The new Mental Health Act legislation makes for interesting reading, to folk working in mental health. It allows nurses (and others) to hold Approved Clinician (AC) status. Being an AC means they can be the Responsible Clinician (RC) for a detained patient, instead of a psychiatrist being the Responsible Medical Officer (RMO). Most psychiatrists will have AC status so can still be RCs come October, but not all psychiatrists will automatically convert to having AC status. The change opens up the option of nurse lead units where psychiatrists have a much more modest role and aren't directly either involved or responsible for detained patients' care.
Tainted Halo asked, "I'm very interested to see how doctors embrace this new world freedom?! . . . what do the learned shrinks think they'll do with it?"
In my corner, we're having none of it.
Well, frankly, we're in the happy position of not needing to. Looking after detained in-patients isn't an onerous duty for us. We're in an urban setting so have benefits of covering a relatively small, tight geographical patch. We've easy access to psychiatrists, section 12 approved doctors and Approved Social Workers. We've frequent review of patients on the ward which is multidisciplinary. The reviews are frequent so they can be small (i.e. just a couple of people meet with the patient each time, rather than a room full of folk to face). As such there's frequent (daily to weekly weekly) input from medical, nursing, occupational therapy, pharmacist, social work and physiotherapy staff.
Recent presentations by CSIP and the DoH explained that change wasn't necessary in units such as ours. Fantastic to hear that for once central agencies aren't advocating change for changes sake.
Since we're able to have our cake and eat it, offering detained patients input from a wide range of professionals all working together, all seems well. The Healthcare Commission have been very happy with our mode and standards of care. We've not had issues from the MHAC either, who are oh so very rigorous. Since our patients, commissioners, carers, Healthcare Commission and MHAC are happy with what we're providing, as are we, we're able to say we've considered other service models but for now ours addresses patients' needs.
If it ain't broke, don't fix it.