27 Jun 2012

02. Mono-consultants

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Go one better

Introduction

The consultant playing table tennis with a patient or sitting in on community meetings? Patients knowing the consultant only by their first name? The consultant and a patient chatting about how soap operas influence people’s views about mental illness? It’s got to be a ward which has just one consultant.

The benefits of each ward having only one consultant (rather than up to eight!!) are staggering. The consultant gets to see patients outside the unreal, stress-fuelled setting of ghastly ‘ward rounds’, gaining a much fuller, more holistic and ‘human’ understanding of patients health, needs, strengths, aspirations. And of course, this creates the possibility of consultants winning patients’ trust and respect, reinforcing the appropriateness of treatment formulations and implementation.

There’s also the similar strengthening of staff relationships with the consultant and much more efficient and accurate communication.

Interestingly, given that the only people who seem keen to retain the unpleasant and dysfunctional system of multiple consultants are, er, consultants, it’s great that the Royal College of Psychiatrists is actually in favour of single consultants:

Adult mental health services have been clear to recommend that ideally one consultant psychiatrist per ward will ensure good clinical leadership and avoid multiple ward rounds.

Inpatient care for older people within mental health services, April 2011


Ward Examples

  • An Acute Care Consultant covers both the adult acute wards and the CRHT.
  • Our Star Wards Steering Group was founded in February 2008 – a time when the service was going through major reorganisation. At that time, the two adult wards, had recently brought in a new way of working known as the Acute Care Consultant model which changed the way the Consultant Psychiatrists worked by introducing a single dedicated Consultant Psychiatrist  based at the unit who was responsible for patients during their inpatient stay instead of their community consultant.
  • “Patients may not want to change consultant at their most vulnerable time so the concept of a single consultant is a positive one”.
  • “More consultants equals more confusion, plus more ward rounds!”

 

Patient Examples

  • I felt it was really important to be as open with my Psychiatrist as much as possible as I wanted to get better sooner rather than later.

 

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