Page 12 - RMO information booklet - 2015 Edition

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Resident Medical Officers...
Mental Health and Addictions
The Mental Health & Addiction Service is the midland regions largest provider of mental health services
and employs over 700 staff covering a range of disciplines.
Medical staff - who we are:
 42 full-time and four part time specialist consultants
 22 registrars
 Three registrar reliever positions
 Six SHO positions
 Trainee interns and medical students
Services are grouped into three main service streams:
1. ACCIS Central and Forensic services
 ACCIS service includes:
 Crisis Team and Home treatment and Triage Team (CAHT)
 Assertive Community Treatment Team (ACT)
 Consultation Liaison
 Central services includes:
 Dialectical Behaviour Therapy
 Specialist Eating Disorders
 Residential Coordination service
 Perinatal Mental Health
 Intellectual Disability Dual Diagnosis Team
2. Puawai: Midland Regional Forensic Psychiatric Service
 Inpatient acute and rehabilitation (medium and minimum secure environments)
 Community Forensic Team (Court Liaison, Prison and Community caseload)
3. Sectors and specialty services
 Inpatient adult acute (53 beds)
 Sector Community Mental Health Teams
 Infant, Child & Adolescent Mental Health
 Community alcohol and Drug services
 Mental Health Services for Older Persons (includes 15 inpatient beds)
Training
We offer an accredited programme for specialist psychiatry training for the Royal Australian and New
Zealand College of Psychiatrists (RANZCP). All learning experiences required for fellowship are offered.
Trainees complete a five year vocational training, which includes ongoing workplace based formative and
summative assessments, a scholarly project, a long psychotherapy case, as well as written and clinical
examinations. Training for certificates of advanced competency is offered in most subspecialties.
Trainees may complete some of their training at satellite centres, which operate at Tauranga (Bay of Plenty
DHB) and Rotorua (Lakes DHB). Trainees from the satellite centres travel to Hamilton for the Formal
Education Programme weekly.
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Resident Medical Officers...
Palliative Care
Specialist palliative care in the Waikato has undergone some changes in the last few years.
The Waikato Hospital team operates principally a consult/liaison service. Occasionally they
admit patients directly under their own care, for very specific indications. In parallel, the Hospice
Waikato team operates an inpatient unit (mostly used for patients with complex symptom control
needs) and also outpatient clinics. The two organisations and medical teams are separate, but
aim to work together in a collaborative and patient-centred manner, including sharing an after-
hours SMO roster.
There is also important rural and regional work. Outpatient clinics are held regularly at all the
rural DHB hospitals and there is also opportunity for support of the ward teams. Most of this
work is the responsibility of Hospice Waikato. The Waikato Hospital team provides the service
to the Lakes DHB region, both the local hospices and DHB teams.
Important telephone numbers are 07 8398899 (Waikato Hospital switchboard), 07 8398691
(Direct line to Waikato Hospital palliative care department, working hours only) and 07 8591290
(Hospice Waikato). Palliative medicine clinical guidelines are available on the intranet.
The hospital consult/liaison team has a rotational registrar as an integral part of the team. This
allows a great opportunity for a registrar from another discipline (for example, an advanced
trainee in another medical subspecialty) to gain firsthand experience in specialist palliative care.
The Clinical Diploma in Palliative Medicine (through the Royal Australasian College of
Physicians) could be achieved over the course of the 6-month registrar rotation. For those
registrars intent on completing the Clinical Diploma, a work program inclusive of some
community hospice work (currently through Waipuna Hospice in the Bay of Plenty) can be
tailored to ensure that all parts of the training curriculum are achieved. There is currently no
registrar work available based at Hospice Waikato, but this will hopefully occur in the future.
Advanced trainee positions in Palliative Medicine are also available. Our current credentialling is
for two advanced trainees across the Midland region. There are compulsory and elective
rotations. Anyone with an interest in palliative medicine advanced training is encouraged to
approach the SMO team.
The in-service educational program includes journal club, formal case review, mortality
meetings, plus weekly educational forums and a monthly palliative care grand round. These
events are typically open to all interested clinicians and are presented from an interdisciplinary
perspective.
It is important to remember that palliative medicine is about the management of patients (and support of
family/whanau) with active, progressive, far-advanced disease for whom the prognosis is limited and the
focus of care is quality of life. Palliative care holds relevance across all disease categories, not just
patients with an advancing malignancy. Our approach is interdisciplinary with valuable contributions from
our nurses, chaplains, cultural workers, and other members of the allied health team.
Palliative care recognises dying as a normal process; it neither hastens nor prolongs death.
Palliative care practitioners are strong opponents of euthanasia as we value this phase of life.
Undoubtedly palliative care grew out of hospice care which some considered a euphemism for
terminal care. The problem with terminal care was its definition. Palliative means to care for,
recognising that cure or even long term control of disease is no longer possible and that quality
of life is the priority. We aim to prevent the patient from some of the troublesome and
distressing symptoms associated with disease progression as a primary aim.