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Dear colleague,
During the COVID-19 pandemic, CQC reduced visits to services to minimise risk to patients, staff and the public. As part of this we introduced an interim methodology for Mental Health Act Second Opinion Appointed Doctors (SOADs) to ensure the statutory safeguard of an independent second opinion could continue.
This approach would not have worked if providers had not been willing to work with us and SOADs. We are grateful for this; please convey our thanks to the relevant people within your organisation.
We are currently preparing for the return to SOAD site visiting, where all parties agree that this is safe, feasible and the most appropriate option for patients. We will work together with you in the coming months so that this is done carefully and effectively.
As part of our ongoing approach, based on how this has worked and some of the challenges and delays reported by providers and SOADs, we are asking for your continued support in:
1. Making sure the clinical background information is sent at the same time as the second opinion request.
This will be our new process irrespective of whether the second opinion is carried out remotely or by a direct visit.
This should continue to be in the form of an already prepared report e.g.:
- a tribunal or managers’ report;
- a recent admission summary; or
- care plan documentation
If this is not in that report; please also send a summary highlighting any key issues relating to the patient’s physical health parameters, risk management, or other matters which a reasonable clinician would regard as important factors in the continuing care and treatment of the patient.
This is essential as SOADs consistently report being unable to access and navigate the various clinical record systems when visiting. Providing this information at the outset is our best way of ensuring SOADs will have the minimum amount of information needed to begin their second opinion and reach their decision while avoiding additional pressure on your services and teams during the activity. Without this information we may not be able to accept and act upon a second opinion request.
2. Fully and accurately completing the SOAD request form so we can act upon the second opinion request.
The most frequent challenges and delays have been reported with:
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Statutory consultees: they must be registered professionals and the profession (as opposed to their job title or role) of the nominated persons must be included. This provides assurance that appropriate people have been identified and prepared so the SOAD can carry out their second opinion.
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Contact detail: mobile numbers or direct lines for those identified must be provided. This helps the SOAD to quickly communicate with the right people to progress the second opinion and make their decision. Potential consultees must be aware that SOADs will need to contact them and are asked to respond as quickly as possible to avoid delays for patients and services.
If you have any questions about this letter or wish to make any suggestions, please email: soadenquiries@cqc.org.uk and you can find more information on our website.
Yours sincerely,
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Jemima Burnage,
Interim Deputy Chief Inspector of Hospitals (Mental Health)
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Simon Wood,
Principle SOAD
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