Locum Consultant General Adult Psychiatrist

Job Purpose

This is an appointment to HSE Dublin and North East Region on a Public Only Consultants’ Contract 2023 by the Health Service Executive. The initial commitment for this post will be to MHS Cavan / Monaghan for 16 hours per week and MHS Louth / Meath for 21 hours. This post may be subject to restructuring in the future to facilitate the reorganisation of acute services in line with new clinical models of acute and community services. It is noted that the post must be congruent with the requirements of, and facilitate implementation of national health policy, the HSE’s National Clinical Programmes including commitment to deliver the relevant performance outcomes.

The prevalence of ADHD in adults is significant with an estimate of 3.4% (range 1.2% - 7.3%) indicated by Fayyad (2007). A meta-regression analysis of six prevalence studies of ADHD found a pooled prevalence of 2.5% (Simon 2009). The prevalence of ADHD in non-psychotic adults in secondary mental health care services in Europe across seven countries is between 1 in 10 and 1 in 5 (Deberdt 2015). A study of ADHD in a variety of settings in the United Kingdom showed a rate of 15.3% in non-psychotic adults attending secondary mental health care (Murphy 2013). Other findings in the same study were

2.5% in the overall adult population and 25% in the prison population. The gender differences in prevalence change from 4:1 males to females in childhood to 2:1 in young adults (Bramham 2012).

The NICE Guidelines on the diagnosis and management of ADHD (2008) state that symptoms of ADHD are distributed throughout the population and vary in severity. Only those with significant impairment, meeting DSM 5 criteria for a diagnosis of ADHD, require assessment and treatment.

Long term follow up studies of adults with ADHD document fewer social relationships and friends, higher rates of academic failure, lower occupational status, increased substance misuse (both alcohol and drugs), increased number of accidents (especially driving) and offending behaviour (Kesler 2005; Murphy 1996; Barkley 2007; Barkley 2002; Able 2007; Biederman 2006). Untreated adult ADHD has a higher cost of illness in economic terms (Adamou 2010).

This evidence outlines the necessity to provide services for adults with ADHD who meet diagnostic criteria.

Appointment will provide specialist assessment and treatment for adults with ADHD.

The ADHD in Adults National Clinical Programme includes a data set specifically to measure team activity and throughput, the Consultant will work with the team to ensure monthly activity is collected and submitted to the National Clinical Programme.

Organisational Context

Attention Deficit Hyperactivity Disorder (ADHD) in the European Consensus Statement on Diagnosis and Treatment of Adult ADHD is described as one of the most common psychiatric disorders of childhood. It is now known to persist into adulthood (Kooij 2010) with over 60% of children continuing to have symptoms and 15% meeting diagnostic criteria in adulthood (Barkley 2002; Faraone 2006). It is classified as a neurodevelopmental disorder, together with specific learning disabilities, in DSM-5 (APA

2013). It occurs in 5% - 7% of children and persists into adulthood in 3.4% (Faraone 2005; Kessler 2006).

In Ireland, assessment and treatment of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) is provided through the Child and Adolescent Mental Health Services (CAMHS). ADHD is one of the listed criteria for referral to these services in the Health Service Executive’s (HSE) Standard Operating Procedure for CAMHS (2014). Likewise, both children and adults with intellectual disability who have co-morbid ADHD have access to Mental Health Intellectual Disability Services. The latter

provide assessment, care and treatment for ADHD and their expansion to ensure full geographic coverage in Ireland is the subject of an ongoing Service Improvement Project (HSE Service Plans 2015- 2018). However there are no equivalent public services for adults with ADHD who do not have a moderate or greater degree of intellectual disability.

The strategy is as outlined in the Model of Care outlined in the ADHD in Adults NCP. It is based on tertiary level ADHD in Adults Clinics being established to provide for catchment area populations of 300,000-400,000 for adults aged 18- 64yrs inclusive.

Essential Criteria

Professional Qualifications

Registration as a specialist in the Specialist Division of the Register of Medical Practitioners maintained by the Medical Council in Ireland in the specialty of psychiatry.

Entry to competition / recruitment process and subsequent appointment

No candidate will be appointed as a Medical Consultant unless (s)he is registered as a Specialist in the Specialist Division of the Register of Medical Practitioners maintained by the Medical Council of Ireland.

The successful interviewee must be registered as a Specialist in the relevant specialty on the Specialist Division of the Register of Medical Practitioners maintained by the Medical Council of Ireland before taking up appointment. The candidate will be allowed a max of 180 calendar days from date of interview to secure this registration and produce evidence of special interest training where relevant.

Should the successful candidate not be registered as a Specialist at that time, the post may be offered to the next suitable candidate (or, in the case of HSE posts, the Public Appointments Service may choose not to recommend that candidate to the employer). Should no suitable candidate exist, a further recruitment process may be initiated.

Please note that appointment to and continuation in posts that require statutory registration is dependent upon the post holder maintaining annual registration in the relevant division of the register maintained by The Medical Council of Ireland.

 Health

A candidate for and any person holding the post must be fully competent and capable of undertaking the duties attached to the post and be in a state of health such as would indicate a reasonable prospect of ability to render regular and efficient service.

Character

A candidate for and any person holding the post must be of good character.

The post holder will be required to be part of the on-call rota and to have access to transport as the post will require frequent travel

See below for full Job Description:

Locum Consultant Psychiatrist Job Spec