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Approved Clinicians and Responsible Clinicians (AC/RC)


An approved clinician is a mental health professional approved by the secretary of state or a person or body exercising the approval function of the secretary of state. Some decisions under the Mental Health Act can only be taken by people who are approved clinicians. All responsible clinicians must be approved clinicians.

An responsible clinician is the approved clinician with overall responsibility for the case. Certain decisions (such as renewing a patient’s detention or placing a patient on a community treatment order) can only be taken by the responsible clinician.

The 2007 amendments to the Mental Health Act 1983 introduced the roles of approved clinician and responsible clinician, enabling mental health professionals other than psychiatrists to carry out duties previously performed by psychiatrists. The introduction of these roles was intended to deliver enhanced quality of care while also ensuring the best use of our skilled and professionally diverse workforce. It is therefore important to ensure the approved clinician is the clinician with the right set of skills to address the patient’s main treatment needs. 

Implementation Guide for wider workforce

The Multi-Professional Approved/Responsible Clinicians Implementation Guide ensures we make the best use of our skilled and professionally diverse workforce. This role allows patients to benefit from the unique perspectives of nurses, social workers, occupational therapists and psychologists.

This guidance has been developed using an expert advisory group (consisting of approved clinicians from the four eligible professions, representatives of mental health trusts across England and professional bodies). A key driver for this work is providing an opportunity to keep senior clinicians in clinical practice and providing direct patient care.

Pilot scheme for SAS Doctors in Psychiatry

HEE is providing mental health professionals who care for patients subject to detention under the Mental Health Act with access to the right education and support in practice. SAS doctors in psychiatry are identified as a part of this workforce who may benefit from educational opportunities in this field to enable them to become approved clinicians. 

SAS doctors are speciality and staff grade doctors (permanent medical staff with at least four years of postgraduate training, two of which are in specialist mental health services). SAS doctors are a diverse group with a wide range of skills and experience. They are an essential part of the medical workforce, and appear in all specialities, including mental health. However, because SAS doctors are not consultants or on a training programme, they sometimes aren’t able to access specialist educational experiences.

Like their nursing, occupational therapy, psychological and social work professional colleagues, SAS doctors in psychiatry can now access an additional NHS-funded learning programme to facilitate their preparations to be an AC/RC. This 24-month pilot programme will be available across England to 43 SAS doctors in psychiatry in 2022/23. The programme will ensure they have protected time for learning and access to an NHS-funded mental health law course. 

For further information, view the SAS Doctor offer presentation pack.

Application process for 2022/23 training programme

Applications for the 2022/23 training programme are now closed. Those who have applied can expect to have a response from HEE by the end of December 2023.