The government is set to introduce a national accreditation system for Approved Mental Health Professionals (AMHP) in response to concerns over variability in the quality of practice and approval processes used by councils.
A new national system of registration for AMHPs and overarching standards for services will be introduced by April 2018, if ministers accept the recommendations of a Department of Health and Care Quality Commission review. The process will be overseen by the new social work regulator and professional standards body announced by the government in January.
AMHPs coordinate Mental Health Act assessments. An estimated 95% are social workers by background, although nurses, occupational therapists and psychologists can also train in the role. AMHPs are currently approved and registered by individual local authorities, with each tasked with assessing AMHP competence.
However, the DH and CQC review concluded stronger national oversight was needed after it uncovered wide variation in the way AMHP services were run and the processes councils used to approve staff to take on the role.
Problems too often ‘hidden’
The report also found poor data collection left policymakers with no way of knowing how many AMHPs were practising across the country.
This sparked concerns that councils may not have sufficient AMHPs warranted to meet their duties to provide a 24-hour AMHP service under the Mental Health Act. A lack of mandatory reporting on key indicators meant “significant challenges” facing AMHP services, such as bed shortages, were too often “hidden” from national datasets, the review added.
To remedy the problems, the report recommended to ministers:
- The DH will work with the AMHP leads network to agree national standards for AMHP services, including the process for approving AMHPs. These standards will be implemented from April 2018, with every local authority expected to follow them.
- Local authority compliance with the standards will be audited by a national registration body. This will most likely be the new social work regulator and professional standards body the government has committed to setting up by 2020.
- A new national register of AMHPs will also be introduced by ensuring professional registers mark when a member of staff is accredited as an AMHP. This work will be overseen by the new social work body.
- CQC and DH will work with the Health and Social Care Information Centre to establish a new national dataset on AMHP services and outcomes, to be introduced by April 2020. This could include data on issues with bed availability and other system pressures.
Greater consistency
Steve Chamberlain, chair of the national AMHP leads network, told Community Care he welcomed the report and was pleased the CQC and DH had worked with AMHP leads when carrying out the review.
He said: “The setting of national standards shouldn’t cause huge changes because while every local authority has its own processes, they are not totally dissimilar. But we can see some advantages in greater consistency in that it will simplify the process when AMHPs transfer between authorities.
“The dataset proposal is important. We’ve been considering as a network some sort of dataset for years but it’s impossible to do voluntarily among 152 local authorities. It’s important that data is collected on the system-wide issues AMHPs are dealing with that cause delays to assessments and admissions, such as lack of beds and the availability of section 12 doctors.”
The review also considered whether AMHP services should be directly regulated by the CQC but stopped short of recommending it. Instead the CQC should use its existing powers to carry out a series of focused inspections next year to determine whether regulation of AMHP services would be needed in the future, the report recommended.
The question of how many AMHP are warranted is misguided as some authorities warrant agency to cover gaps e.g out of hours service and some managers are warranted but only do the required amount to meet reapproval criteria. Some have moved on e.g still warranted and do odd duty. The real question is how many AMPS are employed on a full contract basis. The figures will not be a true reflection of what is really going o on the ground
Very much welcome this have been representing these concerns to CQC for some time. We already capture incredible data on MH Act assessments but do it on different forms and it is often only reported at a local level
A word of caution AMPH are more than our statutory functions we are centrally about relationship based Mental health social work and any regulation of the provision of AMPH must recognise this and resist LAs desire to be seen to fulfill ther statutory duty and reduce our profession to only its statutory function. We are already at risk of this with the MCA BIA pressure and the provision of AMPH teams which has seen other MH social workers downgraded in salary and status
There is a real need to involve the profession through a range of representation including BASW to shape and understand what is being inspected
Agree numbers are not a proxy for provision