Psychiatry

Welcome

Welcome to Psychiatry. We’re so pleased that you’ve chosen to come and work in our department. We hope that you’ll find the experience rewarding. You’ll have exposure to a wide variety of clinical presentations and educational opportunities during your time with us.

Forth Valley Psychiatry

The mental health team provides cover across three locality areas: Falkirk, Stirling, and Clackmannanshire.

Inpatient services

• MHU – The Mental Health Unit in FVRH has five wards. Three are general adult: Ward 1 is the Intensive Psychiatric Care Unit(IPCU); Ward 2 is for Stirling and Clackmannashire patients (North); and Ward 3 is for Falkirk patients (South). The other two wards are Older Adult Psychiatry wards: Ward 4 is for dementia patients, and Ward 5 is our functional old age ward. The MHU is also the base for the perinatal psychiatry team, the hospital addictions team (HAT), and MHAATs (the Mental Health Acute Assessment and Treatment Service). You will work particularly closely with the MHAATs (pronounced ‘EM-hats’) team during your on call shifts.
• Bellsdyke – There are 4 wards on the Bellsdyke site, 5 minutes drive away from FVRH. These are Russell Park (rehab), Trystview (rehab), Trystpark (low secure male forensic unit), and Hope House (low secure female forensic unit).
• Lochview – Learning Disabilities inpatient unit, also 5 minutes drive away from FVRH at the Bungalows.

Other psychiatry services

• 3 General Adult Community Mental Health Teams (CMHT)
• 3 Older Adult CMHTs
• 2 Child and Adolescent Mental Health (CAMHS) teams
• 3 Learning Disability Teams
• 2 Addictions Teams
• 2 Forensic CMHT
• Psychodynamic Psychotherapy department

Key contacts

• Ross Cheape – Line Manager for junior doctors in psychiatry (also Service Manager for Addiction Services and Service Development and Interim Clinical Director for Acute Adult Inpatient and Forensic Psychiatry)
• Lauren Carriero – Rota Co-ordinator and Medical Staffing Administrator
• Gary Cooney – Educational Supervisor for psychiatry trainees (and consultant psychiatrist in General Adult)
• Patrick Hughes – Foundation Doctor Champion (and consultant psychiatrist in General Adult)
• Seonaid McCallum – GP trainee Champion (and consultant psychiatrist in General Adult)
• Navdeep Gill and Paula Beamont – Trainee reps (both CT3s in psychiatry)

Fv.psycdoctorscsd@nhs.scot – generic email inbox for rota queries/leave requests/sickness reporting.

Education

We have an internal educational programme which takes place every second Thursday morning in the department. Usually there are two slots for trainees to make a presentation (journal club or clinical case presentation), followed either by an external speaker or a consultant-led presentation. All junior trainees are expected to take part in this.

There is also West of Scotland deanery-wide teaching available for all junior doctors working in psychiatry on Thursdays. This is currently run on Microsoft Teams, and you will be given more information about this once you arrive in the department.

We have a wide variety of psychiatry subspecialities including Addictions, Perinatal Psychiatry, Eating Disorder Psychiatry, Forensic and Rehabilitation Psychiatry, CAMHS and Learning Disability Psychiatry. Trainees on psychiatry attachment are encouraged to seek extra experiences in an area of interest to them.

Medical staffing

The junior medical rota comprises a mix of FY2s, GP trainees, and core psychiatry trainees (CT1-CT3). Each trainee is attached to a different consultant for their routine clinical work.

There are a few registrars, also attached to a consultant for their routine clinical work. Their on calls will be from home with a consultant available as well.

Most of the consultants have a mix of inpatient and outpatient work. They have their own rota of on calls, and are always happy to be phoned for advice. You can contact them via switchboard.

Mental health work involves a broad MDT, and the inpatient and outpatient settings have a mix of very experienced nurses and HCAs, ANPs, OTs, physiotherapists, pharmacists, and psychologists.

Rota

The rota will be sent to you in advance by Lauren Carriero. If you have any questions about the rota or your shifts, you should send them to the Fv.psycdoctorscsd@nhs.scot email address. On call shifts can be swapped between juniors, but all swaps should be confirmed via the email inbox.

Routine work

The bulk of your work is Monday-Friday, 9am-5pm. You will be attached to a consultant, and your working week will predominantly follow their timetable. An example of what your week might look like is below:

Your role within the inpatient team will involve: attending ward rounds/MDTs, reviewing patients when required, clerking in new admissions, managing medical issues, liaising with relatives and other agencies, and completing discharge letters.

Tips for a good day in the MHU:

Arrive at 9am, get handover from duty doctor

• Check the jobs diary/doctors inbox (fv.mhudutydoctor@nhs.scot) for jobs for your ward
• Plan your day: what’s your consultant doing? Are there admissions coming in? Do you have urgent jobs? When are you doing admin?
• If you need to do admin, find somewhere quiet (not the doctor’s office)
• Ask for (and offer to) help
• Have lunch together

Handover

The main handover is between the day and night shift on call doctors at 8.45am and 8.45pm. The other juniors will come in to work at 9am, and the day time on call doctor can then handover/delegate tasks as appropriate.

At the weekends and on public holidays, there is a 10 am ‘huddle’ on Microsoft Teams. This should be attended by the junior and consultant on call, the nursing manager on call, the lead nurses on site for the MHU, Bellsdyke, and Lochview. This meeting is your opportunity to raise any issues or new patients for consultant review, as well as any areas of clinical concern.

On call work

On call shifts in the MHU are either 8.45am-9pm, or 8.45pm-9am. Only one junior is on call at a time, although in the evenings and at weekends there is a consultant on call at home.

During the day, your main duties are to cover the ward jobs of trainees not in the MHU that day. This includes bloods, medication changes, medical reviews, clerking in admissions etc. You will also be the first person contacted regarding ward emergencies.

At night, your main task is liaison assessments with the MHAATs nursing team. You will also be responsible for urgent ward work.

When on call (or ‘duty doctor’), you are responsible for all 5 FVRH wards for all matters that need a doctor. For the other inpatient sites (Bellsdyke and Lochview), you manage psychiatric issues only, and medical issues go to the Emergency Department/NHS 24.

On calls can be busy, but remember that there is lots of support available. In working hours, you should work as a team with the other juniors. Consultants are always happy to be asked about their own patients. Out of hours, the consultant on call is always available to be phoned for advice, and the MHAATs team are experienced and helpful.

Tips for a good day on call:

• Delegate – not all jobs are for you
• Be proactive in the morning – things get busier later
• Keep on top of jobs in ward diary/email inbox
• Be realistic with what you can achieve on call (don’t plan to get all your meetings/admin done)
• If you’re called about something and you’re not sure what to do: take a number, ask around, and call them back
• Take breaks (ideally with company)

Leave requests

Our department try to accommodate all leave requests within reason. Annual leave requests should be submitted as early as possible to the email inbox above. Before submitting a request, you should ensure you are not on call for any of the days specified, and discuss it with your consultant. You should also try to ensure that there is appropriate cover for your ward area (eg not all old age juniors off at once).

Study leave requests should be discussed with your supervisor. Psychiatry trainees should discuss with Gary Cooney, and GP trainees with Karine Newlands. Foundation doctors just need to discuss with clinical supervisor. They should then be forwarded to Lauren via the generic email.

Unplanned absence

If you are going to be absent from work in normal working hours, call your supervisor/clinical area and email the generic inbox.

If out of hours and you are due to be on call:

1. Call the person currently holding the page (#2005)
2. Email the generic box (fv.psycdoctorscsd@nhs.scot) and your supervisor

The person receiving the call will:

1. Advise the on-call consultant
2. Contact colleagues to arrange cover
3. Liaise with the on-call consultant to make appropriate arrangements
4. On-call Consultant will liaise with the General Manager/Exec on-call and or provide cover themselves