Occupational Therapy News OTnews November 2019 | Page 10

NEWS FOCUS Bring your skills to bear as an approved clinician, says England’s only occupational therapist in the role More occupational therapists should consider training as approved clinicians in mental health, says a pioneering occupational therapist working in the role. An approved clinician is a person approved by the secretary of state for justice for the purposes of the Mental Health Act; certain decisions can only be made by them. Donvé Thompson-Boy, the lead occupational therapist for Bromley, London, in Oxleas NHS Foundation Trust, took on the role after looking for a route to develop her career without turning to management. Donvé says: ‘I had been speaking in supervision about clinical opportunities – what I was finding was I was progressing, but as soon as I reached a particular level it was difficult to progress without needing to accept more management responsibilities rather than clinical ones. And at the same time, our head of therapies was looking at how the trust could develop its non- currently the only occupational therapist in England. Donvé says that occupational therapists have several strengths as a group that could work well for being an approved clinician. ‘Our risk assessment and therapeutic risk management skills, our collaborative working with other multidisciplinary Donvé Thompson-Boy colleagues and all our report writing skills are all transferrable skills and play a significant part when undertaking the role of responsible clinician,’ she says. ‘And a lot of this is about demonstrating clinical leadership – being able to present your clinical rationale, and putting yourself forward for opportunities where you are representing your medical approved clinician pool.’ Donvé undertook five days’ training over a nine-month period to enhance her understanding of mental health law and get up to speed on the competencies needed to complete the portfolio application process, and shadowed other approved clinicians to demonstrate understanding of mental health tribunals and presenting medical evidence to a panel. ‘It is quite different to thinking as an occupational therapist – it’s going from thinking primarily about someone’s functional ability, to at the core being about application of the Mental Health Act and Mental Capacity Act,’ she says. ‘You are responsible for the application of the law and legally accountable for decisions made affecting someone’s liberty; but that’s where we as occupational therapists can come into our own, thinking about the least restrictive options.’ Donvé has now worked with two service users subject to community treatment orders. ‘Different professionals bring different skills, experience, knowledge and a different approach with them. That different approach can contribute to shorter lengths of stays or time detained under the Mental Health Act,’ she says. ‘Who is allocated as the approved clinician will generally depend on what the needs are that are presented. Occupational therapists’ strengths lie in offering a psychosocial model of care. When an approved clinician works with a service user we are named as the responsible clinician, and in that situation I have found that my skills are particularly relevant when working with service users where social connections and a lack of roles or routines is what is predominantly contributing to someone’s profession, which is an important approved clinician competency and will need to be evidenced in your portfolio.’ recovery as opposed to medication. This is generally the basis of the conversation I will have with my medical colleague, in determining who I will work with as a responsible clinician.’ With changes to the Mental Health Act in 2007, the role was opened up to non-medical staff, with nurses, psychologists and social workers becoming eligible to take up the role, but Donvé is professional development and the opportunities you might take up, as part of your career pathway towards gaining approved clinician status. This role give us, as occupational therapists, a wonderful opportunity to step into high profile clinical leadership roles and contribute to a shift in organisational culture’. Contact Donvé on: [email protected]. 10 OTnews November 2019 ‘This role give us, as occupational therapists, a wonderful opportunity to step into high profile clinical leadership roles and contribute to a shift in organisational culture’. Donvé Thompson-Boy She notes that organisational support is crucial to take on the responsibility, but there are key advantages to having an occupational therapist trained in the role. The Care Quality Commission gave very positive feedback as a sign that the trust takes professional development seriously, as well as what it offered in terms of innovative practice, patient experience and choice. Donvé works in the community but suggests that occupational therapists working in a number of areas, including in-patient rehabilitation, learning disabilities and forensic settings could consider taking on the responsibility. She says: ‘You do need to be in a position of clinical seniority before you embark on this, but I don’t think occupational therapists working in mental health are all aware of the opportunity that is available to do this. If you are aware of this as a possibility – even from a band five level – then it can help to think about your