Safeguarding

60 CHAPTER 7 Particular Issues In Mental Health Services
7.5 Guidance on the protection of vulnerable adults in health and social care settings makes clear
the responsibility of all health and social care workers to report allegations of abuse, even if the
information is disclosed in a therapeutic setting. 78 Health and social care organisations in turn are
required to join in multi-agency arrangements and to take appropriate action to protect patients and
the public 78 , including where appropriate referring care workers who have been responsible for
abuse to be included in the Protection of Vulnerable Adults (POVA) list 79 .
7.6 The Government however recognises that some health professionals may be still be uncertain
about the implications of patient confidentiality in relation to such allegations. The Government
therefore accepts in principle that further guidance on information sharing in mental health
services would be helpful and is already working with the Royal College of Psychiatrists,
the Information Commissioners and voluntary organisations to develop such guidance. We
expect to be able to publish the guidance in the spring.
Advocacy and advice
Kerr/Haslam Inquiry p30: Health and social care commission[er]s should resource independent
mental health advocacy as a priority.
p31: The Department of Health should introduce permanent arrangements for the provision of
independent advice for mental health patients.
7.7 Para 5.19 above has already referred to the important role which ICAS plays in advising
patients who wish to raise a complaint or a concern; ICAS is specifically tasked with providing
specialist advocacy support for patients least able to pursue a complaint for themselves; and the
majority of ICAS advocates have now received training in the special needs of patients suffering
from mental illness. In the Department’s view, it would be better to reinforce the skills of ICAS
advocates in helping patients with a variety of needs, rather than to superimpose a different set of
arrangements just for patients with mental illness.
Supervision of consultant psychiatrists
Kerr/Haslam Inquiry p33: The Department of Health in association with NIHME [the National
Institute for Mental Health in England] and the Royal College of Psychiatrists should publish
guidance in relation to clinical supervision of consultant and career grade psychiatrists.
7.8 The Government does not accept that the risks associated with autonomous clinical practice
are different in kind in psychiatry from those in other clinical disciplines, or that consultant
psychiatrists should be subject to clinical supervision. The general safeguards described in this
document and in Trust, assurance and safety – in particular, strengthened clinical governance, a
robust system of revalidation, and closer links between local clinical management and national
regulators via the proposed GMC affiliates – should be sufficient to ensure that any poor practice
or deliberate abuse is rapidly identified and dealt with, in psychiatry as in other disciplines.