Psychiatry Junior

Doctor Handbook
Issue 1
Contents page

1 Roles and responsibilities of junior doctors 3

2 Admission process 3
3 Acute medical problems / psychiatric emergencies 6
4 Seclusion reviews 7
5 Electroconvulsive Therapy (ECT) 8
6 The Law 8
7 General work information 9
8 Teaching and training 12
9 Area specifics: 13
– Norwich 14
– Great Yarmouth and Waveney 14
– King’s Lynn 15
– East Suffolk 15
– West Suffolk 16
10 Useful contacts 16

A warm welcome to Psychiatry!

Dear colleague,
This booklet has been designed with the new trainee in mind. It comes from a compilation of frequently
asked questions and feedback from your predecessors to help you settle into your new role.
We know that trainees can be overwhelmed entering unknown territory in Psychiatry, but we hope that
this booklet will provide a rough guide to settle the nerves. This booklet doesn’t try to replace textbooks
or reference works on the practice of Psychiatry; but it hopefully provides a quick local guide that will
serve in a pinch.
We’ve also added some essentials like how to claim expenses, local contacts and maps to find your
way initially.

I hope that you will have a happy Psychiatry experience and welcome to NSFT!

Dr Trevor Broughton MBBCh, MRCPsych, LLM

Consultant Forensic Psychiatrist
Director of Medical Education

NSFT values Trust strategic goals to

and behaviours achieve our mission
Positively... Respectfully... Together... 1. Improving quality and
achieving financial sustainability
2. Working as One Trust
3. Focusing on prevention,
early intervention and
promoting recovery
1. Roles and responsibilities of junior doctors
Roles, responsibilities and expectations
Roles Responsibilities Expectations
• Psychiatric assessment • Act in a professional manner • Learning and training
and care under senior at all times opportunities, including support
supervision • Maintain confidentiality meeting portfolio requirements
• Physical health care for • Wear appropriate dress as • 24hr Senior availability
NSFT inpatients per policy and ID badge at • Weekly personal / clinical
• Out-of-Hours cover all times supervision

Day job expectations and objectives to be specified in local induction.

On-call guidelines and ward work

!
On-call duties

• New admissions • Sedation

• Acute medical problems • Seclusion reviews
• Medication concerns • Liaising with other
• Acute psychiatric issues (e.g. agitation) professionals

2. Admission process
This involves:
A. Admission clerking
B. Mental state examination (MSE)
C. Risk assessment
D. Physical health
– Venous Thromboembolism (VTE) Assessment Form
– Write up medication chart
– Bloods and ECG (if urgent)

A. Admission clerking
• Reason for admission
– History of presenting complaint
– Route of admission
– Home / mental health ward transfer / acute hospital
• Mental Health Act (MHA) status – informal / under section
• Psychiatric history
– Diagnosis
– Recent treatment
– Previous admissions – see previous admissions to 2015 on Lorenzo,
past letters and tribunal reports have lots of info. It may be worth
requesting access to Carenotes / EPEX system for notes prior to 2015
• Past medical history
• Drug history including allergies
• Illicit substance use

Psychiatry Junior Doctor Handbook Issue 1 NSFT 3

• Family history
• Personal and social history
– Birth, development, childhood, education, occupational history
– Family relationships, relationship history
– Current social circumstances including occupation, accommodation, and relationship
• Premorbid personality
• Forensic history

B. Mental state examination

• Appearance and behaviour
– Self-care / what are they wearing / eye contact
– Agitation / psychomotor retardation / abnormal movements
• Mood and affect
– Subjective (how patient tells you it is) and objective (how it looks to you)
– Do emotions appear appropriate, restricted or excessively changing?
• Speech
– Volume, rate, quantity and flow
– Pressured / mutism / spontaneous vs non-spontaneous
– Presence of neologisms, perseveration, echolalia etc.
• Thoughts – stream, form and content
– Evidence of thought disorder - thought block / flight of ideas /
loosening of associations / derailment
– Delusions – persecutory / reference / grandiose / nihilistic / passivity / thought possession
• Perceptions
– Hallucinations in any modality
– Explore voices – 2nd / 3rd person, derogatory, command / running commentary
• Cognition
• Insight
– Into diagnosis, current mental state, need for medication, need for admission

!
Capacity
• If admitted on informal basis patient must have capacity to consent to admission
• This must be documented in admission clerking; if patient lacks capacity, document
why not and recorded in the capacity form under the Other tab in the clinical notes.
If patient lacks capacity consider 5(2) or deprivation of liberties (DOLS)

C. Risk assessment

Current and historic risks to be documented, to consider the following areas:

•
•
•
•
•
Self harm
Self neglect
Poor engagement with services
Risk of non-adherence with medication
Safegurding of children and
•
•
•
•
Risk of harm from others
Risk of financial exploitation
Risk of sexual disinhibition
Risk to others
!
vulnerable adults
Formulation
• Brief summary of salient points from history and mental state
• Include impression and differential diagnosis

Plan
• Level of nursing observations
– In psychiatric hospitals, patients are checked on a number of times an hour
according to their presentation
– This can be adjusted to manage their risks and are often divided into:
1. General observations – hourly (this is the minimum)
2. Intermittent observations – 4-6 times an hour
3. Constant observations
a. Eye sight b. Arms-length
• Write a medication card and consider when required (PRN) medication
– Do not prescribe PRN medication routinely on admission but tailor it to the patient’s needs

Oral medication which may be used as PRN as a part of a de-escalation strategy:

**This is just a guide, please consult up-to-date literature inc. BNF for current regimes**

Drug Route BNF max Onset Duration Repeat Problems

Lorazepam Oral 4mg/day 30-45 mins 4-6 hrs 4 hourly Respiratory depression
Haloperidol Oral 20mg/day 1 hr 20 hrs 4-6 hourly Can accumulate
Promethazine Oral 100mg/day 30 mins 4-6 hrs Twice daily Prolonged sedation,
seizures

D. Physical health

Each patient should have a routine physical health check and VTE assessment on admission and
six-monthly after that. Findings should be documented in the NSFT Physical Health Form, this can
be located by following the tabs indicated below:

Clinical Physical NSFT Physical

Forms
charts health Health Form

A VTE form should be completed for all patients on admission and on any change in their mobility
or physical health. This form can be found on lorenzo via the following tabs:

Clinical Physical VTE Risk

Notes
charts health Assessment

Patients transferred from different hospitals, even those within the Trust, require an updated
Physical Health form if it has been more than a week since their previous one.

Psychiatry Junior Doctor Handbook Issue 1 NSFT 5

3. Acute medical problems / psychiatric emergencies
Overdose
• Take a history to assess the exact circumstances of the poisoning or overdose and complete a
physical examination
• Consider referral to an acute hospital. Toxbase (available as an app) can be used to obtain
information about the toxicity of different substances and the A&E consultant can be contacted
for advice
• Refer people who have taken poisons with delayed action urgently to hospital, even if the person
appears well and is asymptomatic. Delayed-action medicines include aspirin, iron, paracetamol,
tricyclic antidepressants, co-phenotrope (diphenoxylate with atropine, Lomotil ) and all
modified-release preparations

Self harm
• No suturing equipment is available on NSFT sites, if this is required the patient will need to
attend A&E

Ligature
• Assess the severity of the ligature attempt, including the materials used, the physical effect of the
ligature (i.e cyanotic) and use of ligature cutters, efforts made to avoid discovery, and the presences
of any remaining ligature items

Physical health illness

• Not all staff are physical health trained and psychiatric hospitals are limited in the physical health
care they can provide i.e. no IV fluids/antibiotics so have a low threshold for considering admission
to an acute hospital
• Patients should be medically fit for discharge to the community prior to transfer back to a
psychiatric ward

Alcohol withdrawal
• The Trust policy, Managing Withdrawal Symptoms for Inpatients (C02), can be found on
the intranet
• A thorough history and physical examination should be completed and a decision made as to
whether the patient needs to be initially managed in an acute hospital
• The severity of alcohol dependence questionnaire (SAD-Q) can be used to assess alcohol
dependence:
– A score of >16 is likely to require pharmacological intervention to manage withdrawal symptoms
– A score of >30 on the SAD-Q or drinking more than 30 units a day predicts a severe
alcohol withdrawal
• The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) assesses symptoms of
withdrawal:
– A score of 8 or less typically does not require medication for withdrawal
• Chlordiazepoxide can be prescribed as a reducing regime or PRN to manage symptoms of
alcohol withdrawal
• Prescribe vitamin supplementation – IM Pabrinex initially followed by oral thiamine supplementation

Transfer to acute hospital

• Prior to transfer to an acute hospital consider the risks involved, including any risk of harm to
themselves or others in that setting and risk of absconsion
• If a patient is detained, emergency leave can be authorised by a doctor or nurse in charge and the
responsible clinician / consultant on-call should be informed
Rapid Tranquilisation
• Medication may be required if alternative de-escalation strategies are not successful and the
level of risk to self or others remains high
• Please see the Rapid Tranquilisation policy on the intranet (C111) outlining the procedure and
how to monitor for and manage significant side effects
• Temperature, heart rate, blood pressure, level of hydration and level of consciousness must be
monitored at least every hour for four hours and until there are no further concerns

This chart is an example of common medication used:

Drug Route BNF max Onset Peak Duration Problems
Lorazepam IM 25-30 30-45 mins 1-3 hrs 4-6 hrs Respiratory depression
micrograms/kg
Haloperidol IM 12mg/day 30 mins 4-6 hrs 4-6 hrs Can accumulate
Promethazine IM 100mg/day 15-30 mins 1hr 1 hr Can be very sedating

**This is just a guide, please consult up-to-date literature inc. BNF for current regimes**

Flumazenil injections and cannula must be available in all areas where lorazepam is used.
IM benzodiazepines should not be given within 1 hour after IM olanzapine or vice versa.
If an adult patient is informal but refusing essential treatment, medication may be administered
under the Mental Capacity Act, however, a MHA section should be considered as the patient is
likely significantly unwell.

Queries about medication or other concerns should be discussed with a senior on-call.

4. Seclusion reviews
• All junior doctors should familiarise themselves with the Seclusion and Long-Term Segregation
policy (C107) available on the intranet
• First medical review within one hour
• Medical four hourly reviews thereafter until the first MDT review. Medical review twice in 24 hours
following this (One has to be completed by the responsible clinician / On-call consultant)
• Consider your own safety - Discuss with the staff what is appropriate and whether it is safe to
open the door or carry out a non-contact examination
• Do not open the seclusion door without a PMA team
• Tabs to follow on Lorenzo to locate the seclusion start / stop form:

Clinical Obs and Seclusion record

Inpatient
charts seclusion start stop

• Document:
– Rationale for seclusion
– If restraint was used – Assess for any physical injuries secondary to restraint
– Review medication – What have they had so far? Remember physical health monitoring
if rapid tranquilisation used
– Review the current risks to the patient and others
– Current mental state
– You are the patient’s advocate – Do they really need to remain in seclusion?
Have they been offered drink / food?

Psychiatry Junior Doctor Handbook Issue 1 NSFT 7

5. Electroconvulsive therapy (ECT)
In Norwich this is carried out at the Julian Hospital on Mondays and Thursdays.
You may occasionally be asked to see someone pre or post ECT. They need to have a physical
work up beforehand, including bloods and ECG, and benzodiazepine medication is contraindicated.

In Ipswich this is carried out on Tuesday mornings and Friday mornings.

Pre-ECT assessment
• Medical history should highlight items which may have an impact on anaesthesia
e.g. cardiorespiratory disease, history of any adverse reactions to anaesthesia
• Early advice from the anaesthetist should be sought for patients taking medication for diabetes,
long-term or high dose steroids or MAOIs
• Physical examination including examination for evidence of cardiovascular disease, infection,
obesity, or other factors that may restrict airway management
• Extreme caution should be taken in patients with:
– recent MI or unstable angina
– recent CVA
– raised intracranial pressure / untreated cerebral aneurysm
– unstable major fracture / c-spine injury
– phaeochromocytoma
– uncontrolled cardiac failure or severe valvular disease
– DVT
– cochlear or brain implant
• Patients with implanted pacemakers can receive ECT, although cardioverter defibrillators should
have defibrillation and anti-tachycardia functions temporarily deactivated
• ECT is relatively safe in pregnancy although from second pregnancy consideration should be
given to positioning

!
Possible side effects include:
• Those of general anaesthetic • Nausea
• Headache • Confusion
• Muscle ache • Memory loss (normally transient)

6. The law
Mental Health Act 1983
• Section 5(4) – Nursing staff holding power for 6 hours
• Section 5(2) – Doctor holding power for 72 hours
• Section 2 – MHA assessment, 28 days for assessment / Rx of patient’s condition
• Section 3 – MHA assessment, 6 months for Rx of known condition

If the patient has been under section for over three months a T2/T3 (Consent to treatment) form
should be in place that will restrict what medication can be administered to that patient. This includes
any psychotropic medication including regular or PRN and medication used to treat side effects, it does
not include unrelated physical health medication. In emergencies patients can be treated under an
emergency section 62 that has to be authorised by a consultant.
 Best interest Necessary and
Treatment = Restraint =
of the patient proportionate

Mental Capacity Act 2005

• Applies to all people in England and Wales over 16yrs old
• Statutory Principles:
1. A presumption of capacity
2. All practicable steps to help support the individual make their own decision
3. Respect unwise decisions
4. Best interests
5. Least restrictive option
• When capacity may be lost in future:
– Court of Protection
– Power of Attorney
– Advance Decisions and Advance Statements
• Deprivation of Liberty Safeguards (DoLS)
• Independent Mental Capacity Advocate (IMCA)
• 2-stage test of assessing capacity:
Stage 1.  Do they have an impairment / disturbance in the functioning of their mind or brain?
Stage 2.  The patient should demonstrate an ability to do all four elements of capacitous
decision making (on the balance of probabilities):
– Understand information given to them
– Retain that information long enough to be able to make the decision
– Weigh up the information available to make the decision
– Communicate their decision
• Remember:
Capacity can fluctuate, even over the course of a single day
Assessment is decision and time specific
Anyone with capacity can refuse medical treatment, nobody can legally demand it

7. General work information

Junior Doctor Forum
The junior doctor forum is a construct created by the 2016 contract as a forum to raise any work
related issues and share good practice. Dates are released in advances and occur monthly at different
locations. This will be attended, where possible, by the Director of Medical Education, Medical Staffing
and the Guardian of Safeworking, who is responsible for contractual issues related to junior doctors.

Exception reporting
Initially speak to supervisor, manager and medical staffing to try and resolve informally.

Log exceptions if:

• If cannot be resolved informally
• If there is an immediate safety concern – (Trust Datix should also be completed)
• If it is a repeated incident
• A doctor’s training is being affected

Psychiatry Junior Doctor Handbook Issue 1 NSFT 9

 How to log an exception report:
• Access: https://www.healthmedics.allocatehealthsuite.com/Core/Account
• Obtain log in from medical staffing
• ‘My Exceptions’ tab
• ‘Create New Exception’
• Select the rota the exception report refers to from the drop down box
• Select the supervisor’s name
• Select the exception type
• Complete the date and time of the exception
• Complete any relevant information in the free type boxes

Raising a concern
Any concerns can be brought to your clinical or education supervisor. If these concerns are not
resolved medical staffing, the Director of Medical Education or the Guardian of Safeworking can be
contacted depending on the issue.

Complaints
All complaints should be directed towards the Patient Advice and Liaison Service (PALS) for support
for the patient, their friends and family as well as for staff involved. Discuss with line manager,
educational and clinical supervisor for support and advice.

Mentoring
All new CT1s should be allocated a mentor who is usually a Core Trainee a year or two above them.
Areas where a mentor may be able to support the mentee includes:
• Setting up and queries with the e-portfolio, including workplace-based assessments (WPBAs)
• Annual Review of Competence Progression (ARCP) requirements
• Practical issues or other queries about on-calls
• Difficult situations with colleagues
• Difficult situations with patients (in addition to support from clinical supervisor)
• Deciding placement preferences for Core Training rotations
• Difficulties with personal life, physical and mental wellbeing that are affecting work

Lone working

!
See intranet for policy Q17 ‘Lone Working’. It is defined as:

“Any situation or location in which someone works without a colleague nearby; or

when someone is working out of sight or earshot of another colleague. Lone working
is not unique to any particular group of staff, working environment or time of day.“

Situations where a junior doctor should take extra care may include:
• Seeing a patient alone in a room on the ward or in clinic (use of alarm, telling someone where
you are, sitting by the door, etc.)
• Travelling to and from a ward on an evening or night on-call (driving to each ward is advised
when it is dark, and telephoning when en-route so they know to expect you)
The policy details advice on key areas such as:
• Letting other staff know of your whereabouts beforehand
• Updating your Outlook diary
• Having a charged mobile phone on you at all times
• Code words in an emergency (e.g. “Cancel my appointments for the rest of the day”
followed by “Do you need assistance?”)
• Tips for vehicle safety
• Safety on foot

Leave

• Absence reporting for sick leave

Your clinical supervisor and covering colleague should be notified if you are not able to attend your
shift on a normal working day. Medical staffing should also be contacted if you are on-call so they
can find cover. Medical staffing is not available on weekends and, in this case, switchboard should
be contacted. If Foundation or GP trainee you should also inform your employing organisation.

• Annual leave
Annual leave should be signed off by your clinical supervisor. Ensure the appropriate portion of
annual leave is used each placement. Please discuss with your supervising consultant prior to
rotating if there are any outstanding days you wish to carry over.

Everyone scheduled to work a normal day is off for national bank holidays unless they are
scheduled to work an on-call shift.

Queries regarding allocation of annual leave should be directed to medical staffing.

Expenses

• Study leave
All trainees (beyond FY1) are allocated 30 days of study leave per year. Mandatory regional
teaching / training days are included in this

• Study budget
See intranet for ‘Study Leave Form – Doctors in Training’. This needs completing with the details of
the event / course / conference etc., including signatures from Educational and Clinical Supervisors.
Then email to: [email protected]. As of April 2018, the study budget has been
centralised within HEE. Courses up to £600 for curriculum requirements as defined by the Deanery
can be signed off by your supervisor. For any Aspirational Activity, or courses more than £600, the
approval of the TPD will additionally be required using the form on the Deanery website.
Also see further guidance here: https://heeoe.hee.nhs.uk/Study_Leave

• Travel reimbursement
You need to complete a P9 form that can be found on the intranet under “Confidential - Staff
Appointment Form”, this needs to be signed by your line manager then sent to payroll

8. Teaching and training

Psychiatry Junior Doctor Handbook Issue 1 NSFT 11

Supervision for all trainees (including foundation doctors and GP trainees) is held weekly for an hour
by your clinical supervisor at a time that is convenient. This is a space for you to ask questions, develop
your knowledge and highlight personal or clinical difficulties or concerns.

RCPsych Portfolio
All psychiatry trainees will need to subscribe to the eportfolio on the Royal College of Psychiatrists
website, which is as follows: http://www.rcpsych.ac.uk
This is charged at an annual rate.

Annual Review of Competence Progression(ARCP)

This review is conducted by an official panel with trainees in attendance following a review of your
online portfolio around May - July each year. This is a nation progress and requirements can be found
on the Royal College website.

Workplace Based Assessments (WPBA) CT1 CT2 CT3

Assessment of Clinical Expertise (ACE) 2 3 3

Mini-Assessed Clinical Encounter (mini-ACE) 4 4 4

Case Based Discussion (CBD) 4 4 4

Direct Observation of Procedural Skills (DOPS) Not required

Multi-Source Feedback (MSF) 2 2 2

Not Not
Case Based Discussion Group Assessment (CBDGA) 2
required required
Not
Structures Assessment of Psychotherapy Experience (SAPE) 1 1
required

Case Presentation (CP) 1 1 1

Journal Club Presentation (JCP) 1 1 1

Assessment of Teaching (AoT) Not required

Core Training Requirements

• ARCP requirements as above
• Completion of 12 months in general adult psychiatry and 6 months in old age psychiatry.
• Emergency case log of 55+ cases
• ECT competencies

MRCPsych Teaching
MRCPsych teaching for psychiatry trainees takes place most Tuesdays from 10am-5pm at Fulbourn
hospital in Cambridge. A timetable will be sent out at the start of each term. Attendance is mandatory.
9. Area specifics
NSFT Services

The Trust is divided into localities as follows:

• Central Norfolk (CN) • Suffolk Access and Assessment (A&A)
• Child Family and Youth Pathway (CFYP) • Suffolk Rehab and Recovery Services (SRRS)
• East Suffolk (ES) • Wellbeing
• Great Yarmouth and Waveney (GY&W) • West Suffolk (WS)
• Secure Services (SS) • West Norfolk (WN)

Sites postcodes and maps:

Site Postcode URL

Hellesdon Hospital, Norwich NR6 5BE see map
Julian Hospital, Norwich NR2 3TD see map
Norvic Clinic, Norwich NR7 0HT see map
Northgate Hospital, Gt Yarmouth NR30 8BU see map
Carlton Court, Lowestoft NR33 8AG see map
Fermoy Unit, King’s Lynn PE30 0WF see map
Woodlands, Ipswich IP4 5PD see map
Walker Close, Ipswich IP3 8LY see map
St Clements Hospital, Ipswich IP3 8LS see map
Wedgwood House, Bury St Edmunds IP33 2QZ see map

Psychiatry Junior Doctor Handbook Issue 1 NSFT 13

Norwich Out-of-hours you can use paper prescribing
if you do not have access.
n Hellesdon Hospital (CN) Parking:
Site: Free parking is available on site.
• Thurne – Acute admission ward On-call room:
(Male and female) No on-call room located on this site.
• Glaven – Male acute ward
• Rollesby – Psychiatric intensive On-call Shift Pattern - Norwich Tier 1:
care ward (PICU) Weekend day on-calls: 09:00 – 21:30,
• Waveney – Female acute ward handover 09:00.
• Whitlingham – Female medium and Evening on-calls (Mon-Fri, excluding bank
low secure forensic ward holidays): 17:00 – 21:30, handover 21:00.
• Yare – Male forensic ward Nights: 21:00 – 09:00
• Mother and Baby Unit (as of January
There are two people on-call for Norwich
2019) – 12 beds, may be asked about
during the evening on-calls and weekend day
obstetric and neonatal concerns so will need
on-calls. It is divided into Line 1 and Line 2.
to consider core (e.g. resus) competencies
Line 1 covers the Hellesdon site, and line 2
and liaise with NNUH colleagues as required
covers the Julian hospital, the Norvic clinic and
Parking: A&E if extra support is required. On nights
Free parking available on site. these sites are covered by one person.

On-call room: Norwich local teaching:

Junior doctor room located on site with Thursdays: 13:00 – 15:00
computers and tea making facilities, key Balint group is held weekly on Tuesdays
accessible from reception. 15:00 – 16:00 at Hellesdon Hospital, this is
mandatory for CT1 doctors, but foundation
doctors and GP trainees are also welcome.
n Julian Hospital (CN)
Senior balint group (for CT2 and above) has
Site: started being held monthly on Tuesday
• Sandringham – acute functional, 14:00 – 15:00 as per availability.
Beach – acute organic Psychotherapy supervision is carried out for
• Rose – community CT2-CT3s who are undertaking long case
• Reed – community psychotherapy on Thursdays, 15:30 - 17:00
in Spixworth, Norwich
Parking:
Free parking permits can be obtained for
staff parking during normal working hours. Great Yarmouth and Waveney
On-call room:
Oncall room on site, key accessible from
n Great Yarmouth (GY&W)
Hellesdon reception. Site:
• Northgate hospital – One mixed adult
n Norvic Clinic (SS) acute ward

Site: Parking:
• Male medium secure forensic unit Free parking is available on site.
Please follow the procedure – No keys, bags or On-call room:
mobile phones are allowed on the unit. Please Oncall room situated in Flat 6, key to be
inform switchboard you are there so that you collected from Northgate reception at the
can continue to be contacted if needed. start of rotation.
Electronic prescribing is used (EMA) –
n Lowestoft (GY&W) East Suffolk
Sites: Sites:
• Laurel – Old age cognitive impairment • Woodlands Unit, Ipswich Hospital:
• Fernwood – Old age female ward Poppy Ward – Adult acute
• Foxglove – Old age male ward Avocet Ward – Adult acute
• Dragonfly unit – Adolescent ward (CYFP) Lark Ward – PICU
Parking: Willows Ward – Old age
Free parking is available on site. • Walker Close:
Bungalow 3 – Male neurodevelopmental
On-call room: Bungalow 4 – Female neurodevelopmental
No on-call room located on this site. • St Clement’s site (Foxhall Road):
Suffolk Rehabilitation and Recovery Service
On-call Shift Pattern - Great Yarmouth / Foxhall House – Low secure forensic unit
Lowestoft Tier 1:
Weekend day on-calls: 09:00 – 21:15, Parking:
handover 09:00. On call doctors can obtain a parking permit from
Evening on-calls (Mon-Fri, excluding bank Woodlands reception that enables parking in any
holidays): 17:00 – 21:15, handover 21:00 car park (staff and patient) on the Ipswich Hospital /
Nights: 21:00 – 09.00 Pearson Rd site, with the exception of the green,
yellow and disabled parking bays. There is free
Local teaching: parking available at the old St Clement’s site.
Wednesday 1-2pm at Northgate Hospital
Local teaching:
• Takes place on Thursday afternoons
King’s Lynn • Balint group is held from 12:30 to 13:30
in the large meeting room in Woodlands
Site: • The Academic programme starts at 14:00
The Fermoy Unit – Acute mixed ward (WN) in rooms 7 and 8 in the Education Centre
in Ipswich Hospital
Parking:
Free parking is available on site. On-call room:
• Junior doctor’s office is located off
On-call Shift Pattern – Kings Lynn Tier 1:
reception at Woodlands
Weekend day on-calls: 09:00 – 21:15,
• Kitchen facilities are located in the shared
handover 09:00
services corridor
Evening on-calls (Mon-Fri excluding bank
• The Trust is in the process of renovating
holidays): 17:00 – 21:15, handover 21:00
an on-call flat on Pearson Road for use
Nights: 21:00 – 09.00
after hours
Local teaching:
On-call Shift Pattern - East Suffolk:
Thursday 12:30 at the Fermoy Unit
• Weekend / bank holiday day on-calls:
09:00 – 21:15, handover at 09:00 and 21:00
• Evening on-calls (Mon-Fri excluding bank
holidays): 17:00 – 21:15, handover at 21:00
• Nights: 21:00 – 09:00, handover at 21:00
(handover at 09:00 only on weekends / BH)
• It is the responsibility of the doctor
starting shift to contact the doctor on shift
via switchboard to arrange handover
• This is a resident on call-duty and doctors
should be based on the Woodlands site

Psychiatry Junior Doctor Handbook Issue 1 NSFT 15

West Suffolk 10. Useful Numbers
Site:
Medical Staffing:
• Wedgwood House:
Tel: 01473 266386
Northgate Ward – Adult acute
[email protected]
Southgate Ward – Adult acute
Abbeygate Ward – Old age
Education and Development:
Tel: 01603 421541
On-call room:
[email protected]
Located at Wedgwood House

ICT Service Desk:

On-call Shift Pattern:
Tel: 01603 421284
West Suffolk Tier 1 (GP, F2 and CT1-3)
[email protected]
Full shift doctors need to be based on site
Weekend day on-calls: 09:00 – 21:15,
Hellesdon Hospital main reception
handover 09:00
and Trust-wide switchboard:
Evening on-calls (Mon-Fri excluding bank
Tel: 01603 421421
holidays): 17:00 – 21:15, handover 21:00
Nights: 21:00 – 09:00
Guardian of Safe Working Hours:
Dr Chris Jones
Suffolk Tier 2 Countywide (ST4-7 and SAS)
[email protected]
on-call Weekdays 17:00 to 09:00, weekends
09:00 to 09:00
Director of Medical Education:
Dr Trevor Broughton
On-call Information:
[email protected]
It is the responsibility of the doctor starting
shift to contact the doctor on shift via
Clinical Tutors:
switchboard to arrange handover. Handover
• Dr Sommayya Kajee (Norfolk)
may be by telephone between shifts.
[email protected]
In the event that out-of-hours duties can not be
• Dr Vivek Agarwal (Norfolk)
covered Tier 2 doctors may need to step down
[email protected]
to Tier 1 full working shift.

• Dr Shafy Muthalif (E Suffolk)

Compensatory off days – If you work a daytime
[email protected]
on-call over the weekend the Thursday before
and Monday after are compensatory off days.
• Dr Danica Ralevic (W Suffolk)
If you work nights over a weekend the
[email protected]
Thursday before and Tuesday after are
compensatory off days.

An oncall registrar and / or consultant will also

be available at all times via switchboard.
© July 2018. NSFT. Leaflet code 18/120. GFX 6164
Notes

Psychiatry Junior Doctor Handbook Issue 1 NSFT 17

Norfolk and Suffolk NHS Foundation Trust values and celebrates the diversity of all the communities we
serve. We are fully committed to ensuring that all people have equality of opportunity to access our service,
irrespective of their age, gender, ethnicity, race, disability, religion or belief, sexual orientation, marital or
civil partnership or social and economic status.

Patient Advice and If you would like this leaflet

Liaison Service (PALS) in large print, audio, Braille,
NSFT PALS provides alternative format or a
confidential advice, different language, please contact PALS
information and support,
helping you to answer any and we will do our best to help.
questions you have about
our services or about any Email: [email protected]
health matters. or call PALS Freephone 0800 279 7257

Trust 01603 421421

Headquarters:
Hellesdon Hospital nsft.nhs.uk
Drayton High Road @NSFTtweets
Norwich
NR6 5BE NSFTrust