By the end of ST4 by k2S4876

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									NorthWestern Postgraduate School for Psychiatry


Trainer’s End of Post Structured Report Forensic Psychiatry:
submission to the Annual Review of Competence Progression Panel by the
trainee’s current trainer, summarising the trainee’s progress and achievement in
the placement

Please complete on a computer using the text boxes and drop down boxes, then
print and sign.
When completing this form the trainer must consider the progress of the trainee towards
achieving the competencies required to progress to the next phase of training. There are 18 main
areas in the curriculum which are detailed in the Core and Advanced Specialty Curricula which
can be found on the College website http://www.rcpsych.ac.uk/training/curriculum2010.aspx
Further helpful information can be found in RCPsych Occasional Paper OP69
http://www.rcpsych.ac.uk/files/pdfversion/OP69x.pdf
As a benchmark,
    • By the end of CT/ST1 the trainee will be “safe to make management decisions in
        straightforward cases; under supervision”
    • By the end of CT3/ST3 the trainee will be “safe to make decisions in all but the most
        complex clinical situations; competent”
    • By the end of ST5 the trainee will be “safe in virtually all clinical situations; able to
        supervise others”
    • By the end of ST6 “safe to lead and support others in all situations; mastery - mentors
        other”



Section 1 - Basic information:


Trainee’s name:

GMC number

Current placement (e.g.       Assertive Outreach)


Unit (e.g. North City CMHT)

Dates of placement:                                 Date


Name of Trainer/Clinical supervisor:

GMC number:


Space for additional notes.
NorthWestern Postgraduate School for Psychiatry




Section 2 – Trainer’s Assessment of Trainee’s Performance

When completing this section, please use the drop down boxes to give your
rating of the progress made by the trainee. These cover the main
competencies in the curriculum that need to be attained in order to progress
to the next year of training. Details of what is expected of trainees by the
end of this year are set out for each of the competencies.


Please rate the trainee on a scale from 1 through to 4. Please score 4 if the
trainee has met the requirements for the ILO for the current year of
training. This means that you can use the full range of scores with each
trainee.

1= Little or no evidence of competence
2=Some elements of competence are present
3=Approaching competency
4=Competency attained

The white space box should be completed in all cases where you give a score
of 1-3. Record what the trainee needs to do or demonstrate in order to move
to a score of 4.
NorthWestern Postgraduate School for Psychiatry



1 Be able to perform specialist assessment of patients and document
relevant history and examination on culturally diverse patients to
include: -Presenting or main complaint -History of present illness -
Past medical and psychiatric history -Systemic review -Family history
-Socio-cultural history -Developmental history
 By the end of ST4 the trainee will be        By the end of ST5 the      By the end of ST6 the trainee
 able to take a comprehensive history         trainee will be able to    will be able to supervise the
 from a patient presenting to an inpatient    independently assess       assessment of a forensic patient
 forensic service. Core conditions to be      under supervision any      by a core trainee. They will be
 assessed are in particular schizophrenia,    patient presenting to a    able to independently assess the
 affective disorders, all other psychotic     specialist forensic        most complex cases, involving
 conditions in ICD, all personality           service e.g. prison,       multilayered complicating factors
 disorder especially antisocial, paranoid     police station, NHS or     including personality disorder,
 and borderline, developmental disorders      Independent hospital.      substance misuse, medico legal
 including Aspergers syndrome and                                        and diversity issues.
 organic disorders. The understanding         Assess forensic patients
 and assessment of substance misuse           in differing levels of
 and its role in forensic presentation and    security to identify
 risk is essential.                           clinical need and
 Understand the legal context of forensic     understand the balance
 patient assessment. Understand the           needed for public
 nature of forensic psychiatric services      protection.
 and differing institutions that may affect
 patient presentation. Understand the
 relevance of physical, procedural and
 relational security to patients‟ clinical
 needs and presentation.



       History taking                                                                                1
       Mental state examination                                                                      1
       Physical examination                                                                          1
       Documentation                                                                                 1
       Suggestions for development / comment




2 Demonstrate the ability to construct formulations of patients’
problems that include appropriate differential diagnoses
 By the end of ST4, the trainee      By the end of ST5, the trainee      By the end of ST6, the trainee
 will, be able to independently      will independently construct a      will be able to supervise
 construct a formulation for a       formulation of a patient            students, foundation and core
 patient in a specialist forensic    presenting newly to a specialist    trainees in the development of
 inpatient unit                      forensic service.                   an appropriate formulation for
                                                                         patients in a forensic service.



       Create a Differential diagnosis                                                               1
       Identify Aetiology Factors                                                                    1
       Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry



3 Demonstrate the ability to recommend relevant investigation and
treatment in the context of the clinical management plan. This will
include the ability to develop and document an investigation plan
including appropriate medical, laboratory, radiological and
psychological investigations and then to construct a comprehensive
treatment plan addressing biological, psychological and socio-cultural
domains
 By the end of ST4, the trainee     By the end of ST5, the trainee      By the end of ST6, the trainee
 will be able to independently      will be able to independently       will be able to comprehensively
 formulate a plan of                formulate a plan of investigation   manage a forensic patient
 investigations and treatment for   and treatment for a new patient     presenting a range of complex
 a newly admitted forensic          presenting to specialist forensic   conditions including personality
 inpatient.                         services, especially in prison,     disorder, mental illness,
                                    police custody and the              learning disability with a
                                    community.                          multidisciplinary team,
                                                                        including managing, the CPA
                                                                        process, prison transfers and
                                                                        independent liaison with
                                                                        relevant third parties:-police,
                                                                        government agencies, courts,
                                                                        solicitors.



       Negotiate Treatment                                                                         1
       Further Investigations                                                                      1
       Treatment Planning                                                                          1
       Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry



4 Based on a comprehensive psychiatric assessment, demonstrate the
ability to comprehensively assess and document patient’s potential for
self-harm or harm to others. This would include an assessment of
risk, knowledge of involuntary treatment standards and procedures,
the ability to intervene effectively to minimise risk and the ability to
implement prevention methods against self-harm and harm to others.
This will be displayed whenever appropriate, including in emergencies
 By the end of ST4, the          By the end of ST5 the            By the end of ST6 the trainee will
 trainee will be able to         trainee will competently Use     demonstrate the ability to develop risk
 develop comprehensive           standardized risk                management plans with a
 clinical risk assessment of     assessment tools                 multidisciplinary team. Able to manage
 forensic patients. The          understanding theory,            risks of forensic patients as inpatients,
 trainee will have gained        strengths and limitations of     community patients, prisoners and other
 recognized approval under       actuarial approaches The         specialist facilities. Management of the
 relevant MHA and will           trainee will demonstrate skill   specific risks of Specialist populations of
 demonstrate an                  in developing plans for          forensic patients presenting with high
 understanding of the legal      Medico-legal management of       risk behaviours particularly persistent
 framework for detention and     incompetent forensic             severe self harm, and including those at
 treatment of forensic           inpatient or capacitous          high risk in prisons Understand and
 inpatients including            patient refusing treatment.      develop plans for the medico legal
 restriction orders. The         Demonstrate skills in writing    management of patients out with
 trainee will demonstrate        formal reports addressing        hospital for the purposes of MH
 ability to write formal         simple medico-legal issues       legislation including the transfer of
 reports for Mental Heath        including medical disposal at    prisoners and those in police custody.
 Review Tribunals (MHRT),        court, advice on Restriction     Understand legal clinical and ethical
 hospital managers, and          Orders. Demonstrate ability      issues of the emergency treatment of
 equivalents as well as          to give evidence to courts       prisoners under common law. The
 discharge letters and reports   on simple medico legal           trainee will be able to manage a patient
 for the relevant Government     issues e.g. restriction order    requiring recall to hospital. Manage legal
 bodies that administer          disposal                         aspects of discharging a patient
 Restriction Orders. The                                          including remission to prison, discharge
 trainee will give appropriate                                    to step down services, discharge to the
 evidence to hospital                                             community including compulsory
 managers, MHRT and                                               treatment in the community. Understand
 equivalent hearings                                              the management of a potential hostage
                                                                  situation The trainee will demonstrate
                                                                  the ability to write formal reports to 3rd
                                                                  parties including to courts legal
                                                                  representatives, judicial bodies covering
                                                                  complex issues especially fitness to
                                                                  plead, mental condition defenses,
                                                                  dangerousness and sentencing. The
                                                                  trainee will be able to give evidence to
                                                                  courts on more complex medico legal
                                                                  issues e.g. fitness to plead, defenses,
                                                                  dangerousness

       Psychiatric Emergencies                                                                         1
       Mental Health Legislation                                                                       1
       Broader Legal Framework                                                                         1
       Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry



5 Based on the full psychiatric assessment, demonstrate the ability to
conduct therapeutic interviews; that is to collect and use clinically
relevant material. The doctor will also demonstrate the ability to
conduct a range of individual, group and
 By the end of ST4, the trainee will be    By the end of ST5, the          By the end of ST6, the trainee
 able to perform an assessment of a        trainee will demonstrate the    will demonstrate the ability to
 forensic patient to review                ability to engage in            manage a CPA of a forensic
 psychological treatment needs. The        psychological treatment of      patient, discussing psychological
 trainee will demonstrate an               forensic psychiatric patient.   issues and prescribing relevant
 understanding of different                                                psychological therapies. The will
 psychotherapeutic approaches and                                          demonstrate an understanding
 the impact and therapeutic use of                                         of the impact of victims in the
 security By the end of ST6, the                                           management of a forensic
 trainee will demonstrate the ability to                                   patient
 manage a CPA of a forensic patient,
 discussing psychological issues and
 prescribing relevant psychological
 therapies. The will demonstrate an
 understanding of the impact of
 victims in the management of a

       Progress towards undertaking a psychotherapy case                                               1
       Ability to apply psychological models in formulations                                           1
       Suggestions for development / comment




6 Demonstrate the ability to concisely, accurately and legibly record
appropriate aspects of the clinical assessment and management plan
The trainee should continue to demonstrate the ability to properly record appropriate aspects of
clinical assessments and management plans


       Record Keeping                                                                                  1
       Suggestions for development / comment



7 Develop the ability to carry out specialist assessment and treatment of patients with chronic and
severe mental disorders and to demonstrate effective management of these disease states
 By the end of ST4 the            By the end of ST5 the trainee will     By the end of ST6 the trainee
 trainee will demonstrate the     demonstrate the ability to develop     will demonstrate the ability to
 ability to undertake             rehabilitation and management          manage a CPA of a forensic
 assessments of forensic          plans for long-term forensic patient   patient with long-term enduring
 patients with long-term          with enduring problems                 problems of intractable
 needs.                           demonstrating an understanding of - symptoms and risk
                                  Institutionalization
                                  - Principles of recovery

       Deliver treatment plan for a patient with chronic mental illness                                0
       Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry

8 Use effective communication with patients, relatives and colleagues.
This includes the ability to conduct interviews in a manner that
facilitates information gathering and the formation of therapeutic
alliances
 By the end of ST4, the trainee     By the end of ST5, the trainee         By the end of ST6, the trainee
 will demonstrate the ability to    will demonstrate the ability to        will demonstrate the ability to
 effectively communication with     conduct an independent                 conduct an independent
 forensic patients, relatives and   assessment of patient with             assessment of patient with
 professional colleagues.           carers – especially information        communication difficulties. As
                                    gathering, imparting relevant          part of which they will organise
                                    information, and understanding         and appropriately utilise
                                    levels of confidentiality.             interpreters.

       Ability to conduct interviews                                                                   1
       Ability to use emotional sensitivity                                                            1
       Suggestions for development / comment




9 Demonstrate the ability to work effectively with colleagues,
including team working
 By the end of ST4, the trainee will be able   By the end of ST5, the        By the end of ST6, the trainee
 to describe and understand the role of a      trainee will demonstrate      will demonstrate the ability to
 forensic psychiatrist and the roles and       the ability to work with      effectively contribute to and
 responsibilities of other members of an       multidisciplinary teams       where appropriate lead MDTs
 MDT. Understand the legal responsibilities    and identify and resolve      including CPA, discharge
 of a forensic psychiatrist. By the end of     dysfunction within the        planning (S.117 or
 ST6, the trainee will demonstrate the         team. Develop                 equivalent), Multi-Agency
 ability to effectively contribute to and      awareness of                  Public Protection
 where appropriate lead MDTs including         institutional dysfunction     Arrangements (MAPPA) (or
 CPA, discharge planning (S.117 or             at individual and             Public Protection
 equivalent), Multi-Agency Public Protection   organization level and to     Arrangements Northern
 Arrangements (MAPPA) (or Public               effectively report and        Ireland), Victim liaison, NHS
 Protection Arrangements Northern              facilitate the                management.
 Ireland), Victim liaison, NHS management.     management of
                                               difficulties.

       Team Working                                                                                    1
       Suggestions for development / comment




10 Develop appropriate leadership skills
 By the end of ST4, the trainee     By the end of ST5, the trainee         By the end of ST6, the trainee
 will demonstrate the ability to    will demonstrate the ability to        will demonstrate the ability to
 lead the MDT assessment of a       lead the MDT clinical                  participate in a change
 forensic psychiatric patient, to   management meeting                     management project,
 coordinate and agree an initial    concerning a forensic psychiatric      demonstrating an understanding
 management strategy.               patient, setting treatment goals       of leadership strategies within
                                    both short and long term               the wider management
                                                                           framework.

       Leadership skills                                                                               1
       Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry



11 Demonstrate the knowledge, skills and behaviours to manage time
and problems effectively
The trainee should continue to demonstrate the ability to properly manage time


       Time management                                                                             1
       Communication with colleagues                                                               1
       Problem-solving and decision making                                                         1
       Maintaining continuity of care                                                              1
       Responding to complaints                                                                    1
       Suggestions for development / comment




12 Demonstrate the ability to conduct and complete audit in clinical
practice
 By the end of ST4, the trainee     By the end of ST5 the trainee      By the end of ST6, the trainee
 will demonstrate the ability to    will be able to demonstrate the    will demonstrate the ability to
 undertake an audit relevant to     ability to conduct an audit        initiate supervise and present a
 forensic in patient service as     project without direct             different audit project from
 part of the unit audit cycle.      supervision, be able to set        those conducted in ST4 and 5,
                                    standards and be able to           with a junior colleague.
                                    demonstrate how the results of
                                    an audit project have quality
                                    improvement

       Performing and Presenting an Audit                                                          1
       Suggestions for development / comment




13 to develop an understanding of the implementation of clinical
governance
 By the end of ST4, the trainee     By the end of ST5, the trainee     By the end of ST6, the trainee
 will demonstrate an awareness      will demonstrate an                will demonstrate an ability to
 of risk management issues and      understanding of risk              handle a Singular Untoward
 healthcare governance issues       management issues and              Incident (SUI) and ability to
                                    healthcare governance issues.      work nationally, regionally or
                                    Develop a capacity to use          locally to develop and
                                    governance data e.g. monitor       implement clinical guidelines
                                    pattern of incidents in a secure   and care pathways (if not
                                    unit and develop management        completed in ST5)
                                    strategies.

       Understanding of a Clinical Governance Framework                                            1
       Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry



14 To ensure that the doctor is able to inform and educate patients
effectively
The trainee should maintain the ability to advise patients about the nature and treatment of
common mental illnesses, so the patient may be more able to participate in their treatment and
the ability to advise patients about environmental and lifestyle factors and the adverse effects of
alcohol, tobacco and illicit drugs


        Ability to effectively inform and educate patients                                            1
        Suggestions for development / comment




15 To develop the ability to teach, assess and appraise
 By the end of ST4, the trainee      By the end of ST5, the trainee       By the end of ST6, the trainee
 will demonstrate an ability to      will demonstrate an                  will demonstrate an ability to
 use a number of different           understanding of the basic           organise (including evaluate)
 teaching methods and an ability     principles of adult learning and     educational events (if not
 to conduct workplace-based          of different learning styles and     completed in ST5) and an ability
 assessments (WPBA’s) for            demonstrate ability to assess        to conduct an appraisal of a
 foundation or core trainees         medical student/ foundation          colleague
                                     doctor

        Ability to teach                                                                              1
        Ability to construct a learning plan                                                          1
        Ability to participate in appraisal                                                           1
        Suggestions for development / comment




16 To develop an understanding of research methodology and critical
appraisal of the research literature
 By the end of ST4, the trainee      By the end of ST5, the trainee       By the end of ST6 should
 should be able to frame an          should demonstrate the ability       demonstrate the ability to
 appropriate research question,      to collect data and enter it into    prepare findings of research,
 conduct a relevant literature       standard computer software           audit or similar work for
 search, write a comprehensive       (this may be from the trainee’s      dissemination beyond the
 review of this literature and       own research or audit) and be        trainee’s workplace and be able
 write a research protocol (this     able to demonstrate the              to communicate the importance
 may be for a project that the       incorporation of research            of applying research findings to
 trainee will conduct or it may be   findings in their everyday           colleagues
 in ‘shadow’ form)                   practice


        Use of evidence in practice                                                                   1
        Knowledge of techniques                                                                       1
        Critical Appraisal                                                                            1
        Suggestions for development / comment
NorthWestern Postgraduate School for Psychiatry




17 To ensure that the doctor acts in a professional manner at all times
 By the end of ST4 the trainee     By the end of ST5, the trainee      By the end of ST6 will not only
 will demonstrate an               will demonstrate an                 exemplify the highest standards
 understanding of the issues       understanding of the need for       of professionalism in their own
 surrounding confidentiality and   safe and positive decision-         practice but will also
 the appropriate sharing of        making with respect to risk         demonstrate an ability to
 information and the need for      management for community            support and advise colleagues in
 safe and positive decision-       forensic patients and specialised   dealing with complex
 making with respect to risk       populations e.g. prisons            professional interactions,
 management with respect to                                            including the safe and
 risk management in forensic                                           appropriate sharing of
 inpatients                                                            information, understanding
                                                                       relevant legal and professional
                                                                       frameworks e.g. Human rights
                                                                       legislation, Duties of a
                                                                       Psychiatrist, GMC guidance,
                                                                       MAPPA (or equivalent)
                                                                       guidelines
                                                                       The trainee will demonstrate the
                                                                       ability to recognise the limits of
                                                                       expertise when preparing formal
                                                                       reports or giving evidence to
                                                                       formal bodies such as courts.

       Understanding of Doctor-Patient relationship                                                 1
       Confidentiality                                                                              1
       Risk Management                                                                              1
       Recognising own limits                                                                       1
       Probity                                                                                      1
       Health                                                                                       1
       Suggestions for development / comment




18 To develop the habits of lifelong learning
 In this stage of training, the    In this stage of training, the      In this stage of training, the
 trainee will continue to          trainee ill co tinue to             trainee will continue to
 demonstrate commitment to         demonstrate commitment to           demonstrate commitment to
 their professional development    their professional development      their professional development
 and to professionally-led         and to professionally-led           and to professionally-led
 regulation                        regulation                          regulation

       Maintaining Good Medical Practice                                                            1
       Lifelong learning                                                                            1
       Relevance of Outside Bodies                                                                  1
       Suggestions for development / comment




…………………………………………………………………………………
NorthWestern Postgraduate School for Psychiatry

Please now comment from your first hand knowledge on the following regarding this doctor

Experiential outcomes

Activity                                  Comments
Portfolio Development (has
trainee discussed and shared portfolio
content with trainer on regular basis)
Weekly Supervision (preparation,
attendance and participation)
Progress of PDP (based on PDP
agreed at start of post)
Previous ARCP result                      1

Review of previous ARCP
requirements
Emergency work. ( is the
trainee developing experience
and competence in emergency
psychiatry)
Special interest sessions (if
applicable)
Participation in Psychotherapy
Training
Participation in Research ( if
applicable)
Participation in Teaching
Publications
Presentations
Participation in WPBA
Schedule
Other courses attended –
mandatory and others

Other outcomes in this placement

                                      Notes
Reported adverse
incidents
Complaints (Record if
justified or unjustified in view of
person who investigated
complaint, and trainees approach
to the complaint)
Sick leave. (number of days
sick in this post)

Other leave        (maternity,
paternity, carers, compassionate)


On calls completed
(record number only)
NorthWestern Postgraduate School for Psychiatry



Section 3 - Global Performance and Professionalism

Anything especially good?

Areas for development – 3 to be listed

GMC Registration; are there any restrictions
warnings or other registration matters
(trainers can check a Doctors registration status with the GMC at
www.gmc-uk.org
Concerns identified*

Health                                                              I confirm there #are / #are no health
                                                                    concerns that impact on this trainees
                                                                    fitness to practice
                                                                    Total days sick this academic year
Probity                                                             I confirm there #are / #are no concerns in
                                                                    relation to probity or registration for this
                                                                    trainee (and if there are I have consulted
                                                                    with the Clinical Director and Training
                                                                    Programme Director on this issue
                                                                    beforehand).
Complaints/adverse incidents (or none)


* Where cause for concern is documented the basis for this must be clear and explicit
 Please delete as necessary

Section 4: TRAINER DECLARATION
I confirm that (tick as appropriate):

 I understand that I have a professional duty to document any concerns identified AND



 I have reviewed the evidence required to demonstrate fitness to progress for the relevant year
of training and consider the trainee fit to progress and suitable for a career in psychiatry OR
 I have concerns about this trainee which have been documented in the report and forwarded
to their Programme Director

Signed                                                   Date                        Print Name


Section 5: TRAINEE DECLARATION
I confirm that:
The evidence provided to inform my annual review is a complete, accurate record of my
achievements during this period of my training. I confirm that my trainer has discussed this
report with me and reported any concerns regarding my progress.
NorthWestern Postgraduate School for Psychiatry

Signed                             Date           Print Name

								
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