Gap between policy and practice for some NHS inpatient services

There is a big gap between the aspirations of the governments strategy for mental health No Health without Mental Health and the reality of its implementation in inpatient settings, according to the The Care Quality Commission (CQC) in their Monitoring the Mental Health Act in 2011/12 report published in January.

The third such annual report, it represents the duty the CQC has to monitor how services in England exercise their powers and discharge their duties in relation to people who are detained in hospital under the Mental Health Act, or subject to community treatment orders (CTOs) or guardianship. While it found that there were excellent example of care, naming particular services and hospitals as examples it also found that there had not been enough forward progress from its previous two reports: “For example, 37% of care plans checked by CQC showed no evidence of patients’ views; there was no evidence that patients had been informed of their legal right to an Independent Mental Health Advocate (IMHA) in 21% of records reviewed; almost half (45%) of patient records reviewed still showed no evidence of consent to treatment discussions before the first administration of medication to a detained patient.”

Commenting in the summary the authors of the report state: “It is with great regret that CQC notes that there are themes that recur year on year and paint a picture of practice in some areas of mental health provision that is a far cry from the policy vision.”

Monitoring the Mental Health Act in 2011/12 can be downloaded from the CQC website:

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