E-mail reaction is welcome ,,, click on mica2@tiscali.co.uk
The basic need is to be able to examine the working Practice of the team meeting - who is there is to be registered, what is brought up, what decision was made to be recorded, who is to do it, and the consequence of that reported back to whom.
Managers to find out that the senior clinical lead decision maker is always there at the regular Team Meetings, Reception and Review.
Any member of the team who has uncertainty, or has fresh information, knows that issues arising from that will be aired, for further action.
Two things stand out
1.
There is usually important information in the community network, particularly family members, but also neighbours, day units, police, friends, and family doctors
around the patient perpetrator, that was not made known to the decision makers; which was not sought by them
The professional decision makers had not made their system able to seek out and obtain that information,
nor had they set up and left with a significant community observer, a certain and easy point of contact to deliver observation,
for getting that information into the team, particularly important for family carers,
The team individuals believed that what they were told in a professional interview was the whole truth,
because they felt their interview manner, had built such trust that the patient could always know
what the professional should be told, and would be able to do that.
To obtain that trust confidentiality was assured, and it led to a perceived difficulty in approaching others for their observation.
The natural point of access to accessory input, was the social worker through the office in the hospital,
but the social worker is now embedded ( and lost ) within the team,
and the old function of the social worker keeping in touch with carer or significnt person who mattered, has lapsed.
It should be restored.
2.
Very rarely does an Inquiry Panel go into the actual details of how the mental health team involved
worked as a team: their working practice.
Does the top clinical lead - the consultant - especially any locum consultant
- always attend the reception team meeting where new cases
ar presented, reviewed, assigned, and feed back arranged.
Is there a weekly meeting,similarly attended and those attending registered, where continuing cases can be aired and reconsidered.
Managers should be expected, in their practice, to look to be sure this information, is there. If they feel their scrutiny is fobidden by confidentiality, they must ensure by asking that a clinical senior manager has done it.
(a) a record of who attends , who is there throughout, and how often are all the members there at the meetings.
Where is the record kept of who has attended and some record of what, and which, patient concerns was addressed.
(b) how often do the managers seek to talk separately each of the line managers of the team members,
so that there is a natural occasion when anything an issue within the team, can be expected to be brought up.
The mental health team system must be prepared to accept information in confidence for use within the team only.
There needs to be a point of contact
which the community can use when it is anxious,
where the informant can be protected fom recrimination.
These questions about actual practices - what is actually going on - are never sought.
They are the responsibility of managers to do somethimg [ take an action ] about them
and manage the changes required, by ongoing supervison which will involve meeting the people concerned
One solution was to have an Outpatient for carers.