’s secondment to forensic psychiatry, or research fellows.