Background

Responsible Clinicians are professionals who are primarily accountable for the care and treatment of patients detained under the Mental Health Act, 1983 in England and Wales. The role has only been taken up by under 100 nurses and psychologists since 2007. The aim of this study was to explore the experiences of non-medical Responsible Clinicians, to inform our understanding of interprofessional dynamics and professional identity in contemporary mental healthcare.

Methods

A qualitative study comprising thematic analysis of interviews with twelve non-medical Responsible Clinicians.

Results

A major theme of ‘Interpretations of responsibility’ emerged, with two sub themes: ‘Responsibility as leadership ‘and ‘Responsibility as decision making’. Taking on the role had implications beyond the care of specific patients. Participants saw themselves as having the power to shape their team and service whilst exercising their authority to make difficult decisions about risk and restrictions.

Conclusions

More widespread adoption of the non-medical Responsible Clinician role should not be seen solely as a solution to workforce shortages or lack of opportunities for professional advancement. Consultant nurses and psychologists who take on this role are seising the opportunity to steer service developments more widely, influencing team dynamics and perceptions of accountability.

中文翻译：

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作为专业领导和决策者的责任：与非医学负责临床医生的访谈。

背景

负责任的临床医生是专业人员，主要负责照料和治疗根据1983年《精神健康法》在英格兰和威尔士被拘留的患者。自2007年以来，该角色仅由不到100位护士和心理学家担任。本研究的目的是探索非医学负责临床医生的经验，以加深我们对当代心理保健中专业间动态和专业身份的理解。

方法

一项定性研究，包括对十二位非医学负责临床医生的访谈进行专题分析。

结果

出现了“责任解释”的主要主题，其中有两个子主题：“作为领导的责任”和“作为决策的责任”。承担这个角色的意义超出了特定患者的照顾范围。参与者认为自己有权组建团队和服务，同时行使权力就风险和限制做出艰难的决定。

结论

更加广泛地采用非医学负责的临床医生角色，不应仅视为解决劳动力短缺或缺乏专业晋升机会的解决方案。担任这一角色的顾问护士和心理学家正在抓住机会，更广泛地指导服务的发展，从而影响团队的动力和责任感。