“MULTIPLE cases” of senior clinicians pulling out of Jersey roles have prompted an overhaul of mental-health law that would, for the first time, allow non-doctors to take charge of detained patients.
If the changes are approved, senior nurses, psychologists and other non-medical professionals would be able to become the lead decision-makers or patients held under the Mental Health Law – wielding powers currently reserved to psychiatrists alone.
The proposals, put forward by Health Minister Tom Binet, would replace the existing “responsible medical officer” role with a broader “responsible clinician” status.
While doctors would still make the crucial medical recommendations for detention, suitably qualified professionals from nursing, psychology, occupational therapy and social work could be approved by the minister to oversee detained patients’ care, treatment plans, leave and discharge decisions.
This means a senior nurse or psychologist – not a psychiatrist – could hold ultimate clinical responsibility for Islanders detained for mental-health treatment.
The report states that the change “will enable formal roles under the law in relation to detained patients to be carried out by a wider range of mental-health professionals than at present”.
It mirrors arrangements in England and Wales and is designed to “enable the implementation of a modern workforce configuration”.
There have been “multiple cases” of experienced clinicians from the UK withdrawing from Jersey roles after discovering they would not be able to use their approved clinician status on the Island.
Deputy Binet explained: “At present the fact that a senior nurse, psychologist, occupational therapist or social worker – who may have trained, obtained and exercised approved clinician status in England and Wales – cannot perform a similarly senior and responsible role in Jersey means that individuals with that level of experience are not prepared to move to and work in Jersey.
“There have been multiple cases of potential candidates for roles in Jersey pulling out when they have realised that they would not be able to utilise their approved clinician status for which they have been trained.”
Widening eligibility will increase “the pool of potential candidates for senior clinical roles” and ease pressure on overstretched services, according to the Health Minister.
“It will also enable a wider distribution of certain responsibilities across professionals which will assist in the management of caseloads within the service and provide the conditions to underpin a modern mental-health service,” added Deputy Binet.
At present, only doctors can authorise key steps in detention and treatment. Under the new system, although only registered medical practitioners could make medical recommendations for detention, non-doctor approved clinicians could become a patient’s responsible clinician and exercise significant statutory powers.
The report concedes it will be “important to establish clear protocols for shared care when an responsible clinician is not a medical practitioner”.
It concludes: “The proposed amendment will reflect arrangements which have been in place in England and Wales since 2008, will enable the implementation of a modern workforce configuration which, in turn, will enable Jersey’s mental-health services to recognise and make full use of skills and experience acquired by clinicians in England and Wales or other parts of the UK.”
