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Guest hamilton

Scottish section 20 Training

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I think my patients' persecutory ideas are rubbing off on me! I have recently attended the college training for section 20 approval (like section 12 in England) along with several staff grade colleagues. This is the first time any staff grades have gone from our trust, and there is a feeling that it might be connected to the introduction of a new mental health act in 18 months which will probably require consultants (ie section 20 doctors) to come in to section people during on call hours. Is this just coincidence?

As the old saying goes, just because you are paranoid doesn't mean they're not out to get you!

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hi

I am working in england ,can u clarify regarding oncall hours?Here consultants main workload during on call is sectioning so faar!it seems that is not the case in scotland?

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At present in my trust there is one consultant on call from home after hours. They very rarely have to come in, and patients are detained by junior staff using a 72 hour detention. Under the terms of the new mental health act it may be that 72 hour sections are to be avoided, and instead a section 20 approved doctor must assess the patient at time issue arises, for detention for 28 days. This will have an imoact on the consultants' hours, contract, clinics etc, and so the staff grades may be asked to play a party in this on call duty.

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Lucky for the Consultants and SpRs, they don't have to come out in the middle of the night to section somebody.I would presume the SHOs are using the equivalent of section 4(one doctor plus social worker) to detain someone from the A & E, for a period of 72 hours.

I wonder if it is similar in Wales and N.Ireland.I think the practise in Wales is similar to the one in England.

It would be interesting to hear from people working in Ireland(Republic and North) about the use of MHA during on call hours.

I have heard that consultants are not paid extra for on-calls(at least the place where I work in N.West England) as it is a part of their duty commitment.

There are several trusts who have staff grade doctors as second-on-call who are section 12 approved to assess and detain people under the MHA.

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I'm not too well informed about the Irish (south) situation but I think it is the next of kin that makes the application for section, and the GP supports this. The receiving psychiatrist has little to do with the process. Perhaps someone practising there could tell us.

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The latest guestimate of date of implementation of the MH(S)A is April 2005, so here's still time to influence the code of practice etc...

I understand the main driver to early 28 day sections relates to human rights - i.e. the right to appeal against detention, which is absent from 72 hour sections of the act.

My view would be that the SHO would still apply the emergency section 5pm-9am, but the S20 approved doctor would review this the following day, either recinding it or applying a 28 day section. This would allow more accurate assessment of the need for detention, time to get notes, contact people for information etc. And mean S20 doctors aren't unnecessarily dragged in to complete a piece of paper.

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hmm

thanks for throwing some light on scottish mha.sec20=sec12 of england..

And i love to be 2nd oncall in scotland!! :P

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Even better as a Consultant, then you're 3rd on call - i.e. your SHO deals with everything, your SpR deals with everything else and you can go to the theatre/restaurant/skiiing (delete as appropriate) :lol:

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