This qualitative research explored the views and attitudes of healthcare professionals towards the role of the mental health pharmacist, and whether this group should be enabled to become approved clinicians (ACs) in England and Wales under the Mental Health Act in future. Following ethical approval, recruitment based on systematic purposive sampling principles took place at one mental health trust in England. Six pharmacists, five medical ACs and two mental health nurses participated in one-to-one digitally audio-recorded semi-structured interviews between June and November 2020. The recordings were transcribed verbatim before being inductively coded and thematically analysed. Notwithstanding the wide recognition among participants of several key skills possessed by mental health pharmacists, various obstacles were identified to them becoming ACs in future, including prevalent conventional models of pharmacy services delivery restricting adequate patient access, as well as insufficient training opportunities to acquire advanced clinical skills, particularly in diagnosis and assessment. In addition to the inherent legislative hurdles, fundamental changes to the skill mix within multidisciplinary mental health teams and improvements to the training of pharmacists were reported by participants to be required to equip them with essential skills to facilitate their transition towards the AC role in future. Further research is needed to gain a better understanding of the challenges facing the clinical development and enhanced utilisation of mental health pharmacists and non-medical ACs across services.
BackgroundThe Mental Health Act 1983 was amended in 2007 introducing the role of the Approved Clinician (AC) which could be assumed by individuals from several professional groups. Although the role of mental health pharmacists have undergone significant transformation over the past few decades, pharmacists remain ineligible to train and practise as an AC. There is a paucity of research on non-medical ACs and there are currently no known studies exploring the potential of mental health pharmacists to be considered for the role of AC in future.AimThis qualitative research explored the views and attitudes of a range of healthcare professionals towards the role of the mental health pharmacist, and whether they could and/or should be enabled, via a legislative change, to become ACs in the future.MethodRecruitment based on systematic purposive sampling principles took place at one mental health trust in England. Six pharmacists, five medical ACs and two experienced mental health nurses participated in digitally audio-recorded semi-structured interviews between June-November 2020. The recordings were transcribed verbatim before being inductively coded and thematically analysed.ResultsNotwithstanding the wide recognition among participants of several key skills possessed by mental health pharmacists, various obstacles were also identified to their becoming ACs in future, including prevalent conventional models of pharmacy services delivery restricting adequate patient access, as well as insufficient training opportunities to acquire advanced clinical skills particularly in diagnosis and assessment. Participants also highlighted wider concerns with current uptake of the non-medical AC role which could influence the success of pharmacists’ involvement, including legislative restrictions and a lack of perceived training support.ConclusionChanges to the skill mix within multidisciplinary mental health teams as well as to the training of staff may be required to equip pharmacists with essential skills to be able to transition towards the AC role. Further research is required to gain a better understanding of the challenges facing the clinical development and enhanced utilisation of highly specialised mental health pharmacists across services.
Introduction The 2007 amendment to the Mental Health Act (MHA) 1983 enabled various non-medical professionals to now qualify as approved clinicians (ACs); these included social workers, mental health and learning disability nurses, clinical psychologists and occupational therapists. [1–2] As ACs, these professionals can take on roles of clinical leadership whilst assuming responsibility for patients under the Act. Although mental health pharmacists have recognised specialist clinical roles and regularly work alongside these professionals in caring for patients, they are not presently permitted to practise as ACs. Aim This study sets out to investigate the views of healthcare professionals working in a mental health trust in England on this hitherto unexplored group of the mental health workforce as potential ACs. Methods Upon obtaining ethics approval, pharmacists, ACs and other experienced mental health professionals working in one mental health trust in England were approached via internal trust email to take part in a digitally audio recorded semi-structured interview to explore their views on pharmacists as potential ACs in future. A thematic analysis is being performed on the entire set of transcripts and an additional sentiment analysis will be applied to specific parts of the dataset. Results A total of 11 interviews were completed with 6 pharmacists, 4 medical ACs and 1 ‘other’ mental health professional thus far, with recruitment ongoing. Emerging themes included wide recognition among participants of highly valued key skills of pharmacists within mental health services provision, for instance their ability to access and appraise specialist literature as well as their analytical skills to apply expert knowledge to real-life cases. Participants identified unique challenges to pharmacists potentially becoming ACs in future, namely the traditional organisational structures whereby pharmacists are line managed and clinically supervised from within a pharmacy department which sits external to the clinical teams they typically work in, and the lack of pharmacists being fully embedded in interdisciplinary teams. Conclusion Since this is the first study of its kind to be conducted on a small cohort of participants working within one mental health trust in England, this qualitative study will likely highlight the need for further research to be carried out on the topic, such as data collection in several other NHS trusts as well as recruiting participants from the working group and other stakeholders involved in the most recent amendment of the Act. Whilst data collection and analysis are ongoing, initial findings help shed light on potential barriers and also possible solutions to these, as well as other opportunities for pharmacists wishing to assume higher leadership roles within mental health services in England. References 1. Barcham, C. Understanding The Mental Health Act Changes – Challenges And Opportunities For Doctors. BJMP. 2008;1 (2):13–17. 2. Oates, J., Brandon, T., Burrell, C., Ebrahim, S., Taylor, J. & Veitch, P. Non-medical approved clinicians: Results of a first national survey in England and Wales. International Journal of Law and Psychiatry. 2018;60:51–56.
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