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Core and General Module February 2006
Approved by the Postgraduate Medical Education and Training Board
A Competency Based Curriculum for
Specialist Training in Psychiatry
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Features of the Curriculum This curriculum has several innovative features and this short section describes some of them. The curriculum is intended to be electronic – the College will not publish a printed version, although anyone who wishes to is welcome to print a hard copy for themselves. The curriculum is set out under the domains of Good Medical Practice and the content is then organized in a hierarchical structure within each domain. This structure descends through the sub-headings that Good Medical Practice uses for each domain; then major competencies for each sub-heading. Most of the major competencies have a number of aspects, and the supporting competencies for each aspect are set out under the headings of knowledge, skills and attitudes. For example: Domain from Good Medical Practice 1. Good Clinical Care Sub-heading from Good Medical Practice A. Providing a good standard of practice and care Major competency Undertake clinical assessment of patients with mental health problems Aspect of major competency Consultation Supporting competency (knowledge) Psychiatrists apply knowledge of specific techniques and methods that facilitate
effective and empathic communication between the psychiatrist, patient, carers, colleagues and the wider healthcare system including:
• acknowledging diversity relating to age, gender, race, culture, disability, spirituality and sexuality.
Hyperlinks are embedded to facilitate navigation (in both directions) through the structure. Developing performance is indicated for major competencies or aspects of competencies under the headings of ‘under supervision’ ‘competent’ and ‘mastery’. The stage of training when ‘under supervision’ and ‘competent’ levels of performance are expected is indicated by the use of coloured text – red indicates ST1; orange ST2 and 3; violet ST4 and 5; green ST6.
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INDEX
• Summary of Major Competencies • Competencies for:
1. GOOD CLINICAL CARE 2. WORKING WITH COLLEAGUES
3. PROBITY
4. HEALTH
• APPENDIX 1: Summary of Areas of Core Medical Knowledge Underpinning Specialist Training in Psychiatry
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Summary of Major Competencies Back to Index
1. GOOD CLINICAL CARE 2. WORKING WITH COLLEAGUES 3. PROBITY 4. HEALTH
1. GOOD CLINICAL CARE A. PROVIDING A GOOD STANDARD OF PRACTICE AND CARE MAJOR COMPETENCIES:
• UNDERTAKE CLINICAL ASSESSMENT OF PATIENTS WITH MENTAL HEALTH PROBLEMS o consultation, including history-taking o patient examination, including mental state examination (MSE) and physical examination o patient evaluation, formulation and record keeping
• MANAGE CHRONIC MENTAL ILLNESS o assessment and management of patients with severe and enduring mental illness
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B. DECISIONS ABOUT ACCESS TO MEDICAL CARE MAJOR COMPETENCY:
• USE THE RESULTS OF THE CLINICAL ASSESSMENT TO ENSURE EFFECTIVE PATIENT MANAGEMENT o application of scientific knowledge o patient management including access to appropriate care o treatment (therapeutics) (ST1)
C. TREATMENT IN EMERGENCIES MAJOR COMPETENCY:
• MANAGE EMERGENCIES o assessment and management of psychiatric emergencies (ST1)
D. MAINTAINING GOOD MEDICAL PRACTICE MAJOR COMPETENCY:
• MAINTAIN AND USE SYSTEMS TO UPDATE KNOWLEDGE AND ITS APPLICATION TO ANY ASPECT OF YOUR PROFESSIONAL PRACTICE
o legislation concerning patient care; the rights of patients and their relatives and carers; and research o keeping up to date with clinical advances (ST1)
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E. MAINTAINING YOUR PERFORMANCE MAJOR COMPETENCY:
• MONITOR AND MAINTAIN PROFESSIONAL PERFORMANCE o develop, maintain and routinely practice critical self-awareness o work with colleagues to monitor and maintain your awareness of the quality of care you provide o actively participate in a programme of clinical governance (ST1)
F. TEACHING AND TRAINING, APPRAISING AND ASSESSING MAJOR COMPETENCIES:
• PLAN, DELIVER, AND EVALUATE TEACHING AND LEARNING IN A VARIETY OF ENVIRONMENTS • ASSESS, APPRAISE AND EVALUATE LEARNING AND LEARNERS • SUPERVISE AND MENTOR LEARNERS (STUDENTS AND TRAINEES) • PROVIDE REFERENCES
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G. CONDUCT PATIENT RELATIONSHIPS IN A PROFESSIONAL MANNER MAJOR COMPETENCY:
• CONDUCT PROFESSIONAL PATIENT RELATIONSHIPS o good communication o obtaining consent o respecting confidentiality o maintaining trust o ending professional relationships with patients
H. DEALING WITH PROBLEMS IN PROFESSIONAL PRACTICE MAJOR COMPETENCIES:
• CONDUCT OR PERFORMANCE OF COLLEAGUES • COMPLAINTS AND FORMAL INQUIRIES • INDEMNITY INSURANCE
Back to beginning of section
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2. WORKING WITH COLLEAGUES
A. TREATING COLLEAGUES FAIRLY MAJOR COMPETENCIES:
• CONTINUOUSLY PROMOTE VALUE BASED NON PREJUDICIAL PRACTICE o legal o ethical o diversity
B. WORKING IN TEAMS MAJOR COMPETENCIES:
• WORK EFFECTIVELY AS A MEMBER AND A LEADER OF MULTIDISCIPLINARY TEAMS o effectively, appropriately and constructively work as a member of a team of healthcare professionals o identify and rectify team dysfunctions o recognise and take proper account of differences in values and beliefs within multidisciplinary teams o demonstrate an awareness of the roles and responsibilities of the multi-disciplinary teams within the broader
health and social care context
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C. LEADING TEAMS MAJOR COMPETENCIES:
• DEMONSTRATE APPROPRIATE LEADERSHIP o effectively, appropriately and constructively lead and manage as a member of a team of healthcare
professionals o monitor the team’s work
D. ARRANGING COVER E. TAKING UP APPOINTMENTS F. SHARING INFORMATION WITH COLLEAGUES MAJOR COMPETENCIES:
• COMMUNICATE EFFECTIVELY WITH OTHER HEALTHCARE PROFESSIONALS o record keeping o good verbal and communication skills o working within the framework of legislation, custom and practice
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G. DELEGATION AND REFERRAL MAJOR COMPETENCIES:
• APPROPRIATELY ASSUME, DELEGATE AND DEVOLVE RESPONSIBILITY • IDENTIFY PROCEDURES TO ACCESS ADVICE, ASSISTANCE AND SECOND OPINION
Back to beginning of section
3. PROBITY A. PROVIDING INFORMATION ABOUT YOUR SERVICES MAJOR COMPETENCIES:
• EFFECTIVE AND ETHICAL PROVISION OF INFORMATION
B. WRITING REPORTS, GIVING EVIDENCE AND SIGNING DOCUMENTS MAJOR COMPETENCIES:
• ENSURE THAT REPORTS, EVIDENCE AND DOCUMENTS YOU HAVE A RESPONSIBILITY FOR ARE COMPLETE, HONEST AND ACCURATE
o relevant contemporary legislation o giving evidence and teaching others how to give evidence o writing reports
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C. RESEARCH MAJOR COMPETENCIES:
• ENSURE THAT CPD CONTAINS AN ELEMENT OF RESEARCH o making sense of and appropriately applying research findings to service (e.g. evidence based practice) o complete research projects and disseminate findings appropriately
• CARRY OUT AND SUPERVISE RESEARCH D. FINANCIAL AND COMMERCIAL DEALINGS MAJOR COMPETENCIES:
• PROPERLY MANAGE FINANCIAL AND COMMERCIAL DEALINGS E. CONFLICTS OF INTEREST MAJOR COMPETENCIES:
• AVOID CONFLICTS OF INTEREST AND ADVISE OTHERS ON PREVENTING AND DEALING WITH CONFLICTS OF INTEREST F. FINANCIAL INTERESTS IN HOSPITALS, NURSING HOMES AND OTHER MEDICAL ORGANISATIONS
Back to beginning of section
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4. HEALTH A. IF YOUR HEALTH MAY PUT PATIENTS AT RISK MAJOR COMPETENCIES:
• ENSURE THAT YOUR HEALTH AND THE HEALTH OF OTHERS DOES NOT PUT PATIENTS AT RISK o advice and treatment for mental and physical health problems
Back to beginning of section
Back to IndexBack to summary
1. GOOD CLINICAL CARE
1. GOOD CLINICAL CARE A. Providing a good standard of practice and care B. Decisions about access to medical care C. Treatment in emergencies D. Maintaining good medical practice E. Maintaining your performance F. Teaching and training, appraising and assessing G. Relationships with patients H. Dealing with problems in professional practice
All patients are entitled to good standards of practice and care from their doctors. Essential elements of this are professional competence; good relationships with patients and colleagues; and observance of professional ethical obligations. All aspects of professional service must be conducted with the highest standards of ethics and probity. Effective clinical care or patient care combines many competencies into performance wherein the assessment, care and management of individual patients and groups of patients are the outcomes. At its core this states that the doctor must be able to provide patient care that is appropriate, compassionate and effective.
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Clinical skills including those of investigation, communication and problem solving are developed alongside medical knowledge and professionalism so that the competent psychiatrist will:-
1. communicate effectively and show care, respect and empathy when interacting with patients and carers. 2. gather and handle accurate and appropriate information about their patients.
3. make clinical decisions (about diagnosis and treatment) based on patient information and preferences, contemporary
scientific evidence, available clinical guidance and where available audit results.
4. develop and implement patient management plans.
5. use information technology to support patient care.
6. support and educate patients and carers.
7. work with other health and social care professionals including those of other disciplines to provide patient care.
8. where possible provide and/or support services aimed at the prevention of mental health problems.
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A. PROVIDING A GOOD STANDARD OF PRACTICE AND CARE
Back to beginning of sectionBack to summary
MAJOR COMPETENCIES:
• UNDERTAKE CLINICAL ASSESSMENT OF PATIENTS WITH MENTAL HEALTH PROBLEMS
• MANAGE CHRONIC MENTAL ILLNESS Good clinical care must include an adequate assessment of the patient’s condition, based on the history, symptoms, mental state examination and an appropriate physical examination; providing or arranging investigations or treatment where necessary; referring the patient to another practitioner, when indicated. At all stages of training, psychiatrists must keep colleagues well informed when sharing the care of patients; provide the necessary care to alleviate pain and distress whether or not curative treatment is possible; prescribe drugs or treatment, including repeat prescriptions, only where there is adequate knowledge of the patient’s health and medical needs. Psychiatrists must not give or recommend to patients any investigation or treatment which is not in their best interests, nor withhold appropriate treatments or referral. Report adverse drug reactions as required under the relevant reporting scheme and co-operate with requests for information from organisations monitoring the public health. The psychiatrist should strive to make efficient use of the resources available to them. Psychiatrists must take and accept responsibility for the patient’s journey in all clinical contexts. They will set high standards in clinical practice in their specialist field and will be able to demonstrate strong analytical skills and insight in the clinical decisions they make about the treatment and care of patients psychiatrists practice safely within their specialist field and acknowledge when cases go beyond their expertise and when they need to refer to other specialists for advice. Psychiatrists ensure that they and their colleagues work within the current legislation and ethical guidelines in their field. They monitor clinical practice and evaluate and modify where appropriate protocols in the light of evidence-based research and audit findings. Psychiatrists will ensure clear and effective systems of sharing information, record-keeping and report-writing in the unit.
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MAJOR COMPETENCY:
• UNDERTAKE CLINICAL ASSESSMENT OF PATIENTS WITH MENTAL HEALTH PROBLEMS Back to summary
Aspects Developing Performance
Under Supervision Competent Mastery
Consultation
Elicit information required for each component of a routine psychiatric history using skills detailed below.
In situations of urgency, prioritise what information is needed. Gather this information in difficult or complicated situations.
Serve as a teacher, role model and supervisor.
Patient examination and diagnosis
Assess MSE and physical state in patients with common conditions.
By the completion of their training, psychiatrists will be able to perform a comprehensive psychiatric assessment in people of all ages with mental health problems and mental illness.
Assess and diagnose patients with multiple complicated pathologies.
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Patient evaluation and record keeping
Keep contemporaneous notes. Dictate discharge summaries and letters.
By the completion of training, psychiatrists will be able to identify psychopathology, formulate accurate differential working diagnoses within accepted classification systems, and develop appropriate assessment and care and treatment plans for patients.
Teach, supervise and assist junior colleagues in patient evaluation and in compiling and maintaining good records.
Aspect: Consultation Essential to any specialty of medicine, the ability to communicate and develop interpersonal rapport with patients is of fundamental importance in the practice of psychiatry. The attitude, skills and behaviours that create strong interpersonal ability are integral to the practice of all branches of medicine. Psychiatrists must be able to demonstrate interpersonal and communication skills that result in effective information exchange and working with patients, carers and professional colleagues. This, therefore, includes the following important skills:
• The ability to create and sustain a therapeutic and ethically sound relationship with patients. • The use of effective listening skills to elicit and provide information using effective verbal and non-verbal explanatory,
questioning and writing skills. • The ability to elicit information, including skills in gaining important diagnostic data and data affecting treatment from
individuals from diverse backgrounds, as well as skills in tolerating and managing high levels of stress and emotion.
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Knowledge
Psychiatrists apply knowledge of specific techniques and methods that facilitate effective and empathic communication between the psychiatrist, patient, carers, colleagues and the wider healthcare system including:
• acknowledging diversity relating to age, gender, race, culture, disability, spirituality and sexuality.
• demonstrating an awareness of the impact of discrimination and prejudice on mental health and mental health services.
• taking ensuring that all therapeutic interventions are set within a framework that acknowledges and respectdiversity. Issues of age, social background, race and culture require particular attention on account of thnature and consequences of stigma, discrimination and exclusion. Recog
s e
nise that social inequality and
• s relationship ethics and analytic ethics.
• demonstrating adherence to local, professional and national codes of practice.
exclusion have a potentially devastating effect on the recovery process.
• contributing positively to the role that services have to play in fighting inequality and discrimination.
e or more of the main schooldescribing the theoretical underpinnings of ethical reasoning processes from onof ethical theory, such as consequentialism deontology, virtue ethics,
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Aspect: Consultation
Skills
Psychiatrists consistently demonstrate the following consultation skills:
• elicit and clearly record a complete psychiatric history, including the chief complaint, the history of the present illness, past medical history, past psychiatric history, medication both psychiatric and non-psychiatric, general medical history, review of systems, substance abuse history, family history, forensic history, and personal and social history, and discuss and describe the effect of developmental issues on the assessment of patients.
• listen to and acknowledge perspectives and views of colleagues, patients, carers, advocates, chaplains, spiritual/religious support networks, service user groups and other agencies.
• communicate effectively with patients and families using verbal, non-verbal and written skills as appropriate.
• ssionals about relevant psychiatric and psychological issues.
make a positive difference but also do so in ways that respect and value diversity including age, race, culture, disability, gender, spirituality and sexuality.
• develop and demonstrate competence in consultation skills with patients with cognitive impairment.
• foster a therapeutic alliance with patients.
• share information with patients and carers in a clear, timely and meaningful fashion.
• practice in a manner that seeks to optimise the consent of patients in all aspects of their assessment, treatmentand care.
• engage and sustain relationships with patients in a manner that maximises their participating and optimises co-operation and consent.
educate patients, carers and profe
• work in partnership with patients, carers, families and colleagues to provide care and interventions that not only
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Aspect: Consultation
Attitudes
Demonstrate an understanding of the impact of their own feelings and behaviours on assessment and treatment by:
• reflecting on own practice.
• managing the personal/professional boundary to minimise the impact of work with patients on own processes, mental health and social well being.
Demonstrate respect for the patient taking cultural, ethical, and economic background and its impact into account by:
• practicing in a manner that demonstrates respect for the diverse cultures, beliefs and values of patient
promoting patient rights to choice
s.
• , confidentiality and protection while recognising the complexities of
Demonstrate a p f
• thical codes to
ng and systems, and the consequences of actions and decisions.
organisational, professional and individual values and beliefs.
• applying the method of principles reasoning, casuistry and perspectives to ethipractice.
competing rights, responsibilities and demands. ro essional, ethically sound behaviour and attitude in all patient and professional interactions including:
maintaining the centrality of the best interest of the patient through the consistent application of eall aspects of assessment, treatment and case management.
• making explicit ethical reasoni
• recognising and taking steps to address ethical dilemmas in practice, and the potential for conflict between
cal problems in psychiatric
Back to competency table
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Aspect: Patient examination By the completion of their training, psychiatrists will be able to perform a comprehensive psychiatric assessment in people of all ages with mental health problems and mental illness, including patients with cognitive impairments.
Knowledge
Recognise and identify the effects of psychotropic medication. Use a widely accepted diagnostic system to assist in making the diagnosis and differential diagnosis in each case. State the indications for, and limitations of, tests that are used to evaluate neurophysiological functioning of persons with psychiatric symptoms (e.g. thyroid function tests, EEG, HIV testing, liver function testing etc) and use these test appropriately in clinical practice. Summarise the use of and indications for:
• neuro-imaging in psychiatry
• neuropsychological and other psychological testing
• the EEG in psychiatry
• social investigation in psychiatry
e of cognitive and emotional development may influence the aetiology, presentation and management of
Demonstrate in routine practice an understanding of the use of, and indications for, appropriate medical consultation in psychiatry.
Recognise how the stagmental health problems
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Discuss the use of, indications for, and ethical implications of, genetic investigation in psychiatry. Whenever appropriate in routine practice, demonstrate and understanding of the indications for, and methodology of, blood monitoring of effects of psychiatric medications.
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Aspect: Patient examination
Skills
Work in partnership with patients, carers, families and colleagues when conducting patient examinations and assessments by:
• identifying when a situation is sufficiently complex or multifaceted to require a further opinion.
• engaging with patients, carers, service user groups and significant others to identify issues, problems and good practice in relation to consent, detention and enforced treatment.
• integrating the information obtained from other sources into a formulation of the case into which relevant s are highlighted.
Consistently dem n
• al
, and coping mechanisms.
• employ assessments of capacity that are appropriate to the patient and the decisions to be reached.
• determine which further investigations are appropriate for achieving a comprehensive understanding of each patient.
predisposing, precipitating, perpetuating and protective factoro strate the following examination and case presentation skills:
• demonstrate the ability to make a clear and concise case presentation.
elicit, describe and precisely record the components of the mental status examination, including generappearance and behaviour, motor activity, speech, affect, mood, thought processes, thought content, perception, cognition, judgement and insight, with the use of appropriate terminology.
• perform a physical examination and be able to recognise physical signs and symptoms that accompany or mimic psychiatric disorders.
• assess accurately situations where the level of disturbance is severe and risk of adverse events, such as injury to self or others, may be high.
• assess the person’s presentation in the context of his/her personality, developmental state, resilience, social supports
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Aspect: Patient examination
Attitudes
• Demonstrate an empathic approach to the assessment of all people with mental health problems and mental illness.
• Be aware of and work within own competence, seeking advice from others when necessary.
• Use own experience and evidence elicited from patients, carers, and colleagues to identify problems and understand situations.
Back to competency tableAspect: Patient evaluation and record keeping By the completion of training, psychiatrists will be able to identify psychopathology, formulate accurate differential working diagnoses within accepted classification systems, and develop appropriate ssessment and care and treatment plans for patients. a
Knowledge Delineate appropriate differential diagnoses. Based on a relevant assessment the psychiatrist will demonstrate the knowledge and ability to develop n
edical, laboratory, radiological and psychological examinations.
a d document the following:
• an evaluation plan using appropriate m
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• •
system such as ICD 10 or DSM
♦ psychiatric disorders such as affective ersonality disorders substance misuse
iscuss the prevalence and barriers to recognition of psychiatric illnesses in a variety of settings, including general medical and eneral practice settings.
a complete multi-axial differential diagnosis.
a comprehensive care and treatment plan addressing biological, psychological and socio-cultural domains. In order to do this, the doctor is required to be able to: ♦ discuss the advantages and limitations of using a contemporary diagnostic
IV-R. ♦ use that system in identifying signs and symptoms that comprise a syndrome or disorder.
use the axes of the classification system to evaluate patients. ♦ outline and recognise the typical signs and symptoms of common
disorders, anxiety disorders, dementia, delirium, schizophrenia, pdisorders, and common disorders in childhood.
♦ formulate a differential diagnosis for major presenting problems. ♦ formulate a plan for further evaluation. ♦ assess changes in clinical status and alter management in response to such changes. ♦ develop individualised care plans (within contemporary healthcare system framework).
Dg Aspect: Patient evaluation and record keeping
Skills
Prioritise referrals, negotiate settings and urgency
Maintain medical records that:
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•
ontemporary frameworks for confidentiality.
The psychiatrist l :
identifying causes of patient’s vulnerability and disempowerment, and taking action
using negotiation to develop an agreed care plan with patients, and carers when appropriate
ing from data and events not
evaluating advice, assistance or second opinion for suitability of purpose
prioritising and integrating relevant advice, assistance or second opinions into one’s own practice
Comprehensivel
• f involuntary treatment standards and procedures.
• the ability to effectively intervene to reduce risk.
Based on a comprehensive psychiatric assessment, the psychiatrists will demonstrate the ability to recognise and treat psychiatric disorders. Seek to promote recovery by:
are legible.
• are timely.
• capture essential information useful to psychiatric and non-psychiatric health professionals whilst simultaneously respecting patient privacy and c
• synthesise information into logical treatment plans.
wil ensure the most effective prescription and delivery of treatment to people with mental health problems by
• evaluating and documenting risk
•• formulating a treatment plan
• • reviewing and changing treatment as appropriate
• analysing complex and conflicting information to identify patterns and meanobviously related
••
y assess and document patients’ potential for self-harm or harm to others. This will include:
• an assessment of risk
the correct application o
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• creating, developing or maintaining valued social roles for patients in the communities they come from.
• working in partnership to provide care and treatment that enables patients and carers to tackle mental health problems with hope and optimism and to work towards a valued life-style within and beyond the limits of any mental health problem.
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Aspect: Patient evaluation and record keeping
Attitudes
T
ake account of the person’s ethnic, cultural, social and religious background and sexual orientation.
Demonstrate the ability to recognise value and utilise the cont linary colleagues to develop effectiveness of oneself and others, including:
• actively seeking adv e, assistance or a second opinion from appropriate sources including psychiatric profession n , carers
ng a iveness
second opinion) issues that are not fully understood
Recognise the limits of your ow Provide care and treatment tha ortance of ational activities, advocacy, social networks and welfare benefits
nsure the employment of legal powers for detention (or to enforce treatment) balances the duty of care to the patient and the
Demonstrate the ability to know when there is little more you can do.
ribution of peers and multi-discip
icals, medical professionals, no
dvice, assistance or a second
clarifying (with the source of the advice, assistance or
-medical professionals
opinion without defens
and resistance • receivi
• n competence.
t recognises the imp housing, employment, occupational opportunities, recre
Eprotection of others
Back to competency table
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• MANAGE CHRONIC ILLNESS Back to summary
MAJOR COMPETENCY:
Aspects Developing Performance
Under Supervision Competent Mastery
Assessment and Assess mental and physical
With appropriate assistance and guidance, formulate a
Assess change from previous morbid and premorbid functioning. Appropriately modify management plans when necessary.
Demonstrate particular expertise in the assessment of change. Assist and guide trainees in assessing and managing patients with severe and enduring mental illness.
state of patients with severe and enduring mental illness.
management of patients with severe and enduring mental illness
management plan.
Aspect: Management of long term illness
Knowledge
Outline the natural history of mental disorders. Be aware of reasons for relapses and ways of preventing them and minimising their effects.
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Describe the principles of rehabilitation and recovery.
Summarise the concept of quality of life and how it can be measured.
Aspect: Management of long term illness
Skills
Develop long term management plans. Act as patient advocate in negotiation with support services. Aspect: Management of long term illness
Attitudes
Be sensitive to the effects of chronic illness on patients and their carers. Develop and sustain therapeutic relationships with patients with chronic illness. Work in partnership with primary care and other support services.
Back to competency table
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Back to beginning of sectionBack to summary
B. DECISIONS ABOUT ACCESS TO MEDICAL CARE
The inve or treatment the psychiatrist provides d on their clinical judgement of patients’ kely effectiveness of the tr not allow their views about patients’ festyle, culture, beliefs, race economic o prejudice the
treatment they provide or arra st must not refus delay treatment because t ey believe that ntri
iatrist feels that t ect the r ain this to patients, and tell them of thei ctor
try to g ti nt l need.
able to t f ris y mus ents for e ified and exper ient ist’s
iat s ndition or
stigations needs and the li
or arranges must be baseeatment. The psychiatrist must
li , colour, gender, sexualitnge. The psychiatri
y, disability, age, or social or e or
status, th
patients’ actions have co f the psych
buted to their condition.
heir beliefs might affr right to see another do
I advice or treatment they p.
ovide, they must expl
The psychiatrist must If a psychiatrist is unthe patient to be s
ive priority to the investiga
reat a patient because oen by a suitably qual
on and treatment of patie
ks to themselves, theienced colleague. If pat
s on the basis of clinica
t make adequate arrangems pose a risk to the psychiatr
health or safety the psychproviding treatment.
rist should take reasonable teps to protect themselves before investigating the co
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MAJOR COMPETENCY:
• USE THE RESULTS OF THE CLINICAL ASSESSMENT TO URE EFFECTIVE PATIENT MANAGEMENT Back to summary
ENS
Aspects Developing Performance
Under Supervision Competent Mastery
Application of scientific knowledge
Summarise indications forrecognised treatments
(including drugs and psychosocial treatments) for common illnesses .
Ensure that treatments follow the latest guidelines available from scientific literature.
Plan, implement and manage treatment services for populations of patients.
Undertake referrals of patients to other professionals etc as
Implement care plans that are tailored to specific
Advise and supervise other professionals in the formulation
mentation of care
Patient management including access to
appropriate. patient needs. and impleplans.
appropriate care
Treatment (therapeutics) Demonstrate the ability to apply in clinical practice knowledge of the different classes of
nd relevant side effects. Summarise the different types of, and indications for, psychotherapies, and select the most appropriate for
As for ‘under supervision’ plus the ability to commence and monitor therapeutic treatment in patients, based on a good understanding of the me hanisms of their actions.
Fully manages the treatment of patients via psychotropic medication and basic psychotherapeutic techniques. Provides expert advice to others on difficult cases.
psychotropic medication a
individual patients.
c
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Aspect: Application of scientific knowledge
Knowledge
Develop and maintain an adequate knowledge base and at all times correctly apply it to patient care. Aspect: Application of scientific knowledge
Skills
Develop and maintain systems and resources to keep up to date with knowledge and its application. Aspect: Application of scientific knowledge
Attitudes
Be open to new ideas and developments that will improve patient care.
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Back to competency tableAspect: Patient management including access to appropriate care
Knowledge
Recognise and apply the principles of long-term care and rehabilitation for those people with severe and enduring mental health
roblems. p Apply knowledge of the implications of co-existing medical illness to modify treatment appropriately. Aspect: Patient management including access to appropriate care
Skills
isten actively, ask questions, clarify points and rephrase other stL
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atements to check mutual understanding of clinical issues.
ording to the needs of each individual.
Develop and implement clear, competent care plan informed by research and current best practice, integrating biological, psychological, and socio-cultural interventions, acc Wherever and whenever possible, work with patients and carers to develop collaborative management plans. Keep full and contemporary records of the assessment and management of patients.
Appropriately obtain and document informed consent for treatment whenever possible. Use professional interpreters appropriately and be guided by their advice concerning cultural issues.
ake decisions that are realistic for the situation. T Monitor patients’ clinical progress.
nage patients and ensure their access to appropriate care in the least restrictive fashion. Use knowledge of current legislation to ma
spect: Patient management incl
Attitudes
A uding access to appropriate care
Take account of the issues relating to care from patients varied ethnic and economic backgrounds.
Develop skills in establishing and maintaining a therapeutic alliance. Routinely re-evaluate diagnostic and management decisions to monitor their appropriateness and thus ensure optimal care.
Offer treatment in the most appropriate setting for the individual concerned, utilising the least restrictive option for that individual. Use humanely and appropriately the provisions for involuntary hospitalization and treatment. Recognise and utilise the contributions of other professionals, particularly non-medical professionals, in the care of people with
Test out feasibility and acceptability of decisions.
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mental health problems and mental disord
ers, and collaborate effectively with those professionals to provide optimal care.
Demonstrate a well-developed ability to communicate clearly, considerately and sensitively with people with mental health disorders, as well as carers, other health professionals and mem rs of the general public, in a wide variety of settings.
be
Back to competency table
Aspect: Treatment (therapeutics)
Knowledge
Apply contemporary knowledge and principles in pharmacological and psychological therapies. Aspect: Treatment (therapeutics)
Skills
Demonstrate the ability to initiate and monitor drug therapies.
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Aspect:
Treatment (therapeutics)
Attitudes
Clearly and openly explain treatments and their side effects to patients and carers.
Back to beginning of sectionBack to competency table
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C. TREATMENT IN EMERGENCIES Back to beginning of section
In an emergency, wherever it may arise, you must offe k the assistance you could reasonably be expected to
rovide.
:
Back to summary
r anyone at risp MAJOR COMPETENCY
• MANAGE EMERGENCIES
Aspects Developing Performance
Under Supervision Competent Mastery
Assess and manage under direct supervision patients with common mental illnesses presenting in
suicidal feelings/acts, acute psychosis)
dently assess and manage patients with mental illnesses including uncommon conditions, in
cies
Advise and supervise others in the assessment and management of psychiatric emergencies.
IndepenAssessment and management of psychiatric emergencies, including minimising risk to patients,
emergency (including emergenyourself and others
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Aspect: Emergency care
Knowledge
Maintain an effective working knowledge of current legislation as it applies to psychiatric practice.
pply the principles of risk assessment and management.
Demonstrate expertise in applying the principles of crisis intervention in emergency situations.
A
Aspect: Emergency care
Skills
Routinely employ safe, effective and collaborative management plans.
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A
spect: Emergency care
Attitudes
Maintain a highly professional attitude at all times.
Back to beginning of sectionBack to competency table
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D. MAINTAINING GOOD MEDICAL PRACTICE
Psychia nowledge and skills up to date throughout their working lives. In particupart regularly in educational activities, to maintain and further develop their competence and performance.
is important that mental health professionals understand the legal rights of patients under their care and their own legal gations to patients. Under this capa med consent, effective communication,
de-escalation and control and restraint.
New consultants will set high standards i r clinical care ce ment t essional dev e process o er the skills
s a si dentify ticipation in rc sul ctition standards in h ability to uc
trists must keep their k lar, they should take
Itand professional obli bility come issues of infor
n thei and ensure that they remain fully competent to practi
through their commitand abilities of colleaguefurther training and reseaall aspects of their work. T
o continuing profnd encourage their profes
h opportunities. New coney demonstrate the
elopment and thonal development by itants are reflective pra seek and respond constr
f revalidation. They fosting and ensuring their parers and strive to improve tively to feedback.
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MAJOR NCY:
• MAINTAIN AND USE SYST WLEDGE AN ATION TO ANY AS YOUR PROFESSIONAL PRACTICE
summary
COMPETE
EMS TO UPDATE KNO D ITS APPLIC PECT OF
Back to
Aspects e Developing Performanc
Under Supervision Mastery Competent
Demonstrate an understanding of the need to balance rights and responsibilities.
public safety. Apply human rights, mental health, and case law with regard to consent, confidentiality and compulsion.
g brings together the law, codes of practice, ethics and good
Apply more specialist aspects of the law for
pertains to pacity,
justice system etc.
Train and supervise the work of others and ensure organisations act legally. ethically and effectively.
understanding of how changes in society influence ethics and good practice.
Demonstrate an understanding of how ecision makind
Maintain and use an adequate and up to date knowledge of legislation that applies to any aspect of your professional
Recognise the duty to patients and carers and to
practice.
Demonstrate an
practice, including patient care; the rights of patients, their relatives and carers; and research
example aschildren, incapatients in the criminal
Follow an up-to-date Develop the requisite Keep up to date with clinical advances training curriculum
appraising and applying
attitudes for continuing
Independently identify
Play an active role in the development and
advances.
Develop skills in searching,
learning and professional development.
dissemination of clinical
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Aspects Developing Performance
Under Supervision Competent Mastery
new evidence relevant answerable
(e.g. systematic reviews, qualitative analysis etc) and apply the evidence. Set aside the time and
regular basis.
Develop a culture of critical
questions, search the selection and literature, critically appraise a range of methodologies
implementation of clinical advances.
resources to do so on a
Aspect: Legislation concerning patient care; the ri ts of patients and their relatives and carers; and research
gh
Knowledge Maintain and use an adequate and up to date knowledge of legislation that applies to any aspect of professional practice, including patient care; the rights of patients, their relatives and carers; and research Since some parts of medical practice are governed by law or are regulated by other statutory bodies, psychiatrists must observe and keep up to date with the laws and statutory codes of practice that affect their work.
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Mental health professionals must understand the legal rights of patients under their care and their own legal and professional obligations to patients. Under this capability would come issues of informed consent, effective communication, de-escalation ancontrol and r
d estraint.
In order to practise ethically psychiatrists will need to demonstrate:
• an understanding of and commitment t d human rights of patients and carers
• knowledge of policies, practices and procedures concerning the local implementation of mental health and
o the legal an
related legislation Aspect: Legisla nd their relatives and carers; and research
kills
tion concerning patient care; the rights of patients a
S
The psychiatrist in order to practise ethically will need to conduct a legal, ethical and accountable
ractice that remains open to the scrutiny of peers and colleagues
Psychiatrists should consult with appropriate legal experts when further guidance is required
demonstrate the ability to p
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Aspect: Legislation concerning patient care; the rigesearch
hts of patients and their relatives and carers; and r
Attitudes
Demonstrate the bi a lity to conduct all aspects of professional service with the highest standards of ethics and probity including:
heir families, acknowledging power differentials and
•
• recognising the rights and aspirations of patients and tminimising them whenever possible.
le to patients and carers within the boundaries prescribed by providing treatment and care that is accountabnational (professional), legal and local codes of ethical practice.
Back to competency table
Aspect: Keeping up to date with clinical advances
Knowledge
In order to practise ethically psychiatrists must demonstrate:
• adherence to local and professionally prescribed codes of ethical conduct and practice.
• the ability to work within the boundaries of local complaints management systems.
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Aspect: Keeping up to date with clinical advances
Skills
Demonstrate the ability to renew and keep up
to date in their learning, including:
ng data honestly and, where necessary, taking further training.
Listen to the views of patients and carers and deal with complaints in a sensitive and cooperative manner. Give due weight and consideration to relevant clinical guidelines. Demonstrate a commitment to research as outlined under Research 3.c
• providing and accepting clinical and professional supervision
• actively participating in a programme of clinical governance
• taking part in regular and systematic medical and clinical audit, recordiresponding to audit findings so as to improve practice – for example by under
• contributing to the programme of clinical audit
• participating in significant event reviews and assist in implementing learning outcomes that arise
• participating in risk management initiatives. Initiatives including training and development of policy and procedure
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A
spect: Keeping up to date with clinical advances
Attitudes
Demonstrate commitment to revalidation by:
• developing, maintaining and routinely practicing critical self-awareness.
• responding constructively to assessments and appraisals of professional competence and performance.
working with colleagues to monitor and maintain their awareness of the quality of care they provide.
• stablished standards.
Psychiatrists should demonstrate a commitment to continued professional development by:
• keeping up to date with clinical advances
• keeping up-to-date with changes in practice and participating in life-long learning, personal and professional development for one’s self and colleagu aisal and reflective practice
• keeping up ge and sk their working life. r, taking part which maintain and further develop their competence and performance
• reviewing clinical practice and compare it with e
es through supervision, appr
to date with their knowledregularly in educational activities
ills throughout In particula
of sectionBack to beginning
Back to competency table
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AINTAINING YOUR PERFORMANCEE. M
The psychiatrist must work with colleagues to monitor and maintainawareness of patient safety. In particular, the psychiatrist must take part in regu t, recording data honestly. Where necessary the psychiatrist must respond to the results their practice, for example by undertaking further training; respond constructively to the outcome performance; take part in confidential enquiries and adverse event recognition; and report
ND MAIN OR
Back to summary
the quality of the care they provide and maintain a high
lar and systematic medical and clinical audiof audit to improve
of reviews, assessments or appraisals of ing to help reduce risk to patients.
MAJOR COMPETENCY:
• MONITOR A
TAIN PROFESSIONAL PERF MANCE
Aspects e Developing Performanc
Under Supervision Mastery Competent
Develop, maintain and routinely practi
Discuss strengths and weakness with superv Recognise how critawareness can be pringboar
isor.
ical self-a
d to learning.
back to develop an d appraisal. Demonstrate an understanding the importance of critical self-awareness to teams and
s
Use assessment, appraisal, complaints and other eedf
ce critical self- understanding of own
strengths and weaknesses.
awareness
Help others look at their strengths and weaknesses through supervision an
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Aspects Developing Performance
Under Supervision Competent Mastery
organisations. Serve as a role model
awareness within teams.
facilitating critical self-
Work with colleagues to monitor and maintain your awareness of the quality of care you provide.
Meet regularly for peer supervision, e.g. Case discussion group.
Set up, run and supervise a peer supervision group for more junior staff. Monitor the quality of care you provide through techniques such as 360degree assessment, case based discussions, significant event reviews etc
Actively participate in a programme of
Undertake clinical audit. Decide on and implement Play a role in developing Carry out a survey of
changes as a result of audit etc.
patients’ views on services provided including
Help to develop local
treatment.
guidelines for manageof patient populations.
ment
local and national guidance for clinical governance issues. clinical governance
Treat patients according to local and national guidance.
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Aspect: Critical self-awareness
Knowledge
Identify own knowledge, skills, strengths and weaknesses within clinical, managerial, teaching and research practice. Employ methods of self-evaluation to determine developmental needs. Aspect: Critical self-awareness
Skills
Use own experience and evidence of elicited from patients, carers, and colleagues to identify problems and understand situations.
knowledge.
se strengths and weaknesses to specify continuing professional development needs.
Identify, seek out and pursue opportunities to enhance professional performance. Take appropriate action to optimise opportunities and resolve problems.
Use appropriate methods and sources to evaluate personal experience and U
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Aspect: Critical self-awareness
Attitudes
Act assertively and say no to unreasonable requests. Monitor and evaluate own clinical and managerial practice to establish its effectiveness.
to practice.
Explore and recognise the psychological impact and importance of unconscious processes upon own practice and professional capacities. Monitor stress levels and identify signs of dysfunctional stress.
ntroduce changes to strategies to accommodate unpredicted events.
strategy.
Recognise, reflect and integrate own psychological processes in
Apply stress management techniques to contain and minimise stress levels. I Acquire necessary sources of support to accommodate changed
Back to competency table
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Aspect: Awareness of the quality of care provided
Knowledge
Develop and apply knowledge of means of evaluating the quality of care. Aspect: Awareness of the quality of care provided
Skills
Evaluate the quality of care provided, interpret the findings and make appropriate improvements. Aspect: Awareness of the quality of care provided
Attitudes
Recognise and practice within the limits of own competence. Utilise evaluations and feedback in practice.
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Back to competency tableAspect: Clinical governance
Knowledge
Ensure own practice recognises values, respects and is sensit
ive to cultural ethnic and religious diversity.
Aspect: Clinical governance
Skills
Set objectives for self that are specific, measurable and achievable.
Manage time and resources in a manner that promotes own emotional well being, mental health and personal safety.
Monitor and evaluate feedback.
inimise unhelpful interruptions to and digressions from planned work.
Deal with emergency and crisis situations as they arise and review and reschedule work-plan a Regularly review progress towards meeting objectives and reschedule plans.
M
ccordingly.
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P
rioritise objectives in line with mental health service objectives and policies.
Plan activ
ealistically estimate time needed for activities and make allowances for unforeseen circumstances.
udge the depth and range of information needed to make decisions. Ta
ities that are consistent with objectives and personal resources. R J
ke dec aisions s soon as sufficient information is available.
Aspect: Clinical governance
Attitudes
Identify opportunities to apply creative and innovative techniques, principles and solutions. Evaluate creative and innovative techniques, principles and solutions for validity and relevance. Elicit information about areas of best practice, unease and discontent.
Back to beginning of sectionBack to competency table
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F. TEACHING AND TRAINING, APPRAISING AND ASSESSING
AJOR COMPETENCIES:
• PLAN , AND EVALUATE TEACHING AND LEAR ONMENTS
M
, DELIVER NING IN A Y OF ENVIRVARIET • ASSESS, APPRAISE AND E LEARNEVALUATE LEARNING AND RS
)• SUPERVISE AND MENTOR LEARNERS STUDENTS AND TRAINEES( • PROVIDE REFERENCES
i e educ ther doctors, medical students and non-ls are ed to t
praise colle k. ffe s in all of these activities, in the presentati an s. ill be able to demonstrate an understanding a ple tea ing and learning in clinical contexts. They must be able to take respo pervisi effective arrangements are in place. They
praisals and in written references for colleagues. When providing references the consulta inf ny bearing on their colleague’s competence, performance, and conduct. Psychiatrists must be honest and of any doctor including those they have supervised or trained. Patients m ia mpetent someone who has not reached or maintained a satisfactory standa
Doctors have a professional oblmedical healthcare professionacolleagues and to ap
gation to contribute to th on the team. Consultantsagues and assess their woron and discussion of topics nd commitment to the princinsibility for the su
must demonstrate the ability to be open, honest and objective in ap
ation and training of ousually expect each and train students, trainees and
ctive communication skill New consultants w
They need to demonstrate ed in their personal interactions and practice of effective
on of trainees and ensure thatch
nt must include all relevant
objective when appraising oray be put at risk if the psychrd of practice.
ormation which has a
assessing the performance trist describes as co
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MAJOR COMPETENCY:
• PLAN, DELIVER, AND EVALUATE TEACHING AND LEAR N A VARIETY OF ENVIRONMENTS Back to summary
NING I
Aspect Developing Performance
Under Supervision Competent Mastery
Plan, deliver, assess and evaluate teaching
Based on an understanding Initiate and organize a of fundamental adult educational principles,
range of educationsuch as workshops, and learning in a variety prepare and deliver
teaching though lectures seminars etc.
Support and mentor the
and small group teaching, demonstrating appropriate
Undertake an evaluation of teaching and summarise findings, identifying areas of possible improvement and
courses as part of PDP.
al events
Support junior doctors and other colleagues in
Evaluate teaching of
lf and others, identifying and implementing strategies for
Act as a role model in the organization and delivery of teaching.
teaching of others.
of environments
attitudes and responsibilities.
preparing and delivering educational events.
strategies to achieve improvements.
improvements.
Consider undertaking specific ‘training the trainers’ and other relevant
yourse
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Aspect: Plan, deliver, assess and evaluate teaching and learning in a variety of environments
Knowledge
Demonstrate an understanding of education as applied to medicine. Develop an understanding of the principles of
adult learning, and apply these in your teaching.
Plan and carry out evaluations of teaching, and of educational events as a whole. Interpret and report on findings from evaluations, identifying the best aspects and areas for possible improvement. Aspect: Plan, deliver, assess and evaluate teaching and learning in a variety of environments
Skills
Prepare appropriate teaching materials ensuring, for example, that visual aids are relevant, readable etc. Plan educational activities, clearly setting out overall aims and intended learning outcomes. Teach in a way that is both professional and suited to your own personality, and is also appropriate to the audience and occasion.
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Aspect: Plan, deliver, assess and evaluate teaching and learning in a variety of environments
Attitudes
Show a per mitment to teaching and learning, and a w a doctor and a teacher.
emonstrate an enthusiasm for the s
resp l d
nd as and tak ng events.
Interact appropriately with adult l
sonal com illingness to develop as both
D
pecialty.
Demonstrate sensitivity and Assess information needs a
onsiveness to the educationa
pirations of audiences
needs of students and junior
account of these in planni
octors.
and delivering educationale
earners.
y tableBack to competenc
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MAJOR COMPETENCY:
• ASSESS, APPRAISE AND EVALUATE LEARNING AND LEARNERS Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Assess, appraise and evaluate learning and learners
Evaluate your own learning Evaluate your progress and needs.
Be familiar with the PMETB
and ensure that your contributions to assessments comply with
Carry out assessments (which would be predominantly or exclusively workplace based) with decreasing
own learning needs and those of others. Competently and without
assessments that meet PMETB Principles, and provide appropriate reports
.
Competently carry out a essments using the 4
ace based assessment methods identified for use in the
Consistently demonstrate mastery in planning, conducting and recording assessments that fully meet
METB Principles. Provide clear, fair and supportive feedback with positive suggestions for improvement, if appropriate.
Principles of Assessment supervision, carry out P
them.
and feedback
levels of supervision.
Foundation Programme.
Carry out formal appraisals.
ssworkpl
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Aspect: Assess, appraise and evaluate learning and learners
Knowledge
Demonstrate a good working knowledge of the assessment methods used in your Training Programme
Describe the difference between formative and summative asses ment, and outline the role of each in medical education. Demonstrate a good understanding of the PMETB Principle ent. Develop expertise in applying the PMETB Principles.
e principles of validity, reliability, feasibility and fairness in assessment and appraisal.
s
s of A sessms
Explain th Aspect: Assess, appraise and evaluate learning and learners
Skills
Evaluate and provide feedback on individual (including self-assessment) and team performance. Competently use the four workplace based assessment methods used in conjunction with the curriculum and the Foundation Programme. Provide feedback (including negative feedback).
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Assess, appraise and supervise the performance of others. Aspect: Assess, appraise and evaluate learning and learners
Attitudes
ent, app e educ ken
ecord and report findings accur Ensure that assessments and ap the governing principles and are carried
Recognise that assessmcarefully.
raisal and evaluation are ess
ately and clearly.
praisals comply with
ntial elements in medical ation and must be underta
out honestly and fairly.
R
Back to competency table
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MAJOR COMPETENCY:
• SUPERVISE AND MENTOR LEARNERS (STUDENTS AND TRAINEES)
Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Supervise and mentor Under supervision yourself, Competently supervise, Serve as a role model by provide supervision and mentorship to junior
mentor and guidcolleagues.
colleagues (such as medical students and
e
e junior providing the highest standards of supervision and mentorship, and encouraging others to reach similarly high standards.
learners (students and trainees)
Foundation HousOfficers).
Aspect: Supervise and mentor learners
Knowledge
dentify the skill needs of junior and multi-disciplinary colleagues in the context of providing optimal patient care. I Demonstrate an understanding of the responsibilities of the doctor as a supervisor, teacher and mentor.
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Aspect: Supervise and mentor learners
Skills
Respond appropriately and effectively to probl
Provide clinical supervision.
ppropriate t rea n s. Monitor progress in the clinical sk lin
ems in team or individual performance.
Prepare and deliver a eaching and support to inc
ills of junior and multi-discip
se the clinical skills of junior a
ry colleagues.
d multi-disciplinary colleague
a
spect: Supervise and mentor learners
A
Attitudes
Demonstrate a willingness to supervise the work of less experienced colleagues.
nsure that students and junior doctors are properly supervised.
Demonstrate a recognition of the importance of good supervision and mentoring by personal example. E
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MAJOR COMPETENCY:
• PROVIDE REFERENCES Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Draft references, with the assistance of more
perienced colleagues.
Provide references that are clear, fair, honest and cover the relevant points. Assist junior colleagues in
eferences.
Make your experience and expertise available to colleagues by guiding and assisting them in producing references.
Provide references
ex
drafting r
Knowledge
Aspect: Provide references
Demonstrate an understanding of the points that should be included in a reference and ways in which the reference can be most usefully structured.
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A
spect: Provide references
Skills
Produce references that are well written and properly structured. Aspect: Provide references
Attitudes
Prepare references that are thoughtfully prepared, fair and honest.
Back to beginning of section
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G. RELATIONSHIPS WITH PATIENTS
development of partnership workin
hose people who use services are viewed as partners in care rather than passive recipients chieve this aim, mental health workers will often be required to be assertive in their engagement with and follow up of atients, particularly those with more complex problems.
Psychiatrists n emonstrate the capacity to build trust an n effective relationships with patients and their families. They need to be good listeners and to show respect and understanding for patients’
erspectives on their illnesses or conditi monstrate e consent and confidentiality.
o d relationpati iving pa
t , tyou prescribe, information about any se nat atinformation with patients’ partners, clos rers if they fconsent. When patients cannot give co e th which those close to the patient need or want to know, except where you have re he p ble t
The focus with patients and their families and carers is on the g. It is essential that of services. In order to t
ap
eed to d d to develop and maintai
p ons. They must de a commitm nt to the principles and practice of
Good communication between patiencommunication involves listening to ask for or need about their condition, i
ts and doctors is essential tents and respecting their
s treatment and prognosisrious side effects, altere relatives or ca
effective care anviews and beliefs; gin a way they can undersives and, where appropri ask you to do so, having information
ships of trust. Good tients the information they
and (including, for any drug e, dosage); sharing irst obtained the patient’s
nsent, you should sharason to believe that t
eatient would object if a o do so.
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MAJOR COMPETE
• CONDUCT PROFESSIONAL PATIENT RELATIONSHIPSry
NCY:
Back to summa
Aspects ance Developing Perform
Under Supervision Competent Mastery
Good communication: communicate appropriately, orally and in writing, with patients, carers and colleagues
essential information. ommunicate this essential information.
n gues,
what is essential information and with whom it should be communicated. Accurately, sensitively and appropriately communicate this essential information.
Agree, in discussion with colleagues, what is essential information andwith whom it should be communicated. Accurately, sensitively and appropriately communicate this
Correctly judge, in discussion with colleagues, what is essential information and with whom it should be communicated. Accurately, sensitively nd appropriately a
Teach and routinely serve as a role model to judge, idiscussion with collea
c
Obtain informed consent in straightforward cases.
Obtain informed consent in all appropriate cases.
Teach, supervise and serve as a role model in obtaining verbal and written informed consent.
Obtain informed consent
Respect confidentiality Essential at all stages
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Aspects Developing Performance
Under Supervision Competent Mastery
Apply command other skills to build trusting initial doctor-
Determine issues which are likely to strain the doctor-patient relationship
s to deal with these before they adversely affect the relationship.
Teach, supervise and serve as a role model to others in conducting professional relationships with patients.
unication Maintaining trust and developing a therapeutic alliance with patients
patient relationships. and make effort
Demonstrate an ability to negotiate endings of professional relationships with patients and cin a timely, informative, self-reflective and respectful way; with
Know when to seek advice or other opinions. Demonstrate an ability to manage endings that are complicated by issues such as high dependency,
Teach, supervise and serve as a role model to others in respect of effectively and sensitively managing endings.
Ending professional relationships with patients
arers
appropriate communication to other
complaints, poor therapeutic alliance and
professionals. challenging behaviour.
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Aspect: Good c ommunication
Knowledge
Communicate appropriately, orally and in writing, with patients, carers and colleagues. Aspect: Good communication
Skills
Demonstrate the b nd other
Demonstrate the b
er, its prognosis and any relevant prevention strategies. the results of assessments.
cations.
Demonstrate the ability to communicate effectively with patients, their carers, and significant others by:
a ility to obtain, interpret and evaluate consultations from other medical specialties, other professionals, a the ability to communicate their concerns to others within the care system. community based resources and shall demonstrate
a ility to communicate effectively with the patient and their carers, while also respecting confidentiality:
• information concerning the presenting disord
• the risks and benefits of any proposed treatment plan including possible side effects of medi
• alternatives, if any, to the proposed treatment and care plan.
• providing explanations of mental disorders and their treatment that are understandable, clear and geared to the appropriate educational/intellectual level.
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• recognising the differential power relationship between psychiatrist and patient, and ensuring full and open discussion to encourage participation.
hancing rapport and a therapeutic alliance with patients, carers and others. ecognise and take steps to address tensions, conflicts and imbalances between patients and their carers.
Ensure that patients have access to information, advice and all stages of the treatment process.
Ensure that patients are aware of their rights and how to initiate complaint procedures.
stances.
dable and practical.
Identify and buil g erability.
Take responsibil t
emonstrate an aptitude for good communication between themselves and their patients by:
• listening actively, asking questions, clarifying points and rephrasing other statements to check mutual understanding of clinical issues.
• ensuring that interventions and plans are clearly communicated to patients and opportunities given for appropriate input, so that the patient’s views, wishes and beliefs are always taken into account.
• obtaining informed consent.
• working with interpreters where necessary.
• ensuring the patient is kept informed about treatment at all times especially in cases where the patient has suffered harm under the psychiatrist’s care.
Communicate with all stakeholders involved in an individuals care by:
• being able to communicate across disciplinary, professional and organisational boundaries.
• developing and enR
advocacy at
Adopt a patient-focused approach to practice that acknowledges the rights, values and strengths of the patient in all circum
Provide preventive education and advice, where available, that is understan
din upon patients’ strengths, whilst recognising their vuln
ity o fully inform the next of kin should a patient die under the psychiatrist’s care.
D
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service user groups to address issues, problems and best practice in relation to cultural, ethnic and religious diversity.
Proactively engaging with patients, service us best practice especially in cases where the
atient has suffered harm under the psychiatrist’s care.
• engaging with
er groups to identify issues, concerns and p Aspect: Good communication
Attitudes
The psychiatrist must demonstrate an understanding of the impact of their own feelings and behaviours on communication
etween themselves, patients and all stakeholders in the patient’s care by:
• showing courtesy, consideration and respect.
b
• behaving with an awareness of their own responses.
• behaving in a non-discriminatory manner.
• actively seeking feedback from patients and other relevant individuals and agencies.
eBack to competency tabl
Aspect: Obtaining consent
Knowledge
The psychiatrist must respect the right of patients to be fully ecisions about their care. They must be familiar with the guidance in the booklet Seeking Patients’ Co
involved in dnsent: The Ethical Considerations.
Aspect: Obtaining consent
Skills
The psychiatrist wherever possible, must be satisfied, before providing treatment or investigating a patient’s condition, that the atient has understood what is proposed and why, any significant risks or side effects associated with it, and has given consent.
Engage and sustain relationships with service users in a manner that maximises their participating and optimisconsent by:
• being able to engage service users in a collaborative assessment process
• encouraging active choices and participation in care and treatment
• empowering the patient to decide the level of risk they are prepared to take with their health and safety. This includes working with the tension between promoting safety and positive risk taking, including assessing and dealing with possible risks for service users, carers, family members, and the wider public.
• agreeing health and social care needs in the context of the preferred lifestyle and aspirations of service users their families, carers and friends
p
es co-operation and
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he psychiatrist must demonstrate the aT bility to promote service users’ (and carers’) rights and responsibilities and recognise and
maintain their rights to dignity, safety, effective treatment and care based on the principle of informed consent
spect: Obtaining consent
A
Attitudes
Wherever and whenever possible, the psychiatrist should work with patients and carers to develop collaborative management
Psychiatrists must seek to engage with patients, carers, service user groups and significant others to identify issues, problems and good practice in relation to consent, detention and enforced treatment
plans.
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Aspect: Respect confidentiality
Knowledge
Treat information about patients as confidential. In exceptional cases follow the guidance in the booklet Confidentiality: Protecting nd Providing Information and be prepared to justify your decision to the patient, if appropriate, and to the GMC and the courts, if alled on to do so.
ac
Aspect: Respect confidentiality
Skills
Demonstrate the ability to promote people’s rights and responsibilities and recognise the service user’s right to privacy, dignity, respect and confidentiality.
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Aspect: Respect confidentiality
Attitudes
Respect the ethical principles behind the concept of
confidentiality.
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Aspect: Main i
Knowledge
ta ning trust
Demonstrate an nd respond to the needs of people a
understanding that successful relationships between doctors and patients depend on trust ain n ethical, honest, non judgemental manner.
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Aspect: Maintaining trust
Skills
Develop a relations
• • recording and appropriately sharing information.
• obtaining informed consent.
• taking steps to resolve tensions between patient’s needs, wishes, beliefs and competing demands in line with best practice and ethical practice.
e users in a manner that maximises their participating and
Psychiatrists mu i allenge inequality within their role
g with interpreters where required
• Recognising and where possible lessening the impact of disadvantage, discrimination and oppression on the
r individuals, groups and communities who are
• processes and policies that respect diversity and are socially inclusive
hip of trust with their patient by:
observing confidentiality.
guidance on
• engaging and sustaining relationships with servicoptimises co-operation and consent.
st mprove the trust between themselves and their patients by demonstrating that they will chand will respond to the needs of people sensitively with regard to all aspect of diversity including:
• Behaving in a non-discriminatory manner and workin
Identifying oppression at a structural and individual level in the mental health service
• mental health of individuals, groups and communities
• Identifying the need for empowerment and advocacy foadversely affected by disadvantage, discrimination, oppression
Promoting the development of services,
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Aspect: Maintaining trust
Attitudes
Ascertain and observe the boundaries of relationships by:
• never using their professional position to establish or pursue a sexual or improper emotional relationship with a
• respecting patients’ privacy and dignity.
• respecting the right of patients to a second opinion.
• being readily accessible to patients and colleagues when they are on duty.
• demonstrating awareness of and sensitivity to family, cultural and social circumstances.
• respecting the right of patients to decline to take part in teaching or research and ensuring that their refusal does not adversely affect the relationship with them.
Psychiatrists must demonstrate an awareness of the impact of their own feelings and behaviours on the relationship with their
• not allowing their personal relationships to undermine the trust which patients place in them.
patient or someone close to them. Establish and maintain trust by:
• being polite, considerate, respectful and truthful.
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patients by:
• actively seeking feedback from patients and other relevant individuals and agencies.
• behaving with an awareness of their own responses.
• identifying and questioning their own valu , prejudices, stereotypes and beliefs and sources of structural discrimination within own practice.
es
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Knowledge
Aspect: Ending professional relationships with patients
Recognise that a professional relationship with a patient may be ended where the trust between the psychiatrist and patient is broken. Demonstrate knowledge of the risks and continuity of care difficulties associated with transfer of patient care between rofessionals.
es important in understanding the process of ending and practitioner’s perspective.
p Demonstrate knowledge of how such issues as risk management, severity and complexity of illness, and effective use of resourcesmight influence decisions about endings. Demonstrate knowledge of the psychodynamics, attachment and other issurofessional relationships with patients, and to do this from both the patient’sp
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Aspect: Ending professional relationships with patients
Skills
Ensure that arrangements are made quickly for the continuing ca of the patient, and hand over redoctors as soon as possible. Demonstrate the management process of ending professional relationships with patients through clear and appropriate communications, collaborative working with patients and carers, dealing appropriately with questions and concerns, and communicating in a timely and informative way with fellow professionals – particularly where care transfer is involved. Inform the patient, orally or in writing, the decision behind ending the professional relationship.
re cords to the patient’s new
Aspect: Ending professional relationships with patients
Attitudes
Ensure that a decision to end a professional relationship with a patient must be fair and not contravene guidance. Demonstrate that the decision about ending must be guided by what is in the patient’s best interest. Be open to seeking advice from supervisors or colleagues as appropriate. Do not end relationships with patients solely because they have made complaints, or because of the financial impact of their care or treatment on the practice. A Competency Based Curriculum for Psychiatry
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Demonstr n open, self reflective attitude towards endings, including their possible s nificance to both the patient and practitioner.
ate a ig
Back to competency table
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H. DEALING WITH PROBLEMS IN PROFESSIONAL PRACTICE
MAJOR COMPETENCIES:
• CONDUCT OR PERFORMANCE OF COLLEAGUES • COMPLAINTS AND FORMAL INQUIRIES • I ANCENDEMNITY INSUR
SSTANCE AT INQUIRIES AND INQUESTS• PROVIDING ASSI
re professional may be putting patientsgive an honest explanation of their concerns to an appropriate person from the employing authority, such as the medical dursing director or chief executive, or the director of public health, or an officer from the psychiatrist’s local medical committee, ollowing any procedures set by the employer. If there are no appropriate local systems, or local systems cannot resolve the roblem, and the psychiatrist remains concerned about the safety of patients, they should inform the relevant regulatory body. If
do, they should discuss th al colleague or contact their defence body, ation or the GMC for advice.
Patients who complain about the care or treatment they have received have a right to n ude an explanation of what has happened, and where appropriate, an apology. You must not allow u
ate fully with complaints procedure which applies to You must give, to those who are entitled to ask for it, any relevant information in connection with an investigation into
your own, or another health care professional’s, conduct, performance or health. If you are suspended from a post, or have restrictions put on your practice because of concerns about your performance or conduct, you must inform any other organisations for whom you undertake work of a similar nature. You must also inform any
If the psychiatrist has grounds to believe that a doctor or other healthca at risk, they must
irector, nfpthe psychiatrist is not sure what toa professional organis
eir concerns with an imparti
expect a prompt, open, constructive and
honest response. This will ia patient’s complaint to prej You must co-operour work.
cldice the care or treatment you provide or arrange for that patient.
any formal inquiry into the treatment of a patient and with any y
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patients you see independently of such organisations, if the treatment you provide is within the asuspension or restriction relates.
rea of concern to which the
Similarly, you must assist the coroner or procurator fiscal, by responding to inquiries, and by offering all relevant information to an inquest or inquiry into a patient’s death. Only where your e ad to criminal proceedings being taken against you are ou entitled to remain silent.
RFORMANCE OF COLLEAGUES Back to summary
vidence may ley MAJOR COMPETENCY:
• CONDUCT OR PE
Aspects Developing Performance
Under Supervision Competent Mastery
development to deal promptly and correctly
Dealing with problems in It is essential at all stages of professional with any problems in the conduct or performance of colleagues.
the conduct or performance of colleagues
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Aspect: Dealing with problems in the conduct or performance of colleagues
Knowledge Recognise that safety of patients must come first at all times. Awareness of appropriate person/s at your place of work and the procedures to follow to convey serious concerns. Practice autonomously. Aspect: Dealing with problems in the conduct or performance of colleagues
Skills
protecting patients from risk or harm posed by another doctor’s, or other health care professional’s conduct,
by reporting or investigating without delay where there are serious concerns about a colleague’s performance, health or conduct, to establish whether they are well-founded, and to protect patients.
Challenge discriminatory views, beliefs and practices in relation to individuals and groups experie
toring and review of the service and activities to ensure that anti-discriminatory/anti-oppressive practice is
Demonstrate the ability to place the safety of patients first by:
• performance or health, including problems arising from alcohol or other substance abuse.
•
ncing mental illness. Contribute to the moniA Competency Based Curriculum for Psychiatry
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pro Engage with and assess the risks, needs and perspectives of patients, carers and colleagues and significant
Contribute to the resolution of professional dilemmas: patient-related, staff-related, service-related. Identify and analyse the nature and complexity of potential and actual dile mas and conflicts, balancing the need to remain atient-focused with the rights an hers.
ith others in the clinical team, multidisciplinary team and across relevant agencies to identify a range of
dilemmas.
anage an raise ents.
moted.
others.
mp d responsibilities of ot
Work co-operatively wpossible options to resolve Any psychiatrist with mconcerns about risks to pati
ment responsibilities must ensure that mechanisms are in place through which colleagues c
Aspect: Dealing with problems in the conduct or performance of colleagues
Attitudes
dentify and question own values, prejudices, stereotypes and beliefs and sources of structural discrimination within own practice.
aken towards resolution of professional dilemmas are in line with guidance, and use principles of ethical reasonin
I Ensure decisions and action t
g.
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• COMPLAINTS AND FORMAL INQUIRIES
Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Recognise that it is mandatory to co-operate with any complaints procedure or formal inquiry into the care and treatment of a patient
e entitled to, any relevant information in connection with an investigation into your own or another professional’s conduct performance or health.
Give to thos
Aspect: Complaints and formal inquiries
Knowledge
Demonstrate an awareness:
• that it is mandatory to co-operate with any complaints procedure or formal inquiry into the care and treatment of a patient
• of contemporary NHS complaints procedure A Competency Based Curriculum for Psychiatry
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Should the psychiatrist believe that their ability to trequipment, or other resources, they should:
at patients safely is seriously compromised by inadequate premises,
• put the matter right, if that is possible
• in all other cases, draw the matter other employing or contracting body
• record their concerns and the steps taken to try to resolve them
hin uspension.
e
to the attention of their Trust, or
If suspended from a post, or if restrictions are placed on the practice because of concerns about performance or conduct, inform any other organisations where work is undertaken of a similar nature and any patients independent of such organisations but witthe relevant area of treatment to the s Aspect: Complaints and formal inquiries
Skills
Engage with service user groups to address problems, issues and best practice in relation to disadvantage, discrimination and oppression. Recognise and take steps to address tensions, conflicts and imbalances between patients and their carers. Contribute to the development and maintenance of systems that respond proactively to complaints about disadvantage, discrimination and oppression in the mental health service.
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Aspect: Complaints and formal inquiries
Attitudes
Demonstrate and awareness of a patient’s right to expect a p nd honest response to a complaint and the ability to respond in an appropriate and sensitive manner including where necessary an apology without prejudice to the care or
eatment being offered or arrang
hat a patient’s complaint must not prejudice the care or treatment provided or arranged for that patient.
rompt, open, constructive a
tr
ed.
Require and accept t
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MAJOR COMPETENCY:
• PROVIDING ASSISSTANCE AT INQUIRIES AND INQUESTS Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Recognise that it is mandatory to offer all assistance to a coroner or procurator fiscal in relation to an inquest or inquiry into a patients death
Essential at all stages
Aspect: Provide assistance in relation to inquests or inquiries into patient deaths
Knowledge
Demonstrate an awareness:
• that it is mandatory to offer all assistance to a coroner or procurator fiscal in relation to an inquest or inquiry into a patients death
• of inquest procedures within the UK
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Aspect: Provide assistance in relation to inquests or inquiries into patient deaths
Skills
Demonstrate the ability to write reports and provide evidence
in court
ssista s patie
Back to competency table
Aspect: Provide a nce in relation to inque ts or inquiries into nt deaths
Attitudes
The psychiatrist must assist the coron
er or procurator fiscal by responding to inquiries and by offering all relevant information to an quest or inquiry into a patient’s death. The only exception is if the evidence may lead to criminal proceedings being taken against
the psychiatrist.
in
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MAJOR COMPETENCY:
• INDEMNITY INSURANCE Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Indemnity insurance of NHS
Be aware of the provisions indemnity insurance
and consider purchasing personal supplementary indemnity insurance
Make an accurate judgement of your own insurance needs and ensure that they are properly met
Advise junior colleagues on the role that indemnity insurance plays in a doctor’s profession
spect: Indemnity insurance
Knowledge
A
Recognise that there must be adequate cover for any part of the practice not covered by an employers indemnity scheme and initiate appropriate action.
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Aspect: Indemnity insurance
Skills
N.A. As surance
ection
pect: Indemnity in
Attitudes
N
.A.
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Back to IndexBack to summary
2. WORKING WITH COLLEAGUES
2. WORKING COLLEAGUES WITH A. Treating colleagues fairly B. Working in teams C. Leading teams D. Arranging cover E. Taking up appointments F. Sharing information with colleagues G. Delegation and referral
A. TREATING COLLEAGUES FAIRLY
ts must always treat their colleagues fairly. In accordance with the law, they must not discriminate against colleagues, including those applying for posts, on grounds of their gender, race or disability. Psychiatrists must not allow their views of colleagues’ lifestyle, culture, beliefs, colo uality, or age to prejudice their professional relationship with them.
Psychiatrists must not undermine patients’ trust in the care or treatment they receive, or in the judgment of those treating
Psychiatris
ur, gender, sex
them, by making malicious or unfounded criticisms of colleagues.
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NCY:
• CONTINUOUSLY PROMOTE VALUE BASED NON PREJ PRACTICE Back to summary
MAJOR COMPETE
UDICIAL
Aspects Developing Performance
Under Supervision Competent Mastery
Legal Maintain and apply a current working knowledge of the law as it applies to working relationships
Ethical Develop a fair and ethical approach towards working with col
Consistently demonstrate good ethical practice
Ensure that colleagues are treated ethically and non-prejudicially leagues
Diversity Develop an insight into and respect of diversity
Acknowledge and respect diversity
Ensure that colleagues are always treated in non-
dicial fashion preju
Aspect: Legal
Knowledge
cknowledge that all decisions, working pr be lawful, with particular regard to mployment, equal opportunities and health and safety law
Ae
actices and the working environment must
Demonstrate a basic understanding of employment rights and law, specifically relevant to interviewing.
A
spect: Legal
Skills
NA Aspect: Legal
Attitudes
dopt and encourage a positive, non-discriminatory approach to professional practice and relationships A
Back to competency tableAspect: Ethical
Knowledge
e aware of the major ethical principles and how these should influence working relationships with colleagues. B
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Aspect: Ethical
Skills
ollow ethical principles at all times in dealing with patients and colleagues F
Aspect: Ethical
Attitudes
Demonstrate an awareness of, and sensitivity towards, ethical issues that might affect professional relationships
Back to competency tableAspect: Diversity
Knowledge
Identify key aspects of different cultures and subcultures, including lifestyle, colour, gender, sex
uality and age
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Aspect: Diversity
Skills
Identify sources of discrimination, disadvantage and oppression within the processes, procedures and practices of the clinical andmultidisciplinary teams
Promote the value of cultural, ethnic and religious diversity in the clinical team and the multidisciplinary team Contribute to the development of systems that promote anti-oppressive practice and address structural and individual causes of disadvantage, discrimination and oppression in the mental health service Aspect: Diversity
Attitudes
Identify and question own values, prejudices, stereotypes and beliefs and sources of structural discrimination within own practice
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B. WORKING IN TEAMS
sychiatrists work as members of a number of teams within organisations. They must be able to demonnderstanding of the roles of others and a respect for the knowledge, skills and experience they bring to a team and to an rganisation. They will need to demonstrate strong interpersonal skills and an open and non-discriminatory approach to rofessional working relationships with colleagues.
Healthcare is increasingly provided by multi-disciplinary teams. Working in a tea does not change the psychiatrist’s personal accountability or professional con vided. Wh n a team, the ps must: recognise, respect and support the skills and contributions of colleagues; maintain professional relationships with patients;
gues tea s and nal status and trist’ bilities i
f patients’ c r ta of the team, taking steps to remedy any deficiencies; and be willing to v e performance, conduct or health of team members.
to respect and understand th you h/in yo
P strate an uop
mduct and the care pro en working i ychiatrist
communicate effectively with colleathe psychiatrist’s professioresponsible for each aspect o
within and outside the specialty, the psychiaare; participate in regula
m; make sure that patients role and responsireviews and audit of the s deal openly and supporti
and colleagues understn the team and who isndards and performance
ely with problems in th
It is important e roles of all the people come into contact wit ur team.
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MAJOR COMPE
• WORK EFFECTIVELY AS A MEMBER A LTIDISCIPL S Back to summary
TENCY:
ND A LEADER OF MU INARY TEAM
Aspects Developing Performance
Under Supervision Competent Mastery
Work constructively within teams, respecting the skills and contributions of colleagues.
ognise own role in healthcare teams and contribute appropriately.
Recognise and value the roles of every team member and facilitate the
dership and working of the team.
Serve as a role model, facilitate and manage respect and constructive working within teams.
Rec
lea
Identifying and rectifying team dysfunctions
Demonstrate a basic understanding of team
actors
steps to avoid or rectify dysfunction within the team.
Based on a good understanding of the team’s roles and of the
or rectify any dysfunction within the team.
Effectively manage the team to prevent or rectify any dysfunction, showing
leadership and al skills and a
good knowledge of team dynamics in general, and within your teams in particular.
dynamics and the fthat can make a team dysfunctional. Where it is
individuals who comprise the team, actively prevent
soundinterperson
within your remit, take
Recognise and take proper account of differences in values and beliefs within multidisciplinary teams
Develop an understanding from a theoretical base and put this into practice
Respect and take advantage of this variety within any teams you lead.
Facilitate an atmosphere within teams where individual opinions and the diversity of team members are valued.
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Aspects Developing Performance
Under Supervision Competent Mastery
Liaise effectively wother teams within and outside of medicine
Forge links with such teams as appropriate
Promote and encourage an awareness of the value of multidisciplinary, multi-agency, and multi-professional teams
ith Demonstrate an awareness of the roles and responsibilities of the multi-disciplinary teams within the broader health and social care context
Aspect: Work
as a member of a team
Knowledge
Demonstrate an awareness of:
• team structure, roles and responsibilities.
• team dynamics including strengths and weaknesses of different team member types.
• functional and dysfunctional teams.
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Aspect: Work as a member of a team
Skills
Demonstrate the following team skills:
• to work effectively within a healthcare organisation
• an understanding of your role and that of others within a multidisciplinary team
• orking environment
promote and deliver optimal care
• to work effectively within multi- member, consultant or leader
• the ability to work as a member of fe and effective contribution to the de-escalation and management of anger and violence especially through the use of control and restraint techniques
he roles of individual team members
• help to establish a shared and clear purpose for work, service and activities within clinical, multidisciplinary ering mental health services
establish and employ clinical processes and organisational structures that consistently support consensual practice
Manage own time and work/life balance and contribute to othe gement of time.
ontribute to the control and effective use of resources including money, estates and information and communications technology.
setting
help maintain a healthy, safe and productive w
• disciplinary team structures as
the therapeutic team in making a sa
• the ability to distinguish between different types of team, identifying their tasks and t
teams and across agencies involved with deliv
• rs’ mana
C Contribute to clinical governance and other audit and risk management processes.
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Aspect: Work as a member of a team
Attitudes
Be aware of and work within own competence, seeking advice from others when necessary.
Back to competency tableAspect: Identifying and rectifying team dysfunctions
Knowledge
Based on a knowledge of team working, recognise patterns of effective and dysfunctional team working. Aspect: Identifying and rectifying team dysfunctions
Skills
Recognise team dysfunctions in working life, and use strategies to rectify them and to prevent their development.
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Aspect: Identifying and rectifying team dysfunctions
Attitudes
Value the benefits of team working, and be prepared to act positively when team dysfunctions become apparent.
Back to competency table
spect: Recognise differences in values and beliefs
edge
A
Knowl Develop an awareness of differences in values and beliefs.
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Aspect: Recognise differences in values and beliefs
Skills
Demonstrate the ability to work as a member of the therapeutic team to contribute to evidence based programmes of care and treatment that is sensitive to diversity by:
• challenging structural sources of disadvantage, discrimination or oppressive practice
• national guidance and legislative challenging examples of discriminatory practice and attitudes in line with local and frameworks
Aspect: Recognise differences in values and beliefs
Attitudes
Be sensitive to differences in values and beliefs and, through influence and example, use these to strengthen individual and team performance
Back to competency table
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Aspect: Awareness of the roles and responsibilities of multi-disciplinary teams
Knowledge
Demonstrate a good working knowledge of the legal principles that govern a doctor’s responsibility (shared and distributed) and how they apply to your teams Aspect: Awareness of the roles and responsibilities of multi-disciplinary teams
Skills
Apply a knowledge of team responsibilities and dynamics into effective team building and teamwork Aspect: Awareness of the roles and responsibilities of mu
Attitudes
lti-disciplinary teams
Develop and maintain collaborative
workin s anding g relationships based on re pect and underst
Back to beginning of section
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C. LEADING TEAMS
n leading a team ensure that medical team m dards of c re set inthat might prevent colleagues from other professions following guidance from their own regulatory bodies are brought to the psychiatrist’s attention and addressed; all team members understand their personal and collective r f patients, and for openly and honestly recording and discussing problems; each patient’s care is pro ed and that patients know who to contact if they have questions or concerns; arrangements are in plac es; regular reviews and audit of the standards and performance of the team are undertaken influences of group processes and unconscious processes on team functioning are recognised; and that systems are in place for dealing supportively with problems in the performance, conduct or health of team members. MAJOR COMPETENCY:
• DEMONSTRATE APPROPRIATE LEADERSHIP
ary
I embers meet the stan onduct and ca this guidance; any problems
esponsibility for the safety operly co-ordinated and manage to provide cover at all tim
and any deficiencies are addressed; the
Back to summ
Aspects anceDeveloping Perform
Under Supervision Mastery Competent
At first under supervision, but increasingly independently, work as a member of the healthcare team.
member of the healthcare team, taking on leadership and management roles as appropriate.
Demonstrate excellence in effective management and leadership of a team of health care professionals. Effectively and appropriately lead, manage and work as a member of a team of
Effectively, appropriately and constructively lead and manage as a member of a team of healthcare professionals
Work effectively as a
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iculum for Psychiatry
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Developing Performance
Aspects
Under Supervision Competent Mastery
healthcare professionals. Integrate competing professional views and minimise professional rivalry.
Serve as a role model and teacher to enable junior colleagues to be effective team members and take on appropriate leadership and management roles.
Observe the team’s work, giving praise and encouragement wappropriate and bringing
Monitor the team’s work, giving praise and encouragement where appropriate, managing any problems that are within your remit and
nging any other
Take overall responsibility for monitoring the team’s work, giving appropriate praise and encouragement as well as identifying and rectifying and problems
Monitor the team’s work
here
any problems to the attention of your senior colleagues. bri
problems to the attention of senior colleagues.
A Competency Based Curr
Aspect: Lead and manage as a member of a team
Knowledge
Demonstrate an Demonstrate an understanding of how to effectively and appropriately lead, manage and work as a member of a team of
awareness of team structure, roles and responsibilities.
healthcare professionals. Aspect: Lead and manage as a member of a team
Skills
Provide clinical information and advice to influence decision-making.
ting the skills and contributions of colleagues
• using authority sensitively and assertively to resolve conflict, resistance and disagreement Influence and effect service developments. Adopting a leadership role when necessary to enable individuals, groups and agencies to implement plans and decisions
• identifying and prioritising tasks and responsibilities
Demonstrate the ability to influence the work of teams and individuals by:
• working constructively within teams, respec
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• managing time and resources
• make judgements and recommendations on resource allocation both to patients and within and across services
• implementing business/service plans to meet identified needs or policy requirements
Demonstrate effective leadership by:
• recognising and using influence and authority to effect appropriate change
• using authority appropriately and leading effectively, practicing with consent and recognising power nt vulnerability
Demonstrate clinical leadership skills and seek to foster and encourage junior colleagues to develop and exercise their own leadership skills.
• chairing, facilitating and contributing to meetings
imbalances and patie
Aspect: Lead and manage as a member of a team
Attitudes
Demonstrate effective knowledge of organisational policies and practices to maintain the role and the capacity of the therapeutic team to provide evidence based care that is sensitive to diversity.
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Aspect: Monitor the team’s work
Knowledge
Demonstrate and awareness of contemporary principles and practice of quality assurance, benchmarking and standard setting. A
spect: Monitor the team’s work
Skills
Manage a s outside of remit to senior colleagues.
Co-ordinate and motivate the team appropriately.
ny problems referring problem Gather, handle and interpret data on team performance.
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A
spect: Monitor the team’s work
Attitudes
Give praise and encouragement where appropriate. Manage personal and team reactions to challenging circumstances.
Back to beginning of sectionBack to competency table
D. ARRANGING COVER The psychiatrist must be satisfied that, when they are off duty, suitable arrangements are made for their patients’ medical care. These arrangements should include effective hand-over procedures and clear communication between doctors. If the psychiatrist arranges cover for their own practice, they must satisfy themselves that doctors who stand in for them have the qualifications, experience, knowledge and skills to perform the duties for which they will be responsible. Deputising doctors and locums are directly accountable to the GMC for the care of patients while on duty.
Back to beginning of section
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E. TAKING UP APPOINTMENTS
epted, unless the emplme to make other arrangements.
k to beginning of section
The psychiatrist must take up any post, including a locum post, they have formally acc oyer has adequate ti
BacBack to summary
F. SHARING INFORMATION WITH COLLEAGUES
It is in patients’ best interests for one docto tio omaintaining continuity of a patient’s medica The psychiatrist should ensure that patients are informed about how in e will be providing their care. If a patient objects to such disclosures the p beinformation being shared, but they must not disclose information if a patient maintains such objectio
they sho .
t or adv e General tigation a n nec are of
ychiatrist by a Gpsychiatrist should inform the General Prac t cies able to do so. If the psychiatrist does not tell the patie e m e responsible for providing or arranging all necessary after-c
r, usually a General Practil care.
ner, to be fully informed ab
formation is shared within tsychiatrist should explain the
ut and responsible for
ams and between those whonefits to their care of ns.
When a psychiatrist refers a patient,
uld provide all relevant information about the patient’s history and current condition
t th ractitioIf the psychiatrist provides treatmenPractitioner the results of their investhe patient, unless the patient objects. If
ice for a patient, but is nos, the treatment provided
the patient has not been referr
e patient’s General Pnd any other informatio
d to the ps
ner, they should tell thessary for the continuing ceneral Practitioner, the or when it is impractic
nt, they will b
etitioner before starting treant’s General Practitioner, bare until another doctor agrees to take over.
ment, except in emergenfore or after providing treat e
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MAJOR COMPE
• COMMUNICATE EFFECTIVELY WITH O ROFESSIOBack to summary
TENCY:
THER HEALTHCARE P NALS
Aspects Developing Performance
Under Supervision Competent Mastery
Routinely ensure that contemporaneous notes are made at ward rounds, team meetings, etc.
Maintain clear, accurate and contemporaneous records and communicate relevant information, verbally and in writing, with other professionals.
Develop and implement systems for record keeping and effective communication. Supervise others in record keeping and effective communication.
Record keeping
Excellent verbal and communication skills are essential at all times. They involve listening, respecting the views and beliefs of others, and sharing information in
formats that are easily understood.
Good verbal and communication skills
Be familiar with and able to implement guidelines. Explain the need for best practice, consistency and transparency. Distinguish between guidelines based on statute ethics, scientific
Describe the limits of guidelines Critically appraise and audit the use of guidelines
Draft guidelines with appropriate reference to evidence, ethics and stakeholders. Provide leadership where changes in historical patterns of practice are called for.
Working within the framework of legislation, custom and practice
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Aspects Developing Performance
Under Supervision Competent Mastery
evidence and best practice consensus
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Aspect: Record keeping
Knowledge
Properly compile, structure and maintain records. Demonstrate an awareness that in addition to patient-specific clinical records, psychiatrists who manage will have responsibilities
r records.
for financial, employment, research and othe
Aspect: Record keeping
Skills
Keep clear, accurate, legible and contemporaneous management records of relevant decisions and transactions in accordance with the law and good practice.
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Aspect: Record keeping
Attitudes
Compile, store, use and dispose of records honestly, with proper regard to patient and staff confidentiality, and make them available to those authorised to access them. Seek professional advice where necessary.
Back to competency tableAspect: Good verbal and communication skills
Knowledge
Routinely demonstrate good communication, including listening w h respect and responding promptly to requests for information.
it
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Aspect: Good verbal and communication skills
Skills
that
rioritise areas of promotional need to increase awareness and resolve issues of misunderstanding of psychiatric principles, ractices and services.
Promote and present the values, skills and perspectives of psychiatry within clinical, multidisciplinary teams and the wider environment. Actively communicate the scientific, humanities and spiritual/religious evidence base of mental health services and professionscontribute to ethical and responsive psychiatric practices. Pp
Aspect: Good verbal and communication skills
Attitudes
P
romote good verbal and other communication skills through example, encouragement and self-reflection
Back to competency table
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Aspect: Working within the framework of legislation, custom and practice
Knowledge
Demonstrate a clear knowledge and understanding of the duties you have to patients, and when you should or should not legally elegate or devolve responsibility in their interests.
Demonstrate an understanding, through personal practice and explanation to others, of local isaccess relevant to legislation, custom and practice.
d
sues of service availability and
Aspect: Working within the framework of legislation, custom and practice
Skills
Establish and maintain effective links with relevant organisations to ensure that the profession and its concerns and issues are represented.
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A
spect: Working within the framework of legislation, custom and practice
Attitudes
De to reduce your own workload.
legate or devolve responsibility in the patient’s best interests, and not primarily
ectionBack to beginning of s
Back to competency table
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G. DELEGATION AND REFERRAL
MAJOR COMPETENCIES
PPROPRIATELY ASSUME DELEGATE AND DEVOLVE RESPONSIBILITY
:
• A , • IDENTI ES TO ACCESS ADVICE, ASSISTANCE ANDFY PROCEDUR SECOND OPINION
elegation involves asking a nurse, doctor, m r health ca rovide treatment o the
psychiatrist’s behalf. When the psychiatrist delegates care or treatment they must be sure that the person to whom they delegate is pr ed. ways ation
ded sponsi geme
Referral involves transferring some or all of atient’s care, usually tempora purpose, such as additional investigation, care or t will refer patients to another registered medical practitioner. If this is not the case, the psychiatrist must health care
rofessional to whom they refer a patient is accountable to a statutory regulatory body, and that a registered medical practitioner, sually a General Practitioner, retains overall responsibility for the management of the patient.
D edical student or othe re worker to p r care on
competent to carry out the procedure or about the patient and the treatment nee
ovide the therapy involv. They will still be re
the responsibility for the p treatment, which falls outside the psychiatr
The psychiatrist must alble for the overall mana
pass on enough informnt of the patient.
rily and for a particularist’s competence. Usually the psychiatris
be satisfied that anypu
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MAJOR COMPETENCY:
• APPROPRIATELY ASSUME, DELEGATE AND DEVOLVE RESPONSIBILITY Back to summary
Aspects of major competency
Competency Developing Performance
Under Supervision Competent Mastery
Appropriately assume, delegate and devolve responsibility
Correctly identify your own responsibilities
Appropriately delegate and devolve
towards patients, their carers and relatives, a d to other team m
assume,
responsibility.
Appropriately assume, delegate and devolve responsibility, demonstrating excellent leadership, decision-making and management skills.
nembers.
Aspect: Appropriately assume, delegate and devolve responsibility
Knowledge
Appropriately assume, delegate and devolve responsibility
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Aspect: Appropriately assume, delegate and devolve responsibility
Skills
Exercise appropriate professional skills and knowledge in assuming, del nsibility.
egating and devolving respo
Aspect: Appropriately assu
me, de lve res
Attitudes
legate and devo
ponsibility
Consistently demonstrate appropriate professional behaviour when ass olving responsibility.
uming, delegating and dev
Back to competency table
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MAJOR COMPETENCY:
CCESS ADVICE ASSISTANCE AND SECOND OPINION WHEN DELEGATING AND MAKING REFERRALSBack to summary
• A ,
Aspect Developing Performance
Under Supervision Competent Mastery
Access advice, assistance and second opinion when delegating and making referrals
Identify and utilise sources of advice, assistance and second opinions.
Whenever required,
Whenever required, obtain advice, assistance and second opinions.
sources.
Provide professional advice and opinions when requested.
obtain advice, assistance and second opinions from the best available
Aspect: Access advice, assistance and second opinion when delegating and making referrals
Knowledge
Recognise that the psychiatrist has a particular role in referring (or receiving) people with psychiatric disorders between services,
nsfer of care between services and ensure that these are followed.
across agencies and between disciplines Demonstrate an understanding of the protocols for tra
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Aspect: Access advice, assistance and second opinion when delegating and making referrals
Skills
Find sources of advice assistance and second opinions relevant to the problem at hand Identify procedures to access advice and assistance and second opinion In emergencies, act to ensure necessary referral and treatment Inform agencies, referrers and other workers of the outcome of the referral at all key points Ensure smooth transfer of care in either direction, and give as complete a picture as possible to the receiving doctor, as it will be necessary to their taking over the safe conduct and management of the patient. Aspect: Access advice, assistance and second opinion when delegating and making referrals
Attitudes
Treat receiving or referring professionals with respect and courtesy. Involve the patient and carers in the decision to refer. A Competency Based Curriculum for Psychiatry
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Inform the patient of the reason for referral and the expected outcomes. Take account of the views of members of the clinical team or other workers/agencies when making referrals.
Back to beginning of sectionBack to competency table
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Back to IndexBack to summary
3. PROBITY
3. PROBITY A. our servicesProviding information about y B. Writing reports, giving evidence and signing documents C. Research D. Financial and commercial dealings E. Conflicts of interest F. Financial interests in hospita nd isls, nursing homes a other medical organ ations
A. PROVIDING INFORMATIO VIN ABOUT YOUR SER CES
must ensure the informati issued by the Advertising S
Psychiatrists who publishe information abo provide on ble. It must be published in a way that conforms with th guidance The information published must not make unjustifiable claims about the quality of the services offered. It must not, in any way, offer guarantees of cures, nor exploit patients’ vulnerability or lack of medica Information the psychiatrist publishes about their services must e a service, for example by arousing ill-founded fear for their future health. Similarly psychiatrists m st not advertise their services by visiting or telephoning prospective patients, either in person or through a deputy.
ut the services they e law and with the
is factual and verifiatandards Authority.
l knowledge.
not put pressure on people to usu
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MAJOR COMPETENCY:
• EFFECTIVE AND ETHICAL PROVISION OF INFORMATION
Back to summary
Aspect: Developing Performance
Under Supervision Competent Mastery
Effective and ethical provision of Take care not to exploit
lack of medical knowledge. Liaise with GPs, ocolleagues, patients and carers regarding
referrals and what services are available.
Do not make unjustifiable claims, guarantee a cure or pressure people to accept a treatment. Ensure that information provided is factual and verifiable, and conforms
Authority and other official guidance. Never advertise through direct visits or telephoning. Use a variety of appropriate
ethods of providing information on services (leaflets, posters, etc).
Ensure that all information provided about the service for which you are responsible is legal, ethical and effective. Investigate claims of inappropriate advertising
approaches to providing information on services.
information about your services patients’ vulnerability or
ther
appropriateness of to Advertising Standards and unprofessional
m
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Aspect: Effective and ethical provision of information
Knowledge
Recognise that any information published must conform with the law and with the guidance issued by the Advertising Standards Authority. A
spect: Effective and ethical provision of information
Skills
Liaise with GPs, other colleagues, patients and carers regarding appropriateness of referrals, and establish what services are available. Aspect: Effective and ethical provision of information
Attitudes
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Ensure that patients’ vuln
erability or lack of medical knowledge is never exploited.
n re hat Information the psyc iatrist publishes about their services must not put pressure on people to use a service, for ex p
E su t ham le by arousing ill-founded fear for their future health.
Back to beginning of section
Back to competency table
REP N
B. WRITING ORTS, GIVING EVIDENCE AND SIGNING DOCUME TS The psychiatrist must be hon en w rts, completing or viding evidence in litigation or other f s mea aso eps to verify any statement before they sign a document ot which are false or misleading because they omit relevant informatio or sign a document or provide evidence, they must do so w
est and trustworthy whormal inquiries. Thi
riting repo signing forms, or pronable stns that they must take re
write or sign documents epare a report, complete
. The psychiatrist must nn. If they have agreed to prithout unreasonable delay.
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MAJOR C CY:
• ENSURE THAT REPORTS, E MENTS YOU ONSIBILITY FOR A LETE, HONEST AND ACCURATE
to summary
OMPETEN
VIDENCE AND DOCU HAVE A RESP RE COMP
Back
g Performance Aspects Developin
Under Supervision Competent Mastery
Writing reports, giving evidence and signing documents.
comprehensive, appropriate and timely discharge summaries and referral
verify statements; don’t sign anything you believe to be false or misleading.
ntal Health Tribunals, Managers’ Hearings, Coroners Courts and Courts of Law.
ly and egal
Write reports as an expert witness. Teach theses skills to
Write and sign Write and sign omprehensive, timec
appropriate medico-lreports.
letters to colleagues. Take reasonable steps to
Use a system to maintain up-to-date knowledge of relevant legislation.
Prepare reports for Me
others.
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Aspects Developing Performance
Under Supervision Competent Mastery
Describe and apply understanding of the system of managers’
tribunals.
an up to date knowledge of relevant legislation.
Advise on new drafts of relevant legislation.
MaintainRelevant contemporary legislation
hearings and MHA
Giving evidence and teaching others how to give evidence
tribunals.
Give evidence at managers’ hearings and MHA
Demonstrate good professional skills and knowledge in gathering and delivering evidence. Tes fy as an expert
Teach theses skills to others.
tiwitness.
Writing reports Agree to provide only such reports as are within your
Produce clear and relevant reports on matters that are
Provide expert reports that are clear and
mprehensive.
capability. within your field of expertise.
co
Aspect: relevant contemporary legislation
Knowledge
Demonstrate a sound, contemporary and working knowledge of mental health and allied legislation.
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Aspect: relevant contemporary legislation
Skills
Correctly and appropriately interpret relevant legislation and explain its implications for a specific situation. Aspect: relevant contemporary legislation
Attitudes
nsure that your practice conforms to prevailing legislation and codes of conduct and practice. E
Back to competency tableAspect: giving evidence and teaching others how to give evidence
Knowledge
Demonstrate an appropriate knowledge of gathering, organising and providing evidence.
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Aspect: giving evidence and teaching others how to give evidence
Skills
Formulate opinions clearly and present them to other professionals and as evidence to the courts, including mental health review
ibunals. tr Aspect: giving evidence and teaching others how to give evidence
Attitudes
Carefully gather and provide evidence.
ct in accordance with contemporary codes of practice and conduct.
each and support others in ensuring that reports and evidence are complete, honest and accurate.
A Demonstrate a willingness to t
Back to competency table
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Aspect: Writing reports
Knowledge
emonstr ng that the purpose of these reports is to inform the judges and facilitate them in decision-making. D ate an understandi Aspect: Writing reports
Skills
Use appropriate language, for example avoiding use of medical jargon. Write concise relevant reports. Aspect: Writing reports
Attitudes
Prepare reports and give evidence so as to facilitate the legal processes.
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Back to beginning of sectionBack to competency table
C. RESEARCH
MAJOR C CIES:
• ENSURE THAT CPD CONT SEARCH
OMPETEN
AINS AN ELEMENT OF RE o ense of and appropriately applying e actice)making s research findings to servic (e.g. evidence based pr
esear teo complete r ch projects and dissemina findings appropriately • CARRY OUT AND SUPERVISE RESEARCH
If psychiatrists participate in research they must p
ch from an independeresearch with honesty
ut the c nts first. They must ensure that approval has been obtained for resear nt patients have given consent. The psychiatrist must conduct all and in
are and safety of patie research ethics committee and that
tegrity.
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MAJOR COMPETENCY
Back to summary
• ENSURE THAT CPD CONTAINS AN ELEMENT OF RESEARCH
Aspects Developing Performance
Under Supervision Competent Mastery
Making sense of and Base decisions on the best
question, search the lly
appraise the findings.
Translate the best evidence into best clinical practice
and stakeholder views.
Adopt a service-based approach in which risks and opportunities generate priorities for evidence based practice.
Demonstrate a scientific approach to service
available evidence. taking account of resources improvement. appropriately applying research findings to service (e. g. evidence
Pose an answerable based research)
literature and critica
Complete research projects and disseminate findings appropriately
research under supervision. Uphold ethical approach to research.
conduct research projects
advice about the processes involved in funding and publishing
Independently conducting and lead research programmes. As before plus predicting areas where enquiry is
likely to produce important results.
Carry out aspects of Collaborate with others to
Apply scientific method to research. mostresearch.
Use and
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Aspect: Make
Knowledge
sense of and appropriately apply research findings
Perform a literat Formulate a clini
ranslate it into researchable questions.
nd formulate integrated answers.
Change your clinical practice accordingly, and write this up as a case report. Develop your own research questions as a result.
ure search.
cal question to be answered.
T Assess the relevance of each of the resulting references to the original questions, a
Aspect: Make sense of and appropriately apply research findings
Skills
Critically appraise new research publications including studies with the following methodologies:
• randomised controlled trial
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• case control study • longitudinal cohort study • large scale epidemiological study of e e or incidence
nter data onto a database, use a spreadsheet (such as Excel) and a statistical analysis package (such as SPSS) with help from a
emonstrate the ability to use and interpret basic statistical analyses:
• tests for normality
• tests for comparison of categorical and continuous data
ither prevalenc Estatistician, if necessary. D
• appropriate use of parametric/non parametric statistics
Attitudes
Aspect: Make sense of and appropriately apply research findings
nterpret research findings, taking proper account of the strengths and limitations of evidence-basI ed medicine in applying it to
patients.
Back to competency table
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Aspect: Complete research projects and disseminate findings appropriately
Knowledge
Conduct research and disseminate findings in accordance with agreed principles and practices.
Aspect: Complete research projects and disseminate findings appropriately
Skills
Contribute to the body of psychiatric knowledge and practice t methods. Report and present results honestly and appropriately.
hrough formal and informal
Aspect: Complete research projects
and disseminate findings appropriately
Attitudes
Receive and positively respond to constructive criticism regarding the research (e.g. re-draft a paper following reviewers’ comments).
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Back to competency tableMAJOR COMPETENCY:
• CARRY OUT AND SUPERVISE RESEARCH Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Carry out and supervise research
Inform practice by accessing sources of research information.
Put care and safety of patients first. Gain informed consent prior
t taking part.
Work within REC guidance.
tice.
research or audit; organise and carry out the project; collate data and publish findings.
Supervise research of others. Develop new funding sources. to patien
Ensure honesty and integrity in prac Develop a topic for
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Aspect: Carry esearch
out and supervise r
Knowledge Describe how to judge relative quality of journals through impact factors and citation indices. Aspect: Carry out and supervise research
Skills
Carry out electronic literature searches on internet and library databases. Carry out a piece of research (size and scope appropriate to time available):
ients to the study, receive training in appropriate assessment issues, and
raft a research proposal containing:
• main objectives • introduction • hypotheses • design
• be involved in the recruitment of patsubsequently be involved in assessments
D
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• statistical information
•
arry out an audit of the research.
• power calculation ethical considerations
• dissemination Submit an application for ethical approval to a Local Research Ethics Committee; draft consent and application forms. Access paper and on-line journals. Use time available for research in an efficient and productive manner, so that output is proportionate to the time available. C Aspect: Carry out and supervise research
Attitudes
Demonstrate motivation and ability to work independently. Monitor and evaluate own research knowledge and evidence-based practice to establish its effectiveness.
Back to beginning of sectionBack to competency table
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D. FINANCIAL AND COMMERCIAL DEALINGS
All doctors must be aware of and operate at all times within the legal and ethical framework surroundingommercial activity in healthcare.
They must be honest and open in any financial they should provide information ning patients’ consent to treat must not exploit patients’
ulnerability or lack of medical kn g charge e their patients to give, lend or bequeath
r f milies to make donations to on ; they must not put pressure on ea h r.
A doctor who has financial or commercial interests in orga car other biomedica pa The doctor must be honest in ers and other organisations or individuals. In particular: if the funds are used for the purpose for which they were intended and are kept in a separate account fro their personal finances; before taking part in discussions about buying goods or services, the doctor must dec interest which they or their family might have in the purchase.
financial and c
arrangements with patients. In particular:ment, wherever possible; theyabout fees and charges before obtai
v owledge when makinmoney or gifts which will dire
s for treatment or sectly or indirectly benefit t
rvices; they must not encouraghe doctor. They must not put
pressure on patients or theipatients to accept private tr
a other people or organisatiey must tell patients
nizations providing healthway they prescribe, treat or refer
stment; if they charge fees, t
l companies, must not be affected in the
if any part of the fee goes to another docto
e, or in pharmaceutical or tients.
financial and commercial dethey manage finances, they must make sure that
alings with employers, insur
mlare any relevant financial or commercial
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MAJOR COMPETENCY:
iculum for Psychiatry
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• PROPERLY MANAGE FINANCIAL AND COMMERCIAL DEALINGS Back to summary
Aspect Developing Performance
Under Supervision Competent Mastery
Financial and commercial dealings
Seek advice on and declare
Interact approethically with
gifts other than small tokens. Respond to the needs of people in an ethical, honest,
priately and
representatives of the pha maceutical industry.
ples of payment for financial and commercial
Keep personal and professional funds separate.
ations of relevant professional bodies.
on fees and charges (which should be reasonable and
iven
Contribute to the development of standards of relevant professional bodies.
r Apply princi
non-judgemental manner. dealings.
Adhere to regul
Information
transparent) must be gprior to requesting consent to treatment.
A Competency Based Curr
Aspect: Properl
y manage financial and commercial dealings
Knowledge
Demonstrate and apply in professional practice knowledge of relevant legislation, guidance and practices. Aspect: Properl
Skills
y manage financial and commercial dealings
Maintain clear, auditable records of all financial and commercial dealings.
spect: l and commercial dealings
A Properly manage financia
Attitudes
Demonstrate honesty and openness in any financial arrangements with patients by:
• not encouraging your patients to give, lend or bequeath money or gifts which will directly or indirectly benefit you
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• not putting pressure on patients or their families to make donations to other people or organisations
• not putting pressure on patients to accept private treatment
• not exploiting patients’ vulnerability or lack of medical knowledge when making chservices
ients if any part of the fee goes t
he psychiatrist must be honest in cial dealings rs, insurers and ot ations or
individuals by:
gineparate
ing a hase efore taking part in discussions about ing goo s or services
• providing information about fees and charges before obtaining patients’ consent to treatment
arges for treatment or
If charging fees, informing pat o another doctor.
T financial and commer with employe her organis
• if manaa s
• declarbuy
g finances, making sure funds are used for the purpose for which they were intended and are kept in account from personal finances
ny relevant financial or commercial interest in any purc bd
Back to beginning of section
Back to competency table
E. CONFLICTS OF INTEREST The psychiatrist must act in th ir patients’ best interests when making referrals and providing or arranging treatment or care. So the psychiatrist must not a may affect or be seen to affect their judgement. The psychiatrist s
esk for or accept any inducement, gift or hospitality which hould not offer such inducements to colleagues.
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M
AJOR COMPETENCY:
• Ammary
VOID CONFLICTS OF INTEREST AND ADVISE OTHERS ON PREVENTING AND DEALING WITH CONFLICTS OF INTEREST Back to su
Aspect: Developing Performance
Under Supervision Competent Mastery
• Avoid conflicts of interest and advise others on preventing and dealing with
Take steps to monitor and prevent any conflicts of interest. Advise of you, or your family’s, conflicts of interest before discussions take place about buying goods or services. Act in patients’ best interests, especially when referring
Advise others on preventing and dealing with conflicts of interest. Contribute to developing standards in this area.
conflicts of interest
patients and arranging treatment or care. Ensure that any financial or commercial interest must not affect the way you deal with patients. Do not ask for, encourage, accept or offer any gift, inducement or hospitality which may affect, or be seen to affect, your judgement. Make appropriate bodies (GMC, RCPsych, employer, etc.) aware of any real or potential conflict of interest you may have.
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F. FINANCIAL INTERESTS IN HOSPITALS, NURSING HOMES AND OTHER MEDICAL
If the psychiatrist has financial or commercia care or in pharmaceutical or other biomedical companies, these must not affe for, treats or refers patients. If the psychiatrist has a financial or commercial interest in an organisation to which they plan to refer a patient for treatment or
st tell the patient about their interest. When treating NHS patients the psychiatrist must also tell the health car
reating patients in an institution in which psychiatrists or members of their immediate family have a financial or commercial interest ay lead to serious conflicts of interest. If the psychiatrist does so, their patients and anyone funding their treatment must be made ware of cialist services, they must not accept patients unless they ave bee ility for managing the patient’s care. For a General
to provide primary care services for patients in , they must be prepared to justify their
decision.
ORGANIZATIONS
l interests in organisations providing healthct the way the psychiatrist prescribes
investigation, they mue purchaser.
Tma the financial interest. In addition, if the psychiatrist offers spe
n referred by another doctor who will have overall responsibhPractitioner with a financial interest in a residential or nursing home, it is inadvisable that home, unless the patient asks or there are no alternatives. If the psychiatrist does this
Back to beginning of section
Back to summary
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Back to IndexBack to summary
4. HEALTH
4. HEALTH A. If y put patients at risk our health may
UR HEALTH MAY PUT PATIENTS AT RISKA. IF YO
ial threats to your physical and emotional well being.
a serious condition which you coul or that your judgement or performance cted by a condition or illne take and follow advice from a consultant in
ational health or another suitably qualified colleague on whether, and in what ways, you should modify your practice. o not rely on your own assessment of the risk to patients.
st have all the necessary tests and act n the advice given to you by a suitably qualified colleague about necessary treatment and/or modifications to your clinical
practice.
dentify and assess potentI If you know that you havecould be significantly affeoccup
d pass on to patients, ss, or its treatment, you must
D If you think you have a serious condition which you could pass on to patients, you muo
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MAJOR COMPETENCY:
• ENSURE THAT YOUR HEALTH AND THE HEALTH OF DOES NOT PUT PATIENTS AT RISK Back to summary
OTHERS
g Performance
Aspect Developin
Under Supervision Competent Mastery
Obtain advice and Essential at all stages treatment for mental and
physical health problems Ensure that your health does not put patients at isk.
Essential at all stages
r Aspect: Advice and treatment for mental and physical health problems
Knowledge
Demonstrate a knowledge of Occupational Health and professional regulatory mechanisms.
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Aspect: Advice and treatment for mental and physical health problems
Skills
Maintain a system for monitoring your own physical and mental health. Develop strategies to handle the emotional and physical impact of one’s performance. Identify and assess potential threats to physical and emotional well-being. Identify physical, behavioural, emotional or cognitive signs and symptoms that might impact upon professional performance at work Advise and treat other healthcare workers with mental health problems. Aspect: Advice and treatment for mental and physical health problems
Attitudes
Do not rely on your own assessment of potential risks to others through your own ill health. Take action to address ill health that is affecting performance. Maintain personal, physical and emotional well being and mental health to enable competent performance at work. A Competency Based Curriculum for Psychiatry
Core and General Module Page 150 of 151
A Competency Based Curriculum for Psychiatry
Core and General Module Page 151 of 151
Accept and follow advice (including treatments and modifications to your own practice).
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