Integrated Trusts

CHANGING ROLES FOR MENTAL HEALTH NURSES WORKING IN PARTNERSHIP AND INTEGRATED HEALTH AND SOCIAL CARE TRUSTS

MHNA has been receiving a growing number of queries over recent months on the subject of changing roles and expectations of mental health nurses from employers.

These queries generally relate to expectations that nurses should undertake a wider range or tasks and accept broader responsibilities. These have included the compilations and presentation of social reports for Mental Health Act Review Tribunals, applying for Court Warrants under the provisions of Section 135 (2) of the Mental Health Act, being expected to act as Appropriate Adults under the Police and Criminal Evidence Act 1986.

Some of these new responsibilities have been seen as those of a social care professional or their employer under law. Others have been held by social workers as they have worked separately from health care professionals.

MHNA views the closer working partnerships between health and social care workers and organisations to be encouraged, with the better understanding of each other's roles and the consequent improvement in service and care to service users and their carers and families. However, the development of Partnership and Health & Social Care Trusts have brought many unexpected consequences, and some are highlighted above.

Whilst MHNA cannot suggest a blanket position which would apply to all cases where nurses are being expected to undertake new roles, it holds the view that members should ensure that the following criteria are met before accepting new responsibilities and roles:

Members should only accept new responsibilities where they are within their professional competence.
Undertaking tasks and procedures for which they are not competent could place them in breach of the NMC Code of Professional Practice.

Members should insist that any changes are planned and subject to full consultation. Members should be aware that some roles may place them in a position of conflict of interest, such as the role of Appropriate Adult. Remember- a nurses is always a nurse and cannot choose not to be one so as to undertake a role outside of a nursing remit.

Some roles, whilst traditionally having been seen as the province of social care, can be undertaken by nurses. However, members should ensure that suitable support and supervision, appropriate training and resources and relevant remuneration and grading be in place before accepting these new roles.

Other roles are legally the remit of social care practitioners and their organisations.
Members should be aware that, whilst they might have an involvement in carrying out that activity, they do not have responsibility for it. Members should, therefore, refuse to accept responsibilities and roles from which the legal responsibility lies elsewhere.

Members should also be aware that accepting roles that are other than are appropriately nursing one could place their indemnity insurance cover in jeopardy.

MHNA welcomes and embraces new responsibilities and the growing influence and importance of mental health nursing to overall mental health care. However, it is essential that any changes are consistent and equitable, the drivers for change are identified, the process of introduction is open and transparent (with the involvement of all those involved in the process) and subject to full consultation.

MHNA supports the closer integration of health and social care professional and organisations. It also supports a flexible approach on the part of all workers and employers and a willingness to adapt roles for a more effective mental health service.

However, it will also be continuing to monitor members' experiences and is keen to hear of examples of good as well as bad practice in the introduction of more integrated working. Contact the MHNA to let us hear of your experiences- good and bad- of this process.

Email: brian.rogers@unitetheunion.com (Mobile: 07918 630403)