Book contents
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- 21 Consent to treatment (Scotland)
- 22 Consent to treatment and second-opinion approved doctors
- 23 Mental Health Act (Scotland)
- 24 Seclusion
- 25 Section 17 leave
- 26 Section 136 assessments
- 27 Tribunal reports
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
22 - Consent to treatment and second-opinion approved doctors
from II - Legislation
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- 21 Consent to treatment (Scotland)
- 22 Consent to treatment and second-opinion approved doctors
- 23 Mental Health Act (Scotland)
- 24 Seclusion
- 25 Section 17 leave
- 26 Section 136 assessments
- 27 Tribunal reports
- III Physical health
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
Summary
Setting
This audit may be particularly relevant in forensic or rehabilitation in-patient services, where a high proportion of patients will be subject to section 58 of the Mental Health Act 1983.
Background
Section 58 applies to people who are detained under the Mental Health Act and allows for medical treatment for those who do not consent or are unable to give their informed consent to treatment.Treatment can be given for 3 months without consent, and without the section 58 requirements. After this 3 month period Section 58 applies.
Standards
Standards were obtained from the Mental Health Act Code of Practice (Department of Health, 2008). Of particular relevance were the following:
ᐅ If the patient consents, the approved clinician should complete a certificate.
ᐅ A record of the clinician's discussion with the patient, and of the steps taken to confirm that the patient has the capacity to consent, should be made in the patient's notes.
ᐅ If the patient does not have capacity to consent or does not consent, then the approved clinician must request a visit from a second-opinion approved doctor (SOAD). The treatment proposal must be given to the SOAD before or at the time of the visit.
ᐅ The SOAD must consult with two statutory consultees before issuing a certificate approving treatment. Those consultees must be:
▹ a qualified nurse professionally concerned with the patient's care
▹ another person similarly concerned, who has direct knowledge of the patient in a professional capacity, but who is not a nurse, a doctor or the patient's approved or responsible clinician
ᐅ The consultees should make a record of the consultation with the SOAD, and this should be placed in the patient's records.
ᐅ The approved clinician must communicate the results of the SOAD visit to the patient.
ᐅ A copy of the certificate relating to medication should be kept with the patient's medication chart.
The target is that these standards are met for all patients subject to section 58.
Method
Data collection
Hospital managers should ensure a system is in place to determine which patients are subject to section 58.
- Type
- Chapter
- Information
- 101 Recipes for Audit in Psychiatry , pp. 65 - 66Publisher: Royal College of PsychiatristsPrint publication year: 2011