Yes the situation is the same, it's just it's almost certain OOH that no-one
will be in a position to do it 7 also the Sec 12 docs kicking around and
available are thinner on the ground OOH.
Fay


---- Original Message -----
From: "Paul Bromley" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, November 25, 2004 6:11 PM
Subject: Re: Sectioning under Mental Health Act


> Fay - do you take the same approach to 'in hours' sections as these can be
> even more disruptive time wise - and often again you do not know the
> patient. In my last practice for the last 6 months or so I did actually
> refuse and advised them to get an Approved Section 12 GP in - without
> hearing anything else subsequently. Going to do the section would have
taken
> a couple of hours of my time in the evening after surgery, travelling a
> 16-20 mile round trip (and not having any mileage payment - merely the GP
> fee.)
>
> I agree with you and suspected that a GP payment was cheaper than a
section
> 12 payment.
>
> Best wishes
>
> Paul Bromley
>
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Fay Wilson
> Sent: 25 November 2004 17:11
> To: [log in to unmask]
> Subject: Re: Sectioning under Mental Health Act
>
> Dinesh
> There is advice for OOH organisations which is still applicable even
though
> written in 1999 at http://www.wmrlmc.co.uk/downloads.htm
>
> It has been adopted and put into use in various places outside the West
> Midlands and it works, honestly! It's a case of being professional,
> authoritative and confident & training everyone in the OOHO to understand
> and know what's correct. We also went to a local psych meeting where they
> had ASWs etc and everyone agreed this was the way it should be done and
the
> authorities should either train up and engage a panel of OOH Section 12
> doctors or cough up so that the psych rotas could stand the strain. AFAIK
> they currently get two psychs but it is an issue for the ASW to resolve
not
> the duty doctor (or even the OOH organisation). Note that Sectioning
> patients is not a contractual obligation for NHS GPs (unless specially
added
> to a PMS contract)
>
> NB There was a suspicion that there may be a financial issue for the
> authorities as well since a GP Section payment is less than a sec 12
> approved payment. However, if this really was the motivation I guess they
> would be asking the nearest relative to do it for nothing - the other
> option.
>
> I agree re 136 but we successfully managed to get a very disordered &
> vulnerable (& dangerous) man into psychiatric care OOH via this route when
> the psychiatrists had refused to accept a referral. Definitely last ditch
> but his relatives understood it was the only way for us to get help and
all
> agreed.
>
> Best wishes
>
> Fay
>
>
> ----- Original Message -----
> From: "Dinesh Patel" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Thursday, November 25, 2004 4:44 PM
> Subject: Re: Sectioning under Mental Health Act
>
>
> Section 136..Place of saferty... Aaargh....
>
> Place of safety to a Police officer means a police cell. Most officers
will
> use breach of the peace rather then 136 if they can do so.
> Unfortunately, many with acute mental illness get bunged up in a cold dark
> cell after being handcuffed and bundled into the back of a van. Sometimes
> because a doctor can't get there or there is threat of harm or violence.
> Even if they are taken to hospital , any sign of disturbance and the
police
> are called to cart the disturbed individual to a cell.
> I wouldn't wish anyone to be taken to such a place of safety.
>
>
> So if an out-of-hours doctor (who does not know the patient) is called to
a
> mentally disturbed individual, calls an ASW, is it reasonable and
acceptable
> to direct the ASW that this is now his/her responsibility to find two
> section 12 doctors or do a section 4.
> Is this the policy we should be recommending to all GP out-of-hours
> services?
>
>
>
>
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Fay Wilson
> Sent: 25 November 2004 00:41
> To: [log in to unmask]
> Subject: Re: Sectioning under Mental Health Act
>
>
> Yes Dinesh it is a great pain to have to fit in with both the top and end
> posters (and use plain text which looks so nasty).
>
> You can indeed strike out both bits. the ASWs hate this as there have been
> cases where patients have complained and indeed successfully taken legal
> action. There are other sections and provisions and it really is not the
> duty of the GP to resolve the problem. There is guidance on how ASWs
should
> proceed for instance where the two Sec 12 docs are psychiatrists working
for
> the same Trust. Section 4 allows a patient to be detailed on the rec of
only
> one approved doc; sec 136 (I think) allows a policeman to detain a person
if
> in a public place.
>
> We stopped doing these at our co-op several years ago and after three
months
> of whining and the medical director being called it all settled down and
> proper procedures were put in place 7 we now have no problems at all. It's
> just a case of will.
>
> In these days we should not be asking GPs to put themselves at risk when
it
> is not necessary just to save time and trouble for the system which has
> cynically failed to put resources in place to meet the legal requirements.
> it is a very serious matter to deprive someone of their liberty & should
be
> done only be properly qualified persons.
>
> Fay
>
>
> From: "Dinesh Patel" <[log in to unmask]>
> Sent: Wednesday, November 24, 2004 1:12 PM
>
>
> Fay
>
> Firstly, apologies, I can't stop top posting.
> Secondly,the accepted practice in this situation seems to be that you can
> strike out both bits, i.e. I have previous acquitance or approved under
> section 12. Thirdly, the rules do not say if it is not practicable to get
a
> second doctor who fulfils the either of the above, then a GP who has been
> called to assess the patient can't complete the application. Infact the
act
> does not give any further guidance other then cite the situations when
this
> is likely to happen.
>
> As I understand it, the Mental Act reforms are meant to address these
issues
> but I suspect they will remain as woolly as ever.
>
> Dinesh
>
>
>
>
>
>
>
>
>
>
>
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Fay Wilson
> Sent: 23 November 2004 22:35
> To: [log in to unmask]
> Subject: Re: Sectioning under Mental Health Act
>
>
> From: "Robert Treharne Jones" <[log in to unmask]>
> Sent: Tuesday, November 23, 2004 6:28 PM
>
>
> Can someone remind me what the rules are about sectioning? I had to do
> another last Saturday while on call, and yet again it was anything but
> straightforward.
>
> I got the approved social worker, and he got the consultant, and they
agreed
> my patient needed sectioning after assessing him while I carried on the
> mobile shift many miles away. However they then insisted I return and sign
> the paperwork, even though I'm not approved under section 12 and I'd never
> clapped eyes on the patient until about half an hour before I called them
> out.
>
> I suggested to them that with a consultant and an ASW present they had all
> they required to carry on but the ASW was adamant that I had to sign,
> together with the consultant - which does beg the question, why get social
> services involved in the first place?
>
> Clarification?
>
> ROBERT!!!!!
> However handsome and debonair you are, if you go about signing false
> statement eg "This patient is personally known to me and / or I am
approved
> under section 12 of the MHA" you will get into trouble with the GMC. If
the
> patient sues later for false arrest (as our local psychs tell us has been
> known) you will get it in the neck for behaving irresponsibly.
>
> As a GP it is your duty to make a proper assessment of the situation,
refer
> to the specialist and if the patient wont co-operate, call in the ASW. It
is
> the responsibility of the ASW to organise the two signatories.
>
> There is guidance on this on www.wmrlmc.co.uk if I remember correctly.
> --
> Fay
>
>