Quality Standards in Modern Psychiatric Practice

by TheEditor

Categories: Investigative, Mental Health

Building upon the insights shared in the previous blog, “Challenges of the Modern Psychiatric Consultation,” it is essential to explore specific quality standards that guide psychiatric practice today. These standards, established by various regulatory bodies and professional organisations, are designed to ensure that psychiatrists provide safe, effective, and compassionate care to their patients. Understanding and adhering to these standards not only enhances patient outcomes but also helps practitioners navigate the complex and demanding landscape of modern psychiatry.

In the evolving field of mental health care, quality standards encompass a wide range of practices, from prescribing medications and protecting patient rights, to adhering to new legal precedents, and ensuring continuous professional development. This blog will explore these standards in detail, providing a comprehensive overview for psychiatrists seeking to meet the high expectations set by entities like the General Medical Council (GMC), the Care Quality Commission (CQC), the National Institute for Health and Care Excellence (NICE), and the Royal College of Psychiatrists. By adhering to these guidelines, psychiatrists can strive to overcome the challenges highlighted previously and deliver the highest quality of care to their patients.

Patients, their loved ones and advocates can use these quality standards as a valuable framework to understand the level of care they should expect from psychiatric services. By familiarising themselves with guidelines and standards from organisations like the General Medical Council (GMC), the National Institute for Health and Care Excellence (NICE), and the Royal College of Psychiatrists, they can better advocate for comprehensive, evidence-based treatment. These standards empower patients and their families to ask informed questions about their care, ensure their rights are protected, and actively participate in decision-making processes. Additionally, awareness of these standards can help identify and address any gaps in care, facilitating a collaborative approach to achieving the best possible outcomes in mental health treatment.

The list of standards can be accessed by clicking on each tab on the left. [The list may be updated at any time]

General Medical Council (GMC) Standards:

Good medical practice: This is a framework document that stands on its own but in many parts it is linked to other standards in the list below. It sets out the principles of good practice which all doctors must be familiar with. It is the foundation on which the rest of our guidance is built.

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Confidentiality: good practice in handling patient information: Know when you can make disclosures and when to respect confidentiality. This guidance will help you manage and protect patient information in practice.

Confidentiality: disclosing information for education and training purposes: What to share with medical students, doctors in training and others. This also covers writing case studies and training records.

Confidentiality: disclosing information for employment, insurance and similar purposes: Understand what to include in a report and know what you can and can’t leave out. This also covers the principle of ‘no surprises’ for patients.

Confidentiality: disclosing information about serious communicable diseases: How to balance privacy with keeping others safe. This guidance covers yours, and your colleagues’ health, as well as your patients’.

Confidentiality: patients’ fitness to drive and reporting concerns to the DVLA or DVA: Know what to discuss with patients whose health makes them unfit to drive. Understand when it is their responsibility to report this and when it is yours.

Confidentiality: reporting gunshot and knife wounds: What to tell the police and when to share information without your patient’s consent.

Confidentiality: responding to criticism in the media: Understand what you can and can’t say in response to others’ comments. This covers criticism of you personally and your practice or the health service.

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Maintaining personal and professional boundaries: Understand how to keep a suitable doctor patient relationship.

Using social media as a medical professional: Our guidance on social media, apps and other online tools. This covers professional boundaries, confidentiality and respect for colleagues.

Intimate examinations and chaperones: Examinations can be embarrassing or distressing for patients. This guidance covers examinations of a patient’s intimate areas. It can also apply to any examination where it is necessary to touch or be close to the patient.

Ending your professional relationship with a patient: In rare circumstances the trust between you and a patient may break down. This guidance covers when you should and shouldn’t end the relationship and what to do. This includes closing or relocating your practice.

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Protecting children and young people: the responsibilities of all doctors: How to identify and protect children and young people who are at risk. This includes if they are living with their families or living away from home.

0–18 years: Understand how to provide care to young patients. Including young people who have the capacity to consent. This also covers assessing best interests and discussing sexual activity.

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Decision making and consent: Shared decision making and consent are fundamental to good medical practice. This guidance explains that the exchange of information between doctor and patient is essential to good decision making.

Making and using visual and audio recordings of patients: Know what you can record and when consent is needed. This covers making covert recordings and recording telephone calls. Understand how to store and delete recordings.

Consent to research: Understand how the principles of decision making and seeking consent apply to research.

Good practice in research: Research involving people can be key in improving the care and health of the population as a whole. This guidance will help you to protect patients and maintain public confidence.

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Good practice in prescribing and managing medicines and devices: This guidance gives best practice about prescribing to patients. It includes remote prescribing, unlicensed medicines and shared care.

Guidance for doctors who offer cosmetic interventions: This covers any procedure or treatment aiming to change the way someone looks. Including surgical and non-surgical procedures. These may be invasive or non-invasive.

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Treatment and care towards the end of life: good practice in decision making: Understand decision-making for patients of all ages at the end of their lives. The guidance also covers clinically assisted hydration and nutrition and CPR.

When a patient seeks advice or information about assistance to die: Responding to patients’ who want advice about assisted dying can be difficult. Recognise how you can respect and listen to patients without conflict with the law.

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Leadership and management for all doctors: Some doctors are formal leaders, accountable for the performance of a team or teams. But all doctors are responsible for identifying problems and solving them. This guidance covers what we mean by shared leadership.

Raising and acting on concerns about patient safety: If you believe patient care and/or safety is at risk, it is important you know how to take the appropriate action.

Delegation and referral: You will often work with colleagues to provide care for your patients. Know where your responsibility stops and where it continues.

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Identifying and managing conflicts of interest: Understand how to manage potential conflicts of interest and mitigating the impact of them when you can’t avoid them.

Personal beliefs and medical practice: Peoples’ beliefs and cultural practices can be different from each other’s . Know how to treat all patients with respect, whatever their choices or beliefs.

Providing witness statements or expert evidence as part of legal proceedings: You may be asked to give evidence to courts and tribunals. Our guidance applies when you appear in a professional or non-professional capacity.

Reporting criminal and regulatory proceedings: What you do and don’t need to tell us when you’re subject to criminal or civil proceedings anywhere in the world.

Duty of candour: Understand your duty to be open and honest with patients, or those close to them, if something goes wrong. This covers when to apologise to patients and sharing mistakes with colleagues.

Raising and acting on concerns about patient safety: If you believe patient care and/or safety is at risk, it is important you know how to take the appropriate action.

Nice Quality StandardsNice Guidance
QS8 – Depression in Adults: Outlines priority areas for quality improvement in the care of adults with depression.NG222- Depression in Adults (June 2022): Offers recommendations on the identification and management of depression in adults, including both pharmacological and psychological interventions.
QS14 – Service User Experience in Adult Mental Health Services: Provides a framework for delivering high-quality, patient-centred care in adult mental health services.CG178 – Psychosis and Schizophrenia in Adults: Provides recommendations on the treatment and management of psychosis and schizophrenia in adults.
QS34 – Self-Harm: Offers quality standards for the care and management of people who self-harm.CG185 – Bipolar Disorder: Assessment and Management: Covers the diagnosis and management of bipolar disorder in children, young people, and adults.
QS80 – Psychosis and Schizophrenia in Adults (2015): Sets out the quality standards for the care of adults with psychosis and schizophrenia.CG192 – Antenatal and Postnatal Mental Health(Feb 2020): Focuses on the clinical management and service guidance for mental health conditions during pregnancy and the postnatal period.
QS102 – Bipolar Disorder in Adults (2023): Focuses on the quality standards for the diagnosis and management of bipolar disorder in adults.CG113 – Generalised Anxiety Disorder and Panic Disorder in Adults: Covers the management of generalised anxiety disorder (GAD) and panic disorder in adults in primary, secondary, and community care.
QS115 – Antenatal and Postnatal Mental Health: Provides quality standards for the care of women with mental health conditions during pregnancy and the postnatal period.CG136 – Service User Experience in Adult Mental Health: Provides guidance on improving the experience of care for people using adult NHS mental health services.
QS53 – Anxiety Disorders: Sets out the quality standards for the care and treatment of people with anxiety disorders.CG78 – Treatment of personality disorders
  1. Montgomery v Lanarkshire Health Board (2015): This legal precedent emphasises the importance of informed consent and the necessity for doctors to disclose all material risks to patients.
  2. General Medical Council (GMC) Standards: A frame work document to 34 other standsards which covers all aspects of medical professionalism and ethical practice. GMC standards create duties of care.
  3. Duty of Candour: Legal obligation for doctors to be open and honest with patients when things go wrong, including providing a truthful account of what happened and offering an apology.
  4. Equality Act 2010: Ensuring that all patients receive equal treatment and that there is no discrimination based on protected characteristics such as age, gender, race, disability, etc.
  5. Safeguarding Vulnerable Adults and Children: Adhering to safeguarding protocols to protect vulnerable individuals from abuse or neglect.
  6. Mental Capacity Act 2015

CR180 – Vulnerable Patients, Safe Doctors: Good Practice in our Clinical Relationships (2007)

CR193 – Responsibilities of psychiatrists who provide expert evidence to courts and tribunals (2023)

CR148 – Good Psychiatric Practice: Relationships with Pharmaceutical and Other Commercial Organisations (2017)

CR154 – Good Psychiatric Practice 2019 (3rd Edition):

CR222 – Standards for the Use of Section 136 of the Mental Health Act 1983 (England and Wales) (2011): Provides guidance on the use of Section 136 for detaining individuals in need of immediate care.

CR209 – Good Psychiatric Practice: Confidentiality and Information Sharing (2006)

CR205 – Sexual Boundary Issues in Psychiatric Settings(2017)

OP98 – Continuing Professional Development (2015)

Quality Network for Forensic Mental Health Services (QNFMHS): Standards, publications and resources

Memory Services National Accreditation Programme (MSNAP): Standards for Memory Services: Guidelines for the care and management of patients with memory problems, including dementia.

Standards for Psychiatric Intensive Care (2022)

Standards for Acute Inpatient Services for Working Age Adults, 8th Edition (2022)

Standards for Older People’s Mental Health Service Editors: Hannah Bolger and Eleanor Parker (2017)

Standards for Community Mental Health Services (2019): Outlines the standards for community-based mental health services.

Mental Health Act Code of Practice 2015.

Reference Guide to the Mental Health Act 1983.

Mental Capacity Act Code of Practice

Any other standards found may go into this space.


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