Job planning in neuropsychiatry

• Assessment, diagnosis and formulation of management plans with patients and carers for comorbid neuropsychiatric symptoms associated with known or suspected neurological conditions. These may include but are not limited to epilepsy, movement disorders, neuro-inflammatory disorders, neuro-oncology, acquired brain injury, neuro-degenerative disorders.
• Expertise in diagnostics where psychiatric presentations are suspected to have an organic cause.
• Expertise in the management of psychiatric illnessin patients with complex neurodisabilities.
• Expertise in pharmacological, psychological and behavioural interventions to manage behavioural problems associated with neurological conditions, acquired brain injury and complex neurodisability.
• Assessment, diagnosis and formulation of management plans with patients and carers for functional neurological conditions.
• Expertise in assessment, diagnosis and management of neurocognitive disorders in younger adults.
• Expertise in the diagnosis and management of delirium in clinical neuroscience settings.
• Expertise in pre and post operative assessment and management of neuropsychiatric presentations associated with neurosurgical procedures such as resective surgery, ablations, shunting, vagal nerve stimulation and deep brain stimulation.
• Expertise working in varied settings, including neuroscience centres, neurorehabilitation settings, specialist inpatient settings, general hospitals, residential/nursing homes and patients’ own homes, with multi-professional and multi-agency teams.
• Providing expert opinion and assessment of patients for primary care, secondary hospital care, and colleagues in other psychiatric subspecialties.

Consultant neuropsychiatrists have an important role in leadership. This includes:

• leading Local clinical governance, patient safety initiatives, quality improvement, and innovation in clinical practice
• leading on Quality Network for Neuropsychiatry accreditation
• liaison with management and commissioning teams from across the wider health and social care system to engage in modelling of high quality integrated patient care, care pathways and outcomes
• providing clinical input into commissioning and procurement exercises, for example making valid assessments of need, through to setting and monitoring appropriate standards via engagement with quality networks
• Leadership in the profession through work with the Royal College of Psychiatrists, the British Neuropsychiatry Association, the Association of British Neurologists, the Neurological Alliance and other national/international organisations.

All consultants should have the opportunity to develop and utilise leadership skills, with access to training and real world opportunities to understand and influence service improvements.

SAS psychiatrist job plans should follow the same principles as above. The College supports 8 DCC plus 2 SPA for both specialty and specialist psychiatrists. The model job plan for SAS psychiatrists should reflect the 0.5 SPA difference, which should be added to patient facing DCC.

If the SAS doctor does not have formal or informal educational responsibilities in relation to resident doctors, medical students and other health professionals, the specific time allocated for this in the consultant model job plan should be added to DCC activities for either patient reviews or for liaison with families/carers/other professionals in relation to patient care as appropriate to the service and their role in the team.

In neuropsychiatry services there are many different models of service provision, ranging from highly specialised out-patient services in neurosciences centres or mental health settings, neuropsychiatric in-patient units, neuropsychiatric liaison on general hospital wards and neuro-rehabilitation centres. In these services, consultants work with a broad range of multidisciplinary staff from neurosciences, neurorehabilitation, mental health and primary care services. The workload of a neuropsychiatrist would vary depending on the kind of service provided and local referral criteria.

In addition to expertise in mental health legislation, knowledge of capacity-based legislation is required and time to implement these is needed in all job plans.

Neuropsychiatrists, like general adult psychiatrists, can be appointed to solely in-patient, out-patient, neurosciences liaison neuropsychiatry or mixed jobs.

The expected workload of a full-time consultant neuropsychiatrist is dependent on a rangeof factors, including which elements of service provision are included,the size and composition of teams, sources of referral, types of specialist clinics provided and geographical area served.

The clinicalwork of an out-patient-based neuropsychiatrist can be broken down as set out under ‘Clinical role’. The allocation of these tasks within a job description will depend on the clinical role expected of the consultant and the other staff available to undertake a proportion of these tasks.

It is reasonable for a full-time out-patient neuropsychiatry consultant to have 4.5-5 PAs per week for direct patient care in out-patient assessments. Each clinic would typically attract 1.5 PAs (1PA for clinic plus 0.5PA administration time). New patients in the out-patient clinic require approximately 60 min. Follow-up appointments require 30 min. These times are increased when a new patient is assessed during a home visit; up to 2 h should be allowed. Clinics should be structured so that there is time built into the clinic to teach and supervise trainees.

Time needs to be made available within a job plan for urgent assessments in the clinic if they are to be undertaken by consultant staff. If such assessments are undertaken by other members of the multidisciplinary team, time should be available in the consultant’s job plan for the clinical support and supervision of decisions made. A minimum of 1 PA per week is likely to be required for urgent and emergency work in the form of a ‘hot clinic’ / urgent ward reviews.

In combined outpatient – liaison posts, consultation liaison visits to in-patients will vary in complexity and level of need and times to provide assessment are variable, depending on the patient and the context in which they are being seen.

Multidisciplinary working necessitates attendance at multidisciplinary team meetings to discuss neuropsychiatric aspects of patient care.

Neuropsychiatrists working in teams (resident doctors, ACPs, nursing staff) require 1 PA, which includes time for a weekly meeting plus support and advice to members of the multidisciplinary team about patient care outside the team meeting. Neurosciences centres will require neuropsychiatric input to some of the core weekly, bi-weekly and monthly MDT meetings and sessional time should be made available for this if the consultant is required to attend.

Additional clinical administration time is needed for attendance at multidisciplinary complex patient reviews/requests for 1:1 complex case discussions with wider members of the neurosciences and/or mental health team – a minimum of 0.5 PA per week is recommended and could be used flexibly for urgent reviews where no meetings are scheduled.

Some jobs will need specific sessional time for analysis and reporting such as EEG and PSG data for sleep clinics. This is uncommon but should be considered in relevant circumstances.

If an employer wishes a consultant to spend more time undertaking emergency work or participating in multidisciplinary patient reviews, this would need to be offset by a reduction in out-patient clinics and home visits.

It is expected that each consultant should have sufficient time within their timetable to personally review each patient at least once a week. Consultants should have time to visit the ward each day to be available for day-to-day decisions requiring consultant input.

The principles underpinning safe and effective in-patient work are as set out in the section on general adult psychiatry.

This job would require a balance between outpatient clinics and ward based liaison work. There could be a combination of between 1 and 3 PAs for out-patient clinics and 1–3 PAs for ward assessment and advice. In total, these two roles should amount to 5 PAs.

A weekly ward round would be required to review the patients on neurosciences wards. This is likely to require 1 PA. Clinical liaison and multidisciplinary work would require 1 PA.

Other administrative tasks concerning in-patient care include, for example, unscheduled telephone calls, correspondence, checking of blood results and other investigations including neurophysiology and scans – 0.5 PA in total.

There could be other mixed neuropsychiatry posts that could have different elements of the two jobs in different proportions, based on the local service and commissioning arrangement and nature of specialist neuropsychiatry services.

It is anticipated that these services would have appropriate balance of clinical sessions based on the earlier job examples in this section.

• Specialised Neurology Service Specifications (Adult) April 2026 
• Specialised Neurology Service Specifications minimum services for neurology sub-specialities