1. Responsible Clinician and Approved Clinician Roles

2. Significant changes Extending entry to other professions
Introduces formal approval and re-approval based on specific competences
Responsible clinician role distinct from authority to admit for detention

3. New roles Responsible Clinicians replace RMOs
RCs have overall responsibility after detention
In order to be a RC must be first an Approved Clinician
ACs can be medical or non medical
Non medical AC can come from Psychology,
Nursing and OT
To be an AC must have satisfied
competency tests
RCs can come from non medical AC
group
Whether a non medical AC should become the RC will depend on ‘the most appropriate expertise is needed to meet the patient’s main treatment needs’

4. Authorisation &Training Requirements for Approved Clinicians
Role
Training Required
Medic
Professional Qualification +
Sec 12
Medic +
Approved
Clinician
Professional Qualification
+ Sec 12 + AC
Non-Medic
Professional Qualification + AC
Initial Medical
Assessment for
Detention
Authorised for
Appointed as
Responsible
(GP, FME)

5. Only a doctor can assess and recommend a patient for detention
Before detention :
Only a doctor can assess
and
recommend a patient for detention
After detention ;
Doctors who are approved clinician
may become the RC
Or another professional may take on that role

6. Functions and Responsibilities of Approved Clinicians
Lead responsibility for patient’s care and treatment
Only an AC who is section 12 Approved can make recommendations for detention in hospital under Sections 2,3,4

7. The Competences of the Approved Clinician
Assessment (including assessment and management of risk)
Effective communication
Improve quality, equity and cultural diversity
Care Planning
Leadership in multidisciplinary team working
Treatment
In their application of all the above areas of competence, the AC should be influenced and guided by the “Guiding Principles”

8. Functions and Responsibilities of Approved Clinicians re SCT
Recommend and place a patient on Supervised Community Treatment once satisfied that the relevant criteria are met
(in conjunction with agreement from an AMHP)
Renew SCT within the prescribed time scales
In agreement with an AMHP the RC can impose other conditions that are agreed to be necessary or appropriate
Have the power to recall the patient subject to SCT to hospital if deemed necessary
Discharge the Community Treatment Order

9. Responsible Clinician
The role is to have overall responsibility for an individual’s care and treatment:
“Every patient must be allocated a responsible clinician, who is the approved clinician with overall responsibility for the patient’s case. Hospital managers should have local protocols in place for allocating responsible clinicians to patients. This is particularly important when patients move between hospitals. A patient’s responsible clinician should be the available approved clinician with the most appropriate expertise to meet the patient’s main treatment needs” (DH, 2007).

10. Functions and Responsibilities of Responsible Clinicians
Responsible Clinician can :
renew S 3
discharge S 3
grant leave for patients subject to section 3

11. Hospital Managers Duties in respect of Responsible Clinicians
RCs are appointed by Hospital Managers at point of admission to hospital following detention under the MHA
The suitability of the RC is kept under review by the hospital managers
Hospital Managers must keep an up to date list of ACs available from which RCs can be appointed to a patient’s care

12. Transitional arrangements
The following three groups of section 12 doctors will be approved as ACs from 3 November under the provisions of Part 3 of the Directions.
Group 1
Section 12 doctors who have carried out the functions of an RMO in the 12 month immediately prior to 3 November
• Approval as AC under the transitional arrangements will run until the end of the current section 12 approval. If this is less than 12 months after 3 November, then approval will last 12 months from 3 November.

13. Group 2
who have been in overall charge of the medical treatment for mental disorder of a person in the 12 months prior to 3 November. Will be approved until Nov 2009
……..expected to complete a course for the initial training of approved clinicians (see paragraph 81) in the first year after 3 November If the course is completed the doctor will be approved to be an AC under transitional arrangements for a further 2 years from 3 November 2009.
After this further 2 years doctors in this group will need to apply for approval under the general approval arrangements (see paragraph 81). They will not have to complete a course for the initial training of ACs again. They will, of course, have to meet the other requirements of the general approval arrangements(see paragraph 81).
If the course is not completed by 2 November 2009, approval will not be extended under the transitional provisions and will end on 2 November Doctors in this group who have not completed the training by 2 November 2009 will have to apply to the SHA to be approved as ACs through general approval arrangements (see paragraph 81). They will have to complete a course for the initial training of approved clinicians to be approved under general arrangements as they will not be treated as being an AC in this period. (Direction 14(b) applies)

14. • had overall charge of a patient’s care; or
Group 3
Section 12 doctors who do not fall within groups 1 or 2, but who have been appointed to the post of consultant psychiatrist within the period of 18 months ending on 2 November 2009 (that is 6 months before 3 November 2008 and 1 year after – 3 may 2008 to 3 nov 2009)
Examples
A section 12 approved doctor takes up his first post as a consultant psychiatrist responsible for the care of a patient subject to the provisions of the MH Act in January He will be treated as approved as an AC until 2 November 2009 without having to have completed a course for the initial training of ACs.
A section 12 approved doctor takes up his first post as a consultant psychiatrist in October 2008, but does not meet the requirements to be treated as an AC under Group 1 or Group 2 because he has not:
• had overall charge of a patient’s care; or
• undertake any responsibilities that would fall to an RMO to make;
will be treated as approved as an AC until 2 November 2009 without having to have completed a course for the initial training of ACs.
Would be prudent to check for yourself with the approp s 12 administrator

15. ‘ The Directions (Part 2) directs SHAs to exercise the function of approving persons to act as ACs…….. An SHA shall only approve a person to act as an AC under general approval arrangements if they are satisfied that the person:
• fulfils the professional requirements;
• possesses relevant competencies; and
• has completed a course for the initial training of ACs in the 12 months before approval, or, has been approved (or treated as approved under transitional arrangements as they have acted as an RMO) in the past 5 years.