I wondered if anyone else had experienced some actively unhelpful CTR meetings. I have attended a couple which were useful but many others which were potentially damaging.
The main problem seems to be that the some Panels are over confident and not well informed. They tend to promise things to the patient which cannot be met and are sometimes inappropriate. E.g Asking the patient if he wanted to live in a flat or a house and whether he wanted to have a cat or a dog on discharge. ( When the patient was difficult to place and did not have these sort of choices) Also, there have been several instances of patients being told that the Panel would ensure something happened, before hearing from the clinical team that there were clinical reasons why it could not. e.g being given access to a particular computer game.
Finally, on two occasions the panel have given the patient completely incorrect legal advice and, on the last occasion ,did not accept that it was not their place to do this when I pointed this out.
I know that solicitors only attend CTRs infrequently and may not realise the problems which can arise.
Personally I think these meetings are a waste of time and money. I am sure that this may be a controversial view!
I doubt this will be hugely controversial, as in my experience itās not only professionals who find some of these unhelpful and occasionally positively harmful. I have heard family, friends and patients also criticise them, as well as solicitors. Some do work well : and I understand why they were introduced. But sometimes they appear to be used as a threat (much as appealing to the MHT can be, mistakenly) and sometimes the participants very clearly have an agenda which is not about this particular person and their care. I have occasionally experienced a well run and efficient one, with good time management, but often they seem to assume clinicians have little else to do.
And trying to report the concerns (overstepping/failing to respect boundaries, encouragement of clearly unrealistic goals, promoting one sort of assessment over another and audibly criticising something in front of the patient with no basis other than āpersonal experienceā, among others) is pretty much impossible as far as I can see. Rather like raising concerns about the apparent disregard for limiting information sharing and remembering the need to know matters, when non clinicians/civil servants get involved ā¦
And then thereās the flip side, where funders are reluctant to put people with qualifying labels into the system at all! Thereby denying them the possibility of a useful CTR process, and all that ought to go with identification of a condition needing extra care.
I find making sure a careful note is nade of everything is useful as I have also seen the outcomes produced failing to accurately and fully resemble what took place.
I sense your frustration and annoyance, and you are not alone. This is ripe for reform
I have just been involved in arranging a CTR for the first time.
It was enormously time consuming and I think of limited value. I could not understand some of the recommendations, where they had come from and some where diametrically opposed to the service userās wished.
There appears to be no good mechanism in place to give feedback following completion.
Iām afraid to get started on this. Iāve been to three CTRs in the last 3 years.
Typical. Itās the ānew ageā mindset of offering choice! Apparently - one has to be āseenā to be offering choice. When Iāve asked the stupid question, āSeen by whom?ā - I get the looks which suggest āAre you a consultant?ā - followed by some vague deviation. Everybody likes āto be seenā to be doing good apparently - yuh know Big Brother is always watching. Ahhhā¦ OMG! What am I saying - that canāt be right. Oopsā¦ I contradicted myself at here Can a person be forced to have repeated capacity assessments? - Law and practice / Mental Capacity Act - MHLO Forum I donāt know āmanā, Iām confused, obviously.
Of course!! Donāt you know that āeverybodyā in the last 10 years is a mental health expert - and that if youāre like me - psychiatrists have to cower in a corner (nodding with head tilted slightly to one side, in a posture of the utmost humility).
On one CTR there was an āExpert by Experienceā certified and qualified as such by your beloved CQC. Who am I to say anything - to appear to counter any such āexpert opinionā or āadviceā? As Iāve said before - I am NOBODY!
If/when I am asked my opinion I give it. If not I keep my lips zip-locked.
Reform? Of course - but itās not happening any time soon. Loads of things are ripe and cold on the switched-off back-burner of reform. Take the MHA Bill - still a tangled mess and likely to be a jungle of mind-bending legalese whenever it is finalised into law.
Itās all about waiting lists for bodily problems - the main priority.
From your NHS England: NHS staff delivered a record 18 million treatments in 2024, as the waiting list fell in December for the fourth month in a row.
The overall backlog has dropped again from 7.48 million to 7.46 million, while the estimated number of patients waiting is down from 6.28 million to 6.24 million.
Monthly figures show that hardworking NHS staff delivered a record 18 million treatments in 2024, hundreds of thousands (4%) more than in 2023 (17.35 million) and 5% more than in 2019 (17.1 million).
For the real scoop on why nothing will change in mental health faster than glacial speed, get the facts and figures summarised from the Darzi Report: Findings of Lord Darziās Report 2024
The reality is that these are here to stay, and if the proposals in the MHA Bill progress they will move to having a statutory footing. Its important therefore to keep the person at the centre of any actions in supporting a CTR panel to prepare and in responding subsequently.
Unfortunately,I would almost have to complain every time I attend and I just donāt have the time or energy. I will raise this with the Mental Health Lawyers Association - I think it needs a cohesive approach but I donāt think many lawyers routinely attend them.
