SME - Psychiatry Addiction Medicine

Position Overview

• The Subject Matter Expert – Psychiatry (Addiction Medicine) will provide specialist clinical leadership and assurance for the Substance Use Disorder Audit Programme. The position will ensure that the audit methodology, evidence review, interviews, observations, findings and recommendations accurately reflect contemporary addiction psychiatry, substance misuse treatment, medication-assisted treatment, clinical governance and recovery-oriented models of care.


• Working alongside the Lead Inspector, the SME will assess whether clinical services are safe, evidence-informed, multidisciplinary, person-centred and appropriately designed for the populations served. The position will provide expert interpretation of clinical evidence and advise on treatment pathways, withdrawal management, prescribing governance, risk assessment, rehabilitation, relapse prevention and continuity of care.

Primary Duties and Responsibilities

• Act as the principal clinical adviser to the audit team on addiction psychiatry, substance misuse treatment and related clinical governance matters. 


• Review and clinically validate the SUD audit framework, assessment questions, evidence requirements, scoring criteria and risk indicators.


• Participate in pre-audit document review and identify areas requiring focused clinical enquiry during each facility visit. 


• Assess the facility’s clinical model, including:
  
  
  
  • screening and early identification; 
  
  
  • triage and comprehensive assessment; 
  
  
  • diagnosis and formulation; 
  
  
  • level-of-care determination; 
  
  
  • individualised treatment planning; 
  
  
  • withdrawal management; 
  
  
  • medication-assisted treatment; 
  
  
  • psychosocial interventions; 
  
  
  • management of co-occurring mental and physical health conditions; 
  
  
  • rehabilitation and recovery support; 
  
  
  • relapse prevention; 
  
  
  • discharge planning; and 
  
  
  • follow-up and community reintegration. 
  
  


• Evaluate the clinical appropriateness, consistency and governance of treatment pathways for alcohol, opioids, amphetamines, prescription medicine dependence and other relevant substance-use presentations. 


• Review clinical policies and protocols relating to prescribing, medication monitoring, controlled medicines, diversion prevention and escalation of prescribing risk. 


• Assess governance arrangements for opioid substitution or medication-assisted treatment, including induction, titration, monitoring, review and continuity of prescribing. 


• Evaluate whether clinical services operate through an appropriately constituted multidisciplinary team and whether professional roles, responsibilities, competencies and supervision arrangements are clearly defined. 


• Assess the availability and integration of psychiatry, psychology, nursing, social work, occupational therapy, pharmacy, primary care and other relevant disciplines. 


• Conduct structured interviews with psychiatrists, physicians, nurses, psychologists, pharmacists, social workers, therapists and clinical leaders. 


• Evaluate clinical supervision, continuing professional development, competency assurance and access to specialist advice.


• Assess whether services effectively recognise and manage: 
  
  
  
  • intoxication and withdrawal; 
  
  
  • overdose risk; 
  
  
  • suicide and self-harm risk; 
  
  
  • safeguarding concerns; 
  
  
  • dual diagnosis; 
  
  
  • physical health complications; 
  
  
  • medication interactions; 
  
  
  • relapse risk; and 
  
  
  • service-user deaths or serious incidents. 
  
  


• Determine whether clinical policies are consistent with evidence-based practice and whether they are implemented in routine service delivery. 


• Identify immediate clinical safety concerns and advise the Lead Inspector on their severity, urgency and required escalation. 


• Provide specialist interpretation where clinical practice differs from written policy or where local models require assessment against international best practice. 


• Contribute clinically robust findings, recommendations and corrective actions for each facility report. 


• Identify system-wide clinical capability gaps, including workforce shortages, pathway fragmentation, prescribing risks, limited rehabilitation capacity or inadequate continuity between healthcare and social care. 


• Support the preparation and presentation of the consolidated audit findings and strategic recommendations to the Department of Health. 

• Primary medical qualification recognised by an appropriate national medical regulatory authority. 


• Membership or fellowship of a recognised professional college of psychiatry. 


• Specialist accreditation, board certification or equivalent consultant-level qualification in psychiatry. 


• Specialist training or formal accreditation in addiction psychiatry, substance misuse psychiatry or addiction medicine. 


• Postgraduate qualification in addiction medicine, addictive behaviour, substance misuse or a closely related discipline is highly desirable. 


• Qualification or demonstrated experience in medical education, clinical supervision or professional training is desirable.

• At least 10 years of post-specialist clinical experience, including substantial consultant-level practice.


• Extensive experience in the assessment and treatment of complex substance-use presentations involving alcohol, opioids, stimulants and prescription medicines.


• Demonstrated experience across more than one SUD service setting, including inpatient, outpatient, detoxification, community and rehabilitation services.


• Senior clinical leadership experience within a regional, national or multi-site substance misuse treatment service.


• Experience providing clinical governance, policy development, pathway development and quality assurance across SUD services.


• Practical experience with medication-assisted treatment, opioid substitution treatment, induction and titration arrangements, depot treatment and controlled medication governance.


• Experience supervising consultants, doctors, non-medical prescribers and other members of multidisciplinary clinical teams.


• Demonstrated experience undertaking or supporting clinical audits, quality-improvement programmes and reviews following serious incidents or service-user deaths.


• Experience developing clinical partnerships and referral pathways between addiction services, mental health services, primary care and other relevant agencies.


• International experience, particularly within culturally diverse healthcare settings or the Middle East and Asia, is highly desirable.

• Expert knowledge of addiction psychiatry, substance misuse treatment and recovery-oriented care.


• Strong knowledge of pharmacological and psychosocial interventions for substance use disorders.


• Detailed understanding of withdrawal management, medication-assisted treatment, controlled medicine governance, safe prescribing and diversion prevention.


• Strong understanding of co-occurring psychiatric disorders, physical health complications and clinical risk in SUD populations.


• Ability to assess the clinical quality and safety of services without relying exclusively on individual patient-record review.


• Ability to evaluate multidisciplinary workforce models, clinical competencies, supervision systems and professional accountabilities.