Thursday 26 April 2012

No Quibble

So the final piece of the legal jigsaw is in place (barring an unlikely rebellion in the National Assembly), namely the Code of Practice for Parts 2 and 3 of the Mental Health Measure. See all the details here.

The final version is a considerable improvement on the draft (which in fairness had much to recommend it). As well as a lot of tidying up and clarification the final version addresses the crucial need for clear timescales for the appointment of Care Coordinators (2 weeks) and completion of Care and Treatment Plans (6 weeks).

This was a great concern to Hafal's Members as we foresaw the spectre of Health Boards arguing that it was "reasonable" to take months to complete a Care Plan - and for all we knew a judge, asked to adjudicate if a patient challenged this in court, might have been bamboozled into agreeing with the bureaucrats.

Veteran Hafal activist Lee McCabe, with the support not just of Hafal but of the Mental Health Foundation and Bipolar UK, delivered a punchy campaign on this and related matters during the consultation on the Code and received huge support. It's to the credit of the Welsh Government that they listened and took action on timescales.

For clarity the timescales aren't absolute in the sense that the law is breached if ever the timescale isn't met (and we didn't argue for that) but the timescales have great meaning because, put simply, there needs to be a good reason for exceeding them. And a judge would use the timescales in the Code as the default position on what was reasonable. So woe betide LHBs which routinely exceed the timescales - that will be a breach of the law.

Lee and his supporters didn't get everything we asked for. In particular the Code isn't wholly emphatic about ensuring that Care Plans are truly holistic. The Code does require that the Plans are holistic but we would have liked to have seen crisp advice about what that means - specifically that the eight "life areas" in the Care Plan template are routinely or normally addressed in writing. But this isn't a lost cause. We need to ensure that the understanding of the word "holistic" is crystal clear in practice - so, for example, who could disagree that you can't really call a Care and Treatment Plan holistic if it fails to set out plans for such vital matters for a person in secondary mental health services as accommodation, social life, finances, etc?

So, let's not quibble but rather let's support both patients and practitioners to take mutual advantage from the new law by creating fantastic Care and Treatment Plans which deliver what patients need to achieve recovery and clarify who is doing what - because of course it isn't just for the Care Coordinator to deliver but for the patients themselves, their carers, and a range of other supporters within and beyond mental health services. There is great advantage to the Care Coordinator as well as the patient in formally enjoining that wider support rather than relying solely on the scant resources within secondary mental health services...