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Remedies for work overload of consultant psychiatrists

  • Richard Williams
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Abstract
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Department of Health (1999) National Service Framework for Mental Health. London: Department of Health.
Department of Health (2000) The National Plan for the NHS. London: Department of Health.
General Medical Council (1998) Good Medical Practice. London: General Medical Council.
Kendell, R. & Pearce, A. (1997) Consultant psychiatrists who retired prematurely 1995 and 1996. Psychiatric Bulletin, 21, 741745.
Kennedy, P. & Griffiths, H. (2001) General psychiatrists discovering new roles for a new era. British Journal of Psychiatry, 179, 283295.
National Assembly for Wales (2001) Everybody's Business: A Strategy for Child and Adolescent Mental health. Cardiff: National Assembly for Wales.
Pajak, S., Mears, A., Kendall, T. et al (2003) Workload and working patterns in consultant psychiatrists - an investigation into occupational pressures and burdens. Website of the Royal College of Psychiatrists Research Unit.
Rathod, S., Roy, L., Ramsay, M., et al (2000) A survey of stress in psychiatrists working in the Wessex Region. Psychiatric Bulletin, 24, 133136.
Royal College of Psychiatrists (2001) College Supplemental Charter (Amended March 2001). London: Royal College of Psychiatrists.
Tyrer, P., Al Muderis, O. & Gulbrandsen, D. (2001) Distribution of caseload in community mental health teams. Psychiatric Bulletin, 25, 1012.
Welsh Assembly Government (2002) Adult Mental Health Services: A National Service Framework for Wales. Cardiff: Welsh Assembly Government.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Remedies for work overload of consultant psychiatrists

  • Richard Williams
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eLetters

Roles and responsibilities

Simon R. Wilkinson, Doctor
12 January 2004

I would like to bring to your attention the legislation that was introduced a couple of years ago in Norway, concerning all Health Professionals and their respective roles and responsibilities. It is a comprehensive revision which I believe can inform UK debate.

There are three key terms of treatment responsibility - highest levelis 'Specialist' treatment responsibility, which concerns the overall responsibility for treatment on a ward or outpatient dept. etc. Under thisperson there is a level of 'General' treatment responsibility - which could be when a large unit is subdivided into smaller units, and then the leader of each would have this responsibility. The real key to practice isthe 'Responsible for the patient' level. These are 'case' responsible, andthe new legislation opened up for these to be either doctors or psychologists - or others under special delegation from the specialist responsible. At my hospital they are also defined as 'Information responsible' - ie for cooordinating information to be provided to patientsand their next of kin, and 'Notes responsible' - ie to ensure that each profession contributes information to the hospital notes in a coordinated and comprehensive enough manner. These last two forms of responsibility can be managed in other institutions by the General treatment responsible person. On admission each patient is informed who has which role. On smaller wards the general responsible person and specialist responsible senior may well be the same person.

Each profession is responsible for documenting their treatment, and for documenting information of importance for diagnosis etc. For example if a nurse is the person informed of abuse, he records what he was told, how he responded and in what context. The final hospital notes are coordinated so that there is no duplication by the 'Notes responsible' case manager.

At first doctors felt this to be a major challenge to their position,but it shows a respect for multi-profesional co-responsibility in a manageable way. It is worth looking at.

Simon R Wilkinson MD, FRCPsychAdolescent Psychiatric UnitSogn Centre for Child and Adolescent PsychiatryVinderen 260319 OsloNorwayTel. +47 23492202simonroger.wilkinson@ulleval.no
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