Clare Oakley & Jeremy Kenney-Herbert

Why listen to us? Clare

Consultant for two years in the independent sector

Medical education and research components to job

Jeremy

Nineteen years as an NHS consultant

Clinical Director for ten years

Groundwork

Visit providers early

Can contact in advance of adverts if very keen to work in a particular service

Meet Clinical Director / Medical Director / CEO

Read about the Trust/Specific Service Their website is a good source of information

What are their priorities?

Interview preparation

Prepare early

Ensure up to date with national guidelines

Check for local guidelines/policies

Read up on any relevant government reports

Practice interviews with colleagues and friends

Presentations

Be clear and concise

Keep slides simple

Consider other visual methods

Practice and practice again

Anticipate questions

Patient interviews

Be clear

Be coherent

Be professional

Don’t patronise

Be confident but don’t be arrogant

Be decisive

A big change

Get ready for the paperwork

Feel the responsibility

Meeting the expectations of the consultant role; your perspective and that of others

Time pressure

Things to enjoy

The achievement of reaching your goal

Recognition

Rewards

Beginning of a journey; opportunities

Job satisfaction – making a difference as a doctor

Risks Isolation and loneliness Arrogance/ overconfidence Overwork/ burnout/ stress/ no playtime Indecision, lack of followership Serious incidents/ suicide/ homicide. To what

extent am I responsible? Complaints, litigation/ coroner’s court

Acknowledgment: Rafiq Memon

Colleagues

Crucial

Seek support and be supportive; be a good colleague

Be boundaried

Supervision

Informal

Formal

Clinical

Management

Group

Mentoring v Coaching Psychiatrists' Support Service on Coaching and

Mentoring http://www.rcpsych.ac.uk/workinpsychiatry/psychiatristssupportservice/informationguides/informationguidementoring.aspx

Mentoring at any stage of a psychiatrist’s career is encouraged by the Royal College of Psychiatrists, especially for new consultants, as it can be very helpful at times of transition to a new role. Informal mentoring is frequent, but the value of more formal access to mentoring is now recognised.

Coaching….

Over-confident vs over-anxious “there are two types of new consultants…..”

Self –awareness

How will you react to your new role and responsibilities?

Can you compensate for “weaknesses”; build on “strengths”.

Don’t need all the answers, just a sensible approach

Communication Think about how you communicate as a leader

Democratic vs autocratic

Emails

Never respond when you feel angry

Think twice about need to respond out of hours

Don’t take your work phone on holiday

Do not cc people unless absolutely necessary

No email day….

The value of talking; courtesy goes along way

Trips & slips (hopefully no falls)

Complaints

Serious Incidents

The Coroner’s Court/DHRs/Homicide Inquiries

Complaints Prevention – relationships, PALS, advocates, …

Sorry seems to be the hardest word…..

Apologies are not an acceptance of guilt, negligence etc

Section 2 of the Compensation Act 2006 (an Act of the UK Parliament): “an apology, an offer of treatment or other redress, shall not of itself amount to an admission of negligence or breach of statutory duty”.

Complaints 2 Patients Association Good Practice standards for

NHS Complaints Handling 2014 Open and transparent;

Evidence based;

Logical and rational;

Comprehensive and with a level of detail appropriate to the seriousness of the complaint;

Timely and expeditious;

Proportionate to the seriousness of the complaint(s) raised.

Duty of candour

Apology

Example of a failed opportunity…..

Example of a good outcome…..

Serious Incidents Remain calm during incident and afterwards

Take immediate actions as needed

Leadership

Seek help and be open

Ensure lessons learned are embedded via ward meetings etc

Reflection – appraisal

Support for yourself and your team

Suicides/Homicides

Coroner’s Court

DHR

Homicide inquiries

Probity As through out your career your word is your

honour

Medico-legal; local guidance; your opinions will remain eternal

Who is your master?

Private practice

Conflicts of interest

On call

Probity issues

Dr X – medico-legal frequent flyer who became grounded

Dr Z – the fraud that never was

Complex/challenging patients

Take time to reflect

Boundaries

Discuss in supervision

Speak to colleagues

Ask for a second opinion

“walk towards the problem…”

Your well-being Manage your health

GMC Good Medical Practice

Protect patients and colleagues from any risk posed by your health

28. If you know or suspect that you have a serious condition that you could pass on to patients, or if your judgement or performance could be affected by a condition or its treatment, you must consult a suitably qualified colleague. You must follow their advice about any changes to your practice they consider necessary. You must not rely on your own assessment of the risk to patients.

29. You should be immunised against common serious communicable diseases (unless otherwise contraindicated).

30. You should be registered with a general practitioner outside your family.

Work-life balance

Job planning

Portfolio careers

Job Plans- have one…

The 7.5:2.5 pa split

CR174 (2012) Safe patients and high-quality services: a guide to job descriptions and job plans for consultant psychiatrists

Revalidation Make yourself aware of revalidation requirements at an

early stage

What is revalidation?

Revalidation is the process by which all licensed doctors are required to demonstrate on a regular basis that they are up to date and fit to practise in their chosen field and able to provide a good level of care. This means that holding a licence to practise is becoming an indicator that the doctor continues to meet the professional standards set by the GMC and the specialists standard set by the medical Royal Colleges and Faculties.

Appraisal There are six types of supporting information that

doctors will be expected to provide and discuss at their appraisal at least once in each five year cycle:

CPD

Quality improvement activity

Significant events

Feedback from colleagues

Feedback from patients

Review of complaints and compliments

Appraisal/Revalidation Develop a system to gather information from day 1;

don’t regard appraisal as a deadline based task.

Use an electronic system where possible

Find an appropriate CPD peer group

Important to join a peer group early to plan PDP and learning opportunities

Good source of support

Ensure you submit your return to RCPsych

Extracurricular activities

Medico-legal business

Mental Health Tribunal, Parole Board

CQC inspector/ SOAD

Royal College work, GMC work

Trade union work/ voluntary work

Research/ teaching/ further study

Medical societies

Acknowledgment: Rafiq Memon

Medical education

Look at opportunities for teaching students of other professions as well as medical students

Undertake supervisors training for postgraduate trainees

Consider teaching on the MRCPsych course or offering an SSC at the medical school

Speak to tutors and get advice about how to get involved

Leadership & management

Walk before you can run…show your value….complete some projects

Courses and/or experience and portfolio building?

Faculty Of Medical Leadership and Management

Top tips

Book a holiday

Develop systems to keep track

Focus on clinical work initially

Value your MDT

Get on with your colleagues of all disciplines

Find a senior consultant who will offer wise advice and a more junior consultant to answer silly questions