Louis Appleby: 40 more doctors needed to manage CTOs

Mental health tsar Louis Appleby has issued a call for 40 doctors to come forward to help manage the high numbers of community treatment orders issued for patients.

The much higher than expected number of CTOs has led to a shortage in second opinion appointed doctors (SOADs), whose role is to authorise orders after the first 28 days’ of their operation, thereby safeguarding patients’ rights.


They must also certify the appropriateness of medication given to patients on CTOs after the first month.

Addressing today’s annual conference of the NHS Confederation’s Mental Health Network, Appleby said: “We need just 40 more SOADs at the moment. If every organisation here can produce a doctor for second opinions, the problem would be solved.”

The SOAD service, run by care regulator the Care Quality Commission, has been looking for psychiatrists with at least five years’ experience as consultants to join its panel of doctors.

CTOs are issued to patients who have been detained in hospital so conditions can be placed on their treatment in the community. Patients who breach conditions, for instance by not taking their medication, face recall to hospital.

Appleby, the Department of Health’s national director for mental health, also told the conference that the DH would publish a document on taking forward its New Horizons strategy on mental health.

The document will focus on cross-government working to meet the strategy’s goals of improving both mental health services and the mental well-being of the whole population.

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