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A 450-page code of practice won’t help staff apply the Mental Health Act – they need standardised training

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How can nursing staff be expected to understand and properly apply the government’s Mental Health Act Code of Practice if there isn’t the correct training, staff or support in place?

Last week the Care Quality Commission (CQC) announced that health professionals “lack awareness and understanding” of the Code of Practice, which is supposed to help staff properly apply the Mental Health Act.

Inspectors said that the code, which was implemented 26 years ago, is not being used as intended, by staff and healthcare providers.

As I read through the CQC’s report it got me thinking, and more so concerned, about the reasons why.

According to the health watchdog, staff are not being supported, they receive “varied” training on the matter and the code itself is not user-friendly.

“How can training on the guiding principles to help vulnerable patients not be a priority for healthcare providers?”

And that’s before we factor in the time needed to study the document. It began life as a reasonably manageable 135 pages but is now over 450. Wading through that is a big ask for members of a profession struggling to function with 40,000 vacancies in England alone.

Most worryingly, inspectors found that the “quality, content and focus” of staff training on the code was variable. Yet out of 40 providers asked, only 10 identified the need for further training and development.

How can training on the guiding principles to help vulnerable patients not be a priority for healthcare providers?

As the CQC said, training is essential to ensure staff have the right skills and knowledge to care for people with a mental illness and to ensure they know how to involve patients in decisions about their care.

I would say it’s even more vital now, as the inspectors also warned that providers were also not supporting staff well enough to enable them to have “meaningful and productive conversations with patients” about their goals and recovery.

As a former healthcare assistant working in mental health, it disturbed me that staff aren’t able to have these all-important conversations. I suspect it’s not through lack of desire to do so, but, as the report indicates, more about a lack of support from their employer and a lack of time.

As research reported by Nursing Times this week uncovered, improving conversation between staff and their patients is also essential to reducing the need for physical intervention and restraint in mental healthcare. So, there’s that to think about too.

”Rather concerningly, there was no recommendation for engagement with patients”

As a result of its findings, the CQC has recommended that the Department of Health and Social Care take the lead in developing standardised resources, support and training for staff.

The health watchdog said it also wanted to see the department promote the use of guiding principles to improve practice and enable meaningful engagement with families and carers.

However, rather concerningly, there was no recommendation for engagement with patients.

So, while I support the CQC’s call for better training on the matter, I hope it will cover patient conversation as a priority, to ensure people with mental health conditions receive the care and support they need.

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