Multi-professional approved clinicians’ contribution to clinical leadership

Abstract

Purpose The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act (2007), can enable clinical leadership in mental health settings. Design/methodology/approach A questionnaire was completed by clinical psychology and mental health nursing practitioners in a mental health trust in the UK working towards or having gained approved clinician (AC) status, identifying barriers to implementation of the roles and enablers. Qualitative interview data were also gathered with psychiatrists, clinical psychologist and Mental Health Nurse ACs (three in each group). Findings There are a number of barriers and enablers of distributed leadership promoted by the MPAC role. Themes identified focused on enabling person-centred care, clinical leadership and culture change more broadly within mental health care. The AC role is supporting clinical leadership by a range of professionals, promoting patient choice by enabling access to clinicians with the appropriate skills to meet needs. Clinical leadership roles are promoting links between organisational priorities, teams and patient care, fostering distributed leadership in practice. Research limitations/implications This project reflects the views of a limited number of practitioners within one organisation which limits generalisabilty. Practical implications Organisations need clear strategies linked to workforce development and implementation of the roles to capitalise on their potential to support clinical leadership and person-centred care. Originality/value This study provides initial qualitative data on potential benefits and challenges of implementing the role.

Exploring the Views of Healthcare Professionals Working in a Mental Health Trust on Pharmacists as Future Approved Clinicians

“…In addition to being able to qualify via the portfolio route, applicants could also be given the opportunity to undertake a dedicated training pathway, one that is—in some aspects—akin to the clinical developmental roadmap developed for psychiatric trainees. People choosing to continue to proceed via the portfolio route, however, must also be supported adequately by their respective employers—a common key concern highlighted in this study as well as in the works of Ebrahim and Oates et al [ 4 , 5 ]. To enable this there must be sufficient funding made available to NHS trusts to create training posts as well as new non-medical ACs roles for those already qualified.…”

“…This study highlighted several reasons for this discrepancy, including the training route to becoming a non-medical AC being unclear and laborious for candidates in comparison to medical colleagues. A previous survey by Ebrahim identified additional contributing factors to this difference in numbers, such as a lack of protected clinical time allocated to training by employers [ 5 ].…”

Non-medical approved clinicians: Results of a first national survey in England and Wales

“…Participants said they offered service users a better experience as well as shifting the focus of the multidisciplinary team. Ebrahim's (2018) case study of non-medical ACs in one organisation also found that ACs considered that their role gave them increased power and authority, which could be used to offer service users more choice and could influence the therapeutic focus and nature of relationships in their team. Being approved in the statutory role of AC formalised participants' status as clinical leaders.…”

“…As 'early adopters' in influential roles, their aptitude for and commitment to distributed leadership may have been a key factor in those individuals putting themselves forward and being approved as ACs. Ebrahim (2018) noted that non-medical ACs described their clinical leadership as driving change and service transformation. Where participants in this study described becoming an AC as a 'natural progression', it may be that they, as early adopters in a vanguard organisation were always going to be at the forefront of new approaches to care and would make the most of any role that enabled them to lead innovation.…”

“…Distributed leadership has a number of effects, and is not just about clinical responsibility for detained service users moving from psychiatrists to a nonmedical colleagues. The non-medical AC may proffer distributed leadership through a consensual multidisciplinary approach and meaningful collaboration with service users, characterised as being 'different' to a more directive traditional medical approach (Ebrahim, 2018;Barrow et al 2015). The different requirements for approval between medics and non-medics may have influence here, with the non-medical AC's approach being grounded in a critical engagement with human rights based interpretations of the law.…”