Advanced nursing roles in mental health are taking longer to catch on than in other specialisms, despite being beneficial to patients and helping practitioners to develop their careers, it has been claimed.
Legislation changes almost 10 years ago have made it possible for senior nurses to take over practice previously carried out by social workers and psychiatrists, but the mental health profession has been “on the backfoot” with introducing new senior positions, according to a consultant nurse.
“With advanced nursing and new roles – mental health has been ignored really”
“With advanced nursing and new roles – mental health has been ignored really,” Carol Molloy, a consultant nurse at South Staffordshire and Shropshire NHS Foundation Trust told a group of mental health nurses at a recent conference.
“In general and acute nursing there are lots of new roles and titles, but mental health seems to have been a bit on the backfoot,” she added.
Speaking at the Royal College of Nursing’s international centenary conference at the end of last month, Ms Molloy pointed to two specific new roles that had been created following a revision of the Mental Health Act in 2007.
The approved mental health professional (AMHP) post – which used to be reserved for social workers – has the authority to assess whether there are grounds to detain people with mental health problems.
Meanwhile, the responsible clinician role has a series of duties, including the power to review and recall community treatment orders that are applied to people who have been placed under section but are thought to be able to receive care outside of hospital, and also to bar relatives from discharging patients.
Ms Molloy said both roles helped to provide workforce flexibility. However, she warned “it’s one thing to create roles with a fanfare” but it was “another to implement them and make them sustainable”.
She highlighted that professionals in these new roles required access to ongoing educational support, as well as clearly defined role descriptions.
“It’s one thing to create roles with a fanfare [but it is] another to implement them and make them sustainable”
Nurses in her own organisation had said they found the AMHP post helped them to empower service users and had also allowed them to challenge practice, said Ms Molloy.
As a responsible clinician herself, Ms Molloy noted it was an “interesting” position, which she described as “almost like a glorified care co-ordinator – because not only are you a care co-ordinator but you have the power to do something about it if it’s not working”.
However, she said there had been challenges while holding the post, including ensuring colleagues understood the job, and also convincing tribunals and judges that a nursing opinion – not a medical one – would suffice when making decisions about patient care.
She noted that, as of last year, there were just 32 non-medical responsible clinicians across England and Wales, including 14 nurses.
“Advanced roles are happening very quietly in mental health. In the last five or six years they have been developing, but the acute sector has had them for a while,” she later told Nursing Times.
She suggested such roles were not as visible as in general nursing, which had contributed to the slow pace of their introduction, and also that fewer advanced roles in mental health nursing was partly due to the lack of a clear career pathway for nurses working in the specialism.