Driving quality implementation in the context of the Francis report

to individual autonomy. This is even more important
when there are potential risks to others, when
psychiatrists support decision-making processes
across multi-agency teams to decide on the optimum
way forward, protecting both the public and
the patient in a thoughtful, considered and professional
way.
College action
1 The College will continue to support and
develop best practice, and publish educational
materials to support patient-centred
professionalism and care.
2 The College will revise its report Good
Psychiatric Practice to incorporate the necessary
lessons from the Francis report.
3 The College recognises that it is crucial to
recruit doctors with person-centred skills and
values, and we will explore how our recruitment
methods might become more values
based.
4 The College will continue to influence
the development and implementation of
patient-centred mental health policy and
legislation.
5 We will work in partnership with patients and
carers to develop all of the above.
Patient Safety Expert Advisory Group
The Group is currently updating two major College
reports which asserted the need for compassionate
care and collaboration with patients and
carers – Rethinking Risk to Others in Mental Health
Services (Royal College of Psychiatrists, 2008),
due in 2014, with reference to the findings and
recommendations of the Francis report, and Self-
Harm, Suicide and Risk: Helping People who
Self-Harm (Royal College of Psychiatrists, 2010),
which will be reviewed at a later date.
Faculty of the Psychiatry of Old Age
The Francis report is particularly poignant and relevant
for old age psychiatry. Many of the vulnerable
people who formed the basis of the report were
elderly. There is no complacency in old age psychiatry
regarding the issues raised by the report.
Francis states that caring approaches are applicable
to all, but makes particular mention of elderly
people. All staff need to understand life-cycle
changes and dependency issues in old age.
The Faculty has established a working party to
consider the implications of the Francis report for
psychiatric care for the elderly.
Faculty of General Adult Psychiatry
We recognise the profound importance of the
Francis report and its core recommendation that
patients must be at the heart of everything we
do. We must bear in our minds the need to treat
patients not only with technical expertise, but also
understanding and compassion. To this end, the
Faculty has established a ‘compassion in care’
workstream which aims to make sure that the
right values are instilled in psychiatrists from their
training onwards, are maintained in the clinical
workplace, and that psychiatrists model these
values for others.
Compassion and competence are themes of the
Faculty’s residential conference in 2014.
Faculty of Medical Psychotherapy
Consultant psychiatrists in medical psychotherapy
are increasingly active in developing, leading
and delivering flexible integrated services for
people with a diagnosis of severe and complex
personality disorder. These services are delivered
across clinical pathways through primary care,
secondary mental healthcare, local authority and
criminal justice provisions, and specialist treatment
services provided locally within borough/county
and nationally in specially commissioned tier 4
in-patient personality disorder treatment services.
Not uncommonly, this patient group has faced
cumulative adversities and can become fixed in
their response pattern to adversity – a response
that is frequently replicated in the services set up
to manage their extreme difficulties in caring for
themselves safely and in relating to others.
A Faculty member has recently taken on leadership
of a tier 4 in-patient service that was rigid and
fixed in its approach to challenge and change. He,
the multidisciplinary team and the patients have
decided to encourage patients to be present and
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Occasional Paper OP92