Good morning All - can you please help?
In my role as a nurse and multi-professional AC I am having issues with my Trust with regard to treatment under the MHA.
I am being told that I cannot provide ‘treatment’ for my patients because I am not a registered medical practitioner ie not prescribe them psychotropic medication, ECT, nor complete a T2 or complete a Section 62 in the cases of emergencies.
According to Jones [24th Ed, p.366] there is a separate definition between an ‘Approved Clinician in Charge’ [which I am] and a Registered Medical practitioner.
It states that the Approved Clinician in Charge of treatment needs to be ‘medically qualified’ – here in lies the area of debate – as a nurse who has undertaken specific training in prescribing and as an AC, does that therefore indicate that I am suitably qualified to be in charge of the patients treatment?
Do I have to hold a licence under the Medical Act 1983 in order to do this? I was led to believe this is only for registered medical practitioners and not a MPAC.
I have spoken to Nurse Consultant colleagues who are also ACs across the country and they have not encountered these issues.
I have also discussed with the Chair of the South East Approvals Panel who stated ‘prescribing is done by doctors and NMPs. The MPAC can authorise other statutory forms such as admission/discharge/S17 forms’
Can anyone please help clarify this issue?
Having AC status doesn’t determine what you can and cannot prescribe or supervise.
The MHA requires certain treatments (including all treatment without consent) to be supervised (and in some cases authorised on a statutory form) by an AC - who is, therefore, the AC in charge of that treatment.
That’s to ensure that the person taking final clinical responsibilty has been trained in the relevant law.
There’s nothing in the MHA that says that only a registered medical practitioner can be the AC in charge of any given treatment. A non-doctor independent prescriber who is an AC could therefore be the AC in charge of medicines they prescribe.
But equally the MHA doesn’t itself authorise anyone to prescribe or supervise any particular treatment.
That’s a matter of medicines law, professional standards, local policy etc, just like it is for non-MHA patients.
So, in practice, someone can only be the AC in charge of a treatment for MHA purposes if it’s a treatment they’d be qualified to provide/prescribe even if they weren’t an AC. Otherwise they’d be breaking the law and/or professional standards and/or local policy.
It’s why the MHA deliberately distinguishes between the Responsible Clinician (ie the AC in charge of the patient’s care in general) and ACs in charge of any particular treatment. The best AC to be a patient’s RC won’t always be qualified to prescribe every particular treatment from which they might benefit.