The National Workforce Programme and the Mental Health Act Implementation team worked closely together to assist and support service providers in their preparations to become Mental Health Act ready in 2008.

As a consequence of the workforce implications of the Mental Health Act amendments, a project lead, Chris Merchant was appointed in August 2005 to lead all works in relation to both the workload implications for service providers and mental health professionals, and workforce implications in terms of workforce flexibilities which will be introduced by the Mental Health Act 2007.

The workload elements of the amended legislation are far less onerous than when the project commenced back in 2006, when the project was concerned with the implications of what has now become known as the "Long Bill".

The changes to the 1983 Act principally introduce two significant workforce flexibilities:

1. The introduction of the Approved Mental Health Professional. In principle, this allows non social work mental health professionals to enter into the role having undergone the thorough training and approval mechanisms in place currently for ASW's, which will be modified to meet the requirements of the AMHP role. In principle, there should be little change to the role, with the Government firmly committed to AMHPs continuing in the tradition of ASW's in terms of values and practice, aiming for the least restrictive approach to the use of compulsion and being able to act in an independent position able to challenge the views of other mental health professionals.

The AMHP role will extend the duties and responsibilities of ASWs once the amendments are introduced. It is anticipated that, subject to transitional training arrangements, all current ASWs will become AMHPs and non social work professionals will enter the role gradually over time, subject to service needs and skill mix requirements.

2. The introduction of the Approved Clinician (including Responsible Clinicians). This role replaces the existing RMO role established with the 1983 Act. This workforce change is highly significant, offering the flexibility to Mental Health Trusts to consider options for lead clinicians of service users subject to powers of compulsion, to be appointed from non medical professionals.

These include psychologists, social workers, nurses and occupational therapists. Issues around professional background will be taken on the needs of service users, treatments being admixture or offered to patients, and workforce issues within localities.

Responsible Clinicians will have to demonstrate a set of competences laid down in Regulations, and be formally trained, approved and re-approved. All existing RMO's, once receiving further training will be approved for three years from the date of the Implementation of the amended Act in 2008.

To clarify these roles:an approved mental health professional is one who has extensive knowledge and experience of working with people with mental illness and have received specialist training in the application of the mental health act. Previously this was a role undertaken exclusively by approved social workers up until 2007, when the amendment allowed for other suitably skilled health care professionals to undertake this role.

An Approved Clinician is a health care professional (who has previously undergone specialist training and is deemed competent to become) responsible for the care and treatment of someone detained under the mental health act. Once an Approved Clinician has been designated to the care of a detained patient, they are then deemed the Responsible Clinician for that patient

The Mental Health Act Workforce Project was closely aligned and integrated with the New Ways of Working Programme for all professionals in mental health services and supported the roll out of the Creating Capable Teams Methodology across the country.

In order to develop and support New Ways of Working and the introduction of the Act workforce flexibilities, we established a field testing programme. This was set up to establish non-traditional professionals in the two new roles.
Guidance for Employers in available here.

Other work being undertaken in this area by the implementation team includes:

• A national advisory group has been established with regard to the Approved Clinician. This group is working with the Department of Health to establish governance procedures for the Approved Clinicians. This work is again subject to the outcome of the consulation process relating to the Code of Practice and Regulations.
• Devising and delivering procedures for the transition of Responsible Medical Officers and others to become Responsible Clinicians
• Devising procedures for the transition of Approved Social Workers and people from other backgrounds to become Approved Mental Health Professionals
• Ensuring the smooth transfer of responsibilities, skills and resources of Approved Social Workers and Responsible Medical Officers to the new successor roles (AMHPs and RCs).
• Ensuring arrangements for the conclusion of the work and responsibilities of RMOs and ASWs.
• Ensuring, in partnership with the Regions, that arrangements are in place for the competency training and approval of AMHPs.
  

Read Matching Skills to Need written by Chris Merchant and published in April 2007's Mental Health Today.

We discussed concerns regarding potential difficulties arising from draft secondary legislation. We are aware that there are significant numbers of Section 12 Approved medics who, due to the community settings of their role, may not meet the criteria for conversion as having acted as RMO in the previous 12 months prior to implementation. The AC Advisory Group discussed this matter with DH colleagues and recommended that this group of doctors should be Approved for a period of 12 months within which they would have to attend the AC training.

We have also considered the position of those Registrars who are about to take up position as RMOs. We further recommended that the above criteria apply to this group also. We will issue an announcement as soon as we are notified.

A quick word about SOADs!

In response to queries, the 2007 Act does not require Second Opinion Appointed Doctors to be approved as Approved Clinicians.

The National Mental Health Development Unit (NMHDU) is the agency charged with supporting the implementation of mental health policy in England by the Department of Health in collaboration with the NHS, Local Authorities and other major stakeholders.