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Section 5(2) assessment

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Hello Guys,

Just want to clarify something.

I am on call from 5 pm today. Sometimes the sho who is on call during out of hours does receive call within working hours, but only if the team doctors are not around and something need to be done urgently.

I was called today to do a 5(2) assessment of one patient in a ward and it was within working hours. The unusual thing is that both the Consultant and her SHO were present at the site and it was adviced by the consultant to one of the staff to contact me and ask me to do the assessment. Her SHO was ready to do the assessment but Consultant asked her not to do it as its a duty of the on call SHO.

Now please, could anyone suggest something on what exactly someone should do in this kind of situation...  :-?

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Shouldn't it be the oncall for the day, anyway? I thought you were not on call till after 5? Plus what is your trust policy on the deputy for the Responsible Medical Officer and why couldn't the consultant do it in the first place? He could have felt tht his SHO didn't have 'sufficient experience' or 'sufficient guidance and supervision' (the second one less likely? ;)) as pointed in the Code of Practice.

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In this trust we are on call from 5pm till 9am the next day, but the medical staffs do contact us before 5pm also if could not contact their team. I am not quite sure about the trust policy.

The consultant was busy in the clinic but her SHO was available. I did adviced the nursing staff to contact their SHO but I was later informed by the SHO that according to her consultant its should be done by the on call doctor.

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I was confused so finally I discussed with my own consultant and according to him within working hours all the MHA assessment should be done by the team doctors if they are available at the site.....so I asked her SHO to do the same.

Now I would have to speak to her personally tomorrow so that she does not feel like I am avoiding work......

its just that u dont want to do something which u r not supposed to do.

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Yep cause it can come back to haunt you, especially when you are dealing with someone's life and liberty (and the MHA office!)

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There should be no confusion regarding who does the on call 5(2) assessments.

The reason being that it is the RMO who should be doing it and in this case it is the consultant of the ward. Now in case the consultant is not around, then, during working hours it is his nominated person who is supposed to do it which, in this case would be his SHO.

However out of hours it automatically goes to the on call SHO since that person would then be the nominated one.

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you should bring this to the attention of the MHA administratr in your trust. there should be a clear policy. get them to find out what it is and recirculate it.

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Thanks to all.....

I too had the same information about 5(2) assessments.......but since I have joined this trust I feel like everything is new, everything works in a very different way, there is no clear information about anything.

Just now I spoke to one of my senior colleague and I was informed that here this kind of assessment is usually done by the on call shos whether its within working hours or outside the working hours.

But u r right, I do need to confirm about this, as it looks like not even the consultants are sure what need to be done.

Lets wait till tomorrow......

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In think the consultant is being very smart.

Since he was around and it is his patient, he should be making a recommendation for sec 2 or sec. 3.

section 5(2) is just a short cut, most probably he doesnt want to go for the sec 2 route as maybe expects that things will change. or even will allow the sec5(2) to lapse after 72 hrs. all this is not best practice

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Yeah and Sec 2 or 3 needs a ASW and 2nd opinion. But as I had said earlier the consultant can nominate anyone suitable. but the code of practice does say'in his absence'.

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The code of practice says either the RMO or his nominated deputy- it is not clear who the nominated deputy is- the team SHO or the duty SHO- probably depends on the trust policy. Wonder what would have happened if u were busy as well- would the consultant have then sent his own SHO? Because the code of practice clearly states that aN RMO cannot have 2 nominated deputies!

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were u the consultant 'j'  ;)

:lol: :lol: :lol: :lol:

people are getting paranoid about j again...!

j was behind mtas, now he is observing trainees' answers to 'supposedly' true senarios and fills in WBAs for the College!

:lol::o:lol::o:lol::o

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Rox,

its not about showing smartness, she is a very good and well known consultant in this trust but I think she has not been in this post for very long......became consultant quite recently.

I don't know why but I have a feeling that 'j' is not the consultant we are talking about. :lol:

Well unfortunately I had been very busy whole day today so didn't get any oppurtunity to contact MHA administrator of the trust. I did discussed with my consultant again and I think he is planning to have a formal discussion with other consultants whenever possible.

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I have also heard from one senior colleague that besides the on call rota there is one seperate rota

for 5(2) assessments according to which the person who is on the rota on a particular day will need to do assessments........ atleast my consultant is not aware of this........

We have not seen such rota yet and as far as I can remember. I have never heard of this kind of rota before......

So still nothing is clear yet. :( :-? ::)

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Hi nits

I have worked with trusts where local policy was different with s5(2).

In some trusts, even if the team SHO is around he cannot use 5(2) as the local policy would put the oncall SHO as the nominated deputy. I guess this is what happenned in your case. I know this would feel wierd when the team SHO is around and still cant detain his own patient!

I worked in a trust with this policy. I was the oncall SHO and had to drive to the inpatient unit (2 miles away from my CMHT) to section. In the interim, the nurses can use 5(4).

In other trusts, the team SHO would be nominated as the deputy.

HOpe this clears ur query!

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Dear Sir

Some trusts have a policy of delegating the sec 5(2) to the oncall SHO- but he is only a representative for the consultant- so your consultant was skipping his involvement- because there is another thing involved- as soon as your consultant has the time to arrange for sec 2/ sec 3 he should arrange it instead of going for sec 5(2)- hope this clarifies things- the best person to ask would be the MHA officer within the management staff

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In my last trust during working hours (9h00 - 17h00 Monday to Friday) the consultant's STR1-3 (not registrar) was the nominated deputy.

After hours and on weekends this role fell to the on-call STR.

(Trying to get used to the new terms - I'm such a dinosaur!)

Of course - each trust does whatever it feels like doing. There's a thing on DNUK where some trusts are making doctors take pharmacology tests before prescribing - which is clearly far superior to a 5.5 year medical degree.......

Sad.

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Yes brainbox......

You are right, this trust too has the same policy as you have mentioned. Different trusts have different policies i think.

Anyway, things are quite clear now.

Cheers

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