Mental Health Therapeutic Practitioner

Job Overview

This role will involve several elements which will support the management of people with mental health conditions in primary care, who may be new or known previously to secondary care mental health services.

The post holder will provide assessments, formulation and delivery of psychological intervention in primary care, secondary to this, supporting access to Community Mental Health Teams or other services such as Third Sector and IAPT where needs can be better met by these services. The post holder would be expected to work closely with experts by experience, local communities and will also be involved in raising the awareness of mental health difficulties in the general population.

The post holder will contribute to the provision of psychological interventions in the PCN, which will be under the direction of a qualified clinical psychologist who will retain clinical responsibility for clinical work carried out.

The post holder will be part of the Primary Care MDT team assisting case reviews, triage of those presenting with mental health needs, support GPs with referring patients to Mental Health Services as appropriate and ensure the delivery of physical health checks. For those with SMI and where applicable to the skilled professional, the post holder will support antipsychotic medication management. The role will be embedded within a PCN working with several GP surgeries and within the local Community Hub to enable safe transfers of care.

Main duties of the job

Central and North West London NHS Trust will work with the 30 PCNs across the boroughs of Brent, Harrow, Hillingdon, Kensington & Chelsea and Westminster to embed up to 1 WTE Band 7 MH Practitioner per PCN to drive the delivery of place based integrated care and embed specialist mental health skills in primary care.

Key principles supporting these roles are:

• These MH Practitioners will provide consultation, advice, triage and liaison functions.
• These MH Practitioners would be employed by Central and North West London NHS Trust who will support the HR, clinical supervision and development aspects. Each PCN would need to contribute 50% of salary, pension, NI costs for the role.
• The PCNs would need to ensure that the MH Practitioners would not be expected to pick up all mental health related demand within a PCN footprint and would ensure that member practices make use of all other access routes.
• Central and North West London NHS Trust would ensure that the MH Practitioners are supported by robust clinical governance structures to maintain quality and safety, including supervision where appropriate.
  
  

Working for our organisation

CNWL (Central and North West London NHS Foundation Trust) has almost 8,000 staff providing integrated healthcare to a third of London's population, Milton Keynes and areas beyond.  We involve service users, carers, the public, staff and partner organisations in the way that we are run. 

We offer a generous relocation package (subject to eligibility assessment) and flexible working options, including bank assignments for most roles.  See attached Staff Reward and Wellbeing Handbook detailing our benefits, discounts and wellbeing initiatives for staff.

CNWL NHS Foundation Trust are committed to safeguarding all children and vulnerable adults and expect all staff and volunteers to share this commitment.  We follow safe recruitment practices to protect children and vulnerable adults.

Due to the high response levels we receive for some vacancies, we may expire any of them prior to the advertised closing date and advise you to submit your application as soon as possible. 

Our Agenda for Change employment contracts are subject to a contractual 13 week probationary period.

If you are offered a job, information will be transferred into the national NHS Electronic Staff Records system.

Detailed Job Description And Main Responsibilities

MH Practitioner will:

• work with patients to support shared decision-making about self-management; facilitate onward access to treatment services; and provide brief psychological interventions, where qualified to do so and where appropriate.
• Supervise and oversee the triage function within the mental health teams, being a point of reference for difficult decisions the triage team need to make on a daily basis, and supervising members of the triage team (where dedicated triage teams are the model) and ensuring the integration of the triage process as a part of the team’s function.
• work closely with other PCN-based roles to help address the potential range of biopsychosocial needs of patients with mental health problems. E.g. PCN clinical pharmacists for medication reviews, and social prescribing link workers for access to community-based support.
• operate without the need for formal referral from GPs, including accepting some direct bookings where appropriate, subject to agreement on volumes and the mechanism of booking between the PCN and the provider.
• be supported through the local Community Hub teams by robust clinical governance structures to maintain quality and safety, including supervision where appropriate.
  
  

MH Practitioner role benefits:

• PCNs – benefit from embedded resource to support the decision-making and management of people with mental health conditions. PCNs also benefit from MH providers overseeing all clinical supervision, registration and training requirements for these roles.
• Community Mental Health Hubs – benefit from strengthened link with GPs to support access to specific mental health input and higher quality triage function.
• Service users and carers – benefit from local and specialist resource that address their biopsychosocial needs closer to their homes and local communities and high-quality initial triage.
• System – benefits from roles that promote greater linkage between secondary and primary care services and enable move towards the place-based delivery of care.
  
  

Key Result Areas & Performance:

The characteristics of the core population are people with enduring mental health needs (psychosis; bi-polar; complex depression; trauma) and complex emotional needs who may find it difficult to:

• make or maintain relationships
• connect with other people, including friends, family or work colleagues
• manage and control their emotions
• cope with life and difficult feelings
• control their behaviours and impulses
  
  

Service users seen by the post holder will include those who have experienced high levels of distress and common mental health difficulties. Some service users may present with a high level of risk to both themselves and sometimes to other people. Assessments and interventions will be delivered both in the PCN and via the Mental Health Community Hub where suitable.

All clinical duties will be carried out under the supervision and direction of a qualified professional in the Community Hub Team. The post-holder has a responsibility to perform all tasks within the values of Central and North West London NHS Trust. Under such direction and with these conditions, the duties will be:

Clinical

• Supervise and oversee the triage function within the mental health teams, being a point of reference for difficult decisions the triage team need to make daily, and supervising members of the triage team (where dedicated triage teams are the model) and ensuring the integration of the triage process as a part of the team’s function.
• Provide specialist bio-psycho-social and mental state assessment for patients either as part of the transfer of care process or following request by primary care team.
• Provide advice to primary care to help prevent inappropriate referrals and provide support to patients and to find other ways of meeting their mental health needs.
• Carry out robust risk assessments and care planning in primary care environment.
• Provide access and /or deliver a broad range of psychosocial interventions for individual patients where needed.
• To be responsible for providing and receiving complex, sensitive, distressing and emotional information in relation to health issues where there are often barriers to acceptance.
• To spend sustained amounts of time with service users whose behaviour may be aggressive and hostile, who may have poor verbal communication skills and self-care and special physical and/or mental needs.
• To be mindful of the needs of individuals and families from a wide range of racial, cultural, sexual, religious and social backgrounds and, with service users and colleagues, co-produce innovative ways of communicating and working across language and cultural barriers.
• Where appropriate, provide expert advice regarding the pharmacological management of mental health patients to non-mental health professionals, seeking clinical guidance from the designated Consultant Psychiatrist/GP in relation to any specific prescribing advice.
• Be required to work in conjunction with individual members of the primary care team, patients and carers to develop personalised relapse/crisis plans
• Develop systems of engagement with key 3rd sector partners to identify and promote access to mainstream activities.
• Demonstrate a high standard of record keeping and documentation with adherence to Trust policy and an understanding of professional guidelines and application of confidentiality.
• Work with colleagues to develop and promote the service philosophy, framework of care delivery and strategic objectives, taking responsibility for specific areas of policy and strategy delivery.
• Work with colleagues to develop clinical expertise and high standards of professional practice.
• Deliver care that is evidence based, reflecting current best practice and research, demonstrating clinical excellence and high standards of professional practice to other staff.
• Demonstrate sound understanding of the legal and ethical issues in caring for people with a mental health condition. In particular, demonstrating sound understanding of the Mental Health Act (1983) and Mental Capacity Act and its use in a non-mental health setting.
• The post holder, in carrying out the above clinical work will identify the themes/training needs that emerge within the wider primary care team and mental health team. The post holder will work with others as part of the Community Mental Health hub to put together training packages, and support the delivery of training.
  
  

Person specification

Qualifications And Training

Essential criteria

• Professional qualification in mental health e.g. Occupational Therapy, Social Work or Mental Health Nursing (RMN) with current NMC/HCPC registration
• Attained at least Level 2 Maths and English (equivalent to GCSE grade 9-4 (A*-C))
  
  

Desirable criteria

• Educated to degree or Diploma level with other courses relevant to primary care mental health services e.g. CBT, Brief Solution Focussed Therapy etc
• RGN/physical health qualification
• Evidence of recent and on-going relevant further professional development
• Attendance at specialist short courses relevant to the post (e.g. MBT or DBT, Trauma Informed Care, Group Approaches)
  
  

Experience

Essential criteria

• Experience of work in the NHS, PCNs or outreach work, or local engagement work (e.g. youth worker, mentoring, peer support etc.), experience of working in voluntary sector, working in community groups.
• Work with client groups with serious mental health problems: mental health care and/or  working with carers and/or  delivering therapeutic group interventions and/or  working in MDTs and/or  audit, evaluation or research
• Work in multi-cultural settings
• Mental health issues as a service user or carer
  
  

Desirable criteria

• Evidence of experience in a Band 6 position or equivalent
• Other relevant post registration experience
• Work with interpreters
• Work with behaviours that challenge services
• Work with people with complex emotional needs (personality disorder)
• Conducting service-related research and or audit experience
• Experience of teaching/training in a formal or informal setting
• Experience of working in a primary care setting/ social care/ voluntary sector
• Experience of supervising junior staff within own and/or other disciplines
  
  

Knowledge

Essential criteria

• Basic understanding of health care systems and structures: staffing, roles and responsibilities, the role of hospitals, primary care and community care
• Team/self-management and organisation skills that enable a number of complex activities and clinical work to be undertaken, revising and adjusting these according to the needs of individual patients and the service
• Knowledge of counselling skills/cognitive behavioural skills, psychosocial interventions
• Knowledge of recovery approaches as used with those with mental health conditions
• Work with people from a wide range of backgrounds
• Contain and work with organisational stress and able to hold the stress of others
• Manage effectively exposure to distressing/highly emotional circumstances
• Manage effectively verbal aggression from service users, families, etc. and the risk of physical aggression
• Assessment and treatment of Deliberate Self Harm
  
  

Desirable criteria

• Ability to interpret research and apply to practice
• Specialist knowledge of mental health conditions as well as their relationship to physical disorders
  
  

Operational

Essential criteria

• Computer literate
• Being able to work flexibly across local environments
• Awareness of diversity of cultural norms and being able to respond to this appropriately
• Concentrate intensely for a substantial proportion of working time, during client contact, teaching/supervision sessions, team meetings, preparing written work etc.
• Use IT packages – word processing, e-mail and internet, Excel and Access
• Ability to use or learn NHS clinical systems
• Accept accountability for own work, and of working towards defined results
• Plan, organise and prioritise own workload
  
  

Desirable criteria

• Experience in using SystmOne