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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.

A 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. 

A New National Curriculum for training Mental Health Professionals seeking ‘Approved Clinician’ Status

NHS England’s Directorate for Workforce, Training and Education (WT&E), formerly Health Education England (HEE), has published a new national Curriculum for training programmes aimed at developing relevant competencies for mental health professionals intending to apply for ‘Approved Clinician’ status via ‘the portfolio route’.

A Responsible Clinician (RC), as defined by the Mental Health Act 1983 has overall responsibility for a patient’s case where the patient is liable to be detained for admission for assessment or treatment, is a community patient or is subject to guardianship under the Act. In order to have RC responsibilities, a mental health professional must have Approved Clinician (AC) status as defined by the Act.

AC status and RC responsibilities via the portfolio route are currently available to:

  • doctors who are not on the specialist register for psychiatry
  • mental health and learning disability nurses,
  • psychologists,
  • occupational therapists and
  • social workers. 

Mental health professionals who want to gain AC status via the portfolio route apply to one of four regional Department of Health and Social Care (DHSC) Approval Panels and provide a portfolio of evidence to the Approval Panel demonstrating that they meet the required competencies. Individuals applying for AC status via the portfolio route will have differing learning needs and development opportunities to enable them to evidence the required competencies. Some will be able to access support from their employer, relevant regional organisations or their professional bodies. Some Higher Education Institutions (HEIs) have developed academic courses, which are not mandatory, but do provide training that can sit alongside employer support to prepare an individual for applying for AC status. HEIs are expected to map their course content, learning objectives and assessments to the relevant AC competencies. 

This new curriculum will support national standardisation of academic training for mental health professionals seeking to apply for AC status. It also emphasises the important role of equality, diversity and inclusion in AC training and the role of Experts by Experience in the design and delivery of these programmes.

The curriculum will also set out the criteria that will directly inform a national NHSE WT&E procurement for a standardised training course, delivered by HEIs from Autumn 2024, to support the preparation of individuals to undertake AC responsibilities and develop the required AC portfolio in order to gain AC status.

Finally, the curriculum signposts to the wider system support needed, primarily from the trainee AC’s employer. The Guidance for seeking Approved Clinician status via the portfolio route (DHSC, October 2017) and Multi-Professional Approved/Responsible Clinicians Implementation Guide provide further important information.

Read the full National Curriculum to Develop Relevant Competencies for Professionals Intending to Apply for ‘Approved Clinician’ Status via the Portfolio Route

NHSE 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 psychiatrists are one part of this workforce who may benefit from accessing development opportunities that enable them to become Approved Clinicians.  

SAS psychiatrists are Speciality and Specialist doctors (permanent medical staff with at least four years of postgraduate training, two of which are in specialist mental health services), a diverse group with a wide range of skills and experience. They form a large and essential part of the medical workforce, working across in all secondary care medical specialities, including in mental health. However, because SAS doctors are neither consultants nor part of a formal training programme, they often cannot access specialist education and development available to other categories of medical or healthcare colleagues.  

NHSE funds education and development for mental health nursing, occupational therapy, psychological and social work professional colleagues who wish to become Approved Clinicians.  During 2023/2024, SAS psychiatrists will also have access to this support via a 24-months pilot programme,  available across England to approximately 31 SAS psychiatrists, with places allocated by regions. The programme will ensure they have protected time for learning and access to an NHS-funded mental health law course.  

Round two of applications are now open as of 4 December 2023 and will close midnight 18 December 2023. 

For further information, view the SAS Doctor Approved Clinician Training Applicant Information Pack here

To submit your application form, please follow this link: SAS Doctor Approved Clinician Training pilot; Application Form 2023 

To complete the Medical Director approval form, please follow this link: SAS Doctor Approved Clinician Training; Medical Director Approval Form 2023

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.