Redeployment Reflections from Radha Bisnauth, Clinical Psychologist in Learning Disabilities

Hi Radha, can you tell us a bit about yourself? 

I am a Clinical Psychologist working in the community with adults with a Learning Disability. I have worked with my current service since Early 2010. My work mainly involves a mixture of individual therapy work mainly from a Cognitive Behavioural Therapy (CBT) perspective, working with others where there are behaviours of concern using a positive behaviour support approach; multi-disciplinary teams (MDT), care providers, families, day services, specialist colleges. Service development is also part of my current role (Autism Spectrum Disorder (ASD), staff well-being).  

How did the pandemic affect your work and what was your experience on being redeployed? 

The Covid-19 pandemic has impacted greatly on the Learning Disabilities Service I work for. In January 2021, the service prioritised critical functions with only those service users who required this level of input remaining active. In response, a duty team was created to meet the needs of non-urgent service users no longer receiving regular input and with that and a weeks notice I became part of this new team. This team was meeting the needs of many service users now on dormant caseloads. This was exciting but really daunting. I had been doing my substantive role for 10 years and had not ventured into anything like this.  

My team consisted of me, an occupational therapist, an intensive support nurse and a community nurse. A mini MDT!  

 The main functions of the team were: 

• Effectively ensure any changes in service user’s health and risk could be assessed quickly and the necessary action taken (follow up calls, escalation to the Citywide MDT, escalation to crisis response) 
• Answer queries, provide information, support and reassurance to a wide variety of patients, their carers and others during this difficult time 

How did this work differ to your substantive post? 

This role was very different to my substantive post for a number of reasons.  

• I no longer held a caseload for the first time in my career which was freeing but scary as I was taking daily calls from clients and carers I did not know.  
• I was operating outside the Psychology Service; watching what was happening with the Citywide MDT and my psychology colleagues from a different position.  
• The duty team was interfacing with other parts of the Learning Disability service I had not had previous experience of doing e.g. Intensive Support crisis response and on-take psychiatry.  

I was on a really steep learning curve!  

As a team we also set up a number of operation processes from scratch; data collection, planning leave/ cover so the system could operate safely, setting up a daily handover and a place to connect as we were all working remotely. We would often get distressed carers calling in so having instant support from the other team members throughout the day was essential to the role. This last point is something I have found not readily available in the world of remote working.  

What are your reflections on this experience? 

This role has brought me experience of new skills and reinforced and added value to others: 

• Care co-ordination in both low risk and high risk situations – when the calls came in I had to build a clinical picture and quickly make a decision about what input was needed 
• Risk assessment – in every phone call we carried out a live risk assessment 
• Active listening – this was so important in building a rapport with often distressed carers 
• Leadership – we had shared leadership; the four of us developed a shared vision putting in place processes to support service delivery (e.g. cover, clinical handover, support for each other, re-writing the standard operating procedure for duty). It was great doing this with other professions. 
• Sharing of MDT knowledge within the team – we all held different perspectives because of our different training. We brought this experience to team. Bringing these together was essential in thinking about service users holistically 
• I brought formulation into clinical handover to help build a picture of presenting difficulties and what was maintaining these, therefore guiding some of the discussions about intervention 

While I was asked to move to this new team with short notice, I am very grateful I was a part of this team. This experience has highlighted the importance of connections at work to support well-being as for many services the way we work now has changed as a result of the pandemic. The experience also pushed me outside of my comfort zone and showed me that I could do something different with my clinical psychologist skills.  

Thank you Radha for sharing your experiences on being redeployed during the pandemic.