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A Competency Based Curriculum for Psychiatry

Core and General Module Page 1 of 151

Core and General Module February 2006

Approved by the Postgraduate Medical Education and Training Board

A Competency Based Curriculum for

Specialist Training in Psychiatry



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.



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



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



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)



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



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



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



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



G. DELEGATION AND REFERRAL MAJOR COMPETENCIES:

• APPROPRIATELY ASSUME, DELEGATE AND DEVOLVE RESPONSIBILITY • IDENTIFY PROCEDURES TO ACCESS ADVICE, ASSISTANCE AND SECOND OPINION


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



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




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 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.



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.



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.



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.



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.



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,



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



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



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



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.



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



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



• •

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:



•

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



• 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.



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




• MANAGE CHRONIC ILLNESS Back to summary

MAJOR COMPETENCY:



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.



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 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



MAJOR COMPETENCY:

• USE THE RESULTS OF THE CLINICAL ASSESSMENT TO URE EFFECTIVE PATIENT MANAGEMENT Back to summary

ENS



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



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.



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



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.



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


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.



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



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



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



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.



A

spect: Emergency care

Attitudes

Maintain a highly professional attitude at all times.




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.



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





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.



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



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.


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.



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



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




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


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





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.



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



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




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.



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.



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.




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



MAJOR COMPETENCY:

• PLAN, DELIVER, AND EVALUATE TEACHING AND LEAR N A VARIETY OF ENVIRONMENTS Back to summary

NING I

Aspect Developing Performance


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



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.



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



MAJOR COMPETENCY:

• ASSESS, APPRAISE AND EVALUATE LEARNING AND LEARNERS Back to summary



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



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).



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




MAJOR COMPETENCY:

• SUPERVISE AND MENTOR LEARNERS (STUDENTS AND TRAINEES)

Back to summary



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.



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



MAJOR COMPETENCY:

• PROVIDE REFERENCES Back to summary



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.



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.




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.



MAJOR COMPETE

• CONDUCT PROFESSIONAL PATIENT RELATIONSHIPSry

NCY:

Back to summa

Aspects ance Developing Perform


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





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.



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.



• 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





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



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.




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


Skills

Demonstrate the ability to promote people’s rights and responsibilities and recognise the service user’s right to privacy, dignity, respect and confidentiality.




Attitudes

Respect the ethical principles behind the concept of

confidentiality.


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.



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,



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.



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


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




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


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


Demonstr n open, self reflective attitude towards endings, including their possible s nificance to both the patient and practitioner.

ate a ig





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



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



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



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


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.


MAJOR COMPETENCY: A Competency Based Curriculum for Psychiatry


• COMPLAINTS AND FORMAL INQUIRIES

Back to summary



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


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.



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



MAJOR COMPETENCY:

• PROVIDING ASSISSTANCE AT INQUIRIES AND INQUESTS Back to summary



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



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


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



MAJOR COMPETENCY:

• INDEMNITY INSURANCE Back to summary



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.



Aspect: Indemnity insurance

Skills

N.A. As surance

ection

pect: Indemnity in

Attitudes

N

.A.

Back to beginning of sBack to competency table




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.





NCY:

• CONTINUOUSLY PROMOTE VALUE BASED NON PREJ PRACTICE Back to summary

MAJOR COMPETE

UDICIAL



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



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



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




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.



MAJOR COMPE

• WORK EFFECTIVELY AS A MEMBER A LTIDISCIPL S Back to summary

TENCY:

ND A LEADER OF MU INARY TEAM



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.





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.



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.



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.



Aspect: Identifying and rectifying team dysfunctions

Attitudes

Value the benefits of team working, and be prepared to act positively when team dysfunctions become apparent.


spect: Recognise differences in values and beliefs

edge

A

Knowl Develop an awareness of differences in values and beliefs.



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




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




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


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



iculum for Psychiatry


Developing Performance

Aspects


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



• 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.

Back to competency tableA Competency Based Curriculum for Psychiatry


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.



A

spect: Monitor the team’s work

Attitudes

Give praise and encouragement where appropriate. Manage personal and team reactions to challenging circumstances.


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.




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



MAJOR COMPE

• COMMUNICATE EFFECTIVELY WITH O ROFESSIOBack to summary

TENCY:

THER HEALTHCARE P NALS



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





evidence and best practice consensus



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


Skills

Keep clear, accurate, legible and contemporaneous management records of relevant decisions and transactions in accordance with the law and good practice.




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



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




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.



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




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



MAJOR COMPETENCY:

• APPROPRIATELY ASSUME, DELEGATE AND DEVOLVE RESPONSIBILITY Back to summary

Aspects of major competency

Competency Developing Performance


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



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




MAJOR COMPETENCY:

CCESS ADVICE ASSISTANCE AND SECOND OPINION WHEN DELEGATING AND MAKING REFERRALSBack to summary

• A ,



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



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


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.





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



MAJOR COMPETENCY:

• EFFECTIVE AND ETHICAL PROVISION OF INFORMATION

Back to summary

Aspect: Developing Performance


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



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



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.



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.



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


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.





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.



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.



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




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.




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.



MAJOR COMPETENCY

Back to summary

• ENSURE THAT CPD CONTAINS AN ELEMENT OF RESEARCH



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



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



• 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.




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).



Back to competency tableMAJOR COMPETENCY:

• CARRY OUT AND SUPERVISE RESEARCH Back to summary



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



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



• 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.




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



MAJOR COMPETENCY:

iculum for Psychiatry


• PROPERLY MANAGE FINANCIAL AND COMMERCIAL DEALINGS Back to summary



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



• 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



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.



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


• 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.

Back to beginning of sectionA Competency Based Curriculum for Psychiatry


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 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



MAJOR COMPETENCY:

• ENSURE THAT YOUR HEALTH AND THE HEALTH OF DOES NOT PUT PATIENTS AT RISK Back to summary

OTHERS

g Performance

Aspect Developin


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.



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




Accept and follow advice (including treatments and modifications to your own practice).

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