An independent investigation into the care and ... - Hundred Families

Medical outpatients and its relationship to the CMHT
8.25 We asked a clinical director from the time of the incident about the relationship
between medical outpatients and Manor Gate CMHT. She thought medical staff worked in
isolation in the outpatient department. She described the relationship:
“There was a sort of belief system, as I say, that you needed to refer to the CMHT
notwithstanding that you‟re in the CMHT and that medical outpatients were a
body with a separate life of their own……there was a belief that the medical clinic
had a sort of existence of its own, policies and procedures e.g. using RiO 1 , were
things that the doctors were exempt from.”
8.26 Locum staff-grade psychiatrist 2 described having large clinics and practising in
isolation from other members of the CMHT, though he could and did discuss cases with
consultant psychiatrist 1.
8.27 Consultant psychiatrist 1 told us her view of the relationship between outpatients
and the CMHT:
“I felt very much that the standard CPA patients – as they were called in those
days – who were under a doctor, were considered to be the doctor‟s problem. That
was a problem for me as a consultant because these standard patients aren‟t
easygoing, no problems. Standard patients have many crises, and the only way in
which any doctor can safely manage a large clinic is if the whole team helps you
with that clinic when the need arises.”
8.28 Locum staff-grade psychiatrist 2 made an electronic record on RiO of Mr Z’s
outpatient appointment in September 2009. The appointments in March and December
2009 were not recorded electronically. The trust was in the process of moving from the
use of paper clinical records to recording on RiO. Staff were under instruction to use RiO
at this time, but practice was still mixed - especially in outpatient clinics.
1 RiO is the trust’s electronic patient record system.
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