Exposed pipes

On top of one of the University of Auckland buildings across Grafton Gully are exposed pipes from the cooling and air conditioning systems. I have previously blipped this building which is strangely attractive, despite the brutalist touch of the pipes. The east face of the building has a sort of wave pattern over the windows, making it a standout amongst the generally unexciting buildings in Central Auckland.

Today i led a workshop for the psychiatrists in our DHB; on the roles, responsibilities and appointment of Responsible Clinicians under the Mental Health Act. By the time I started the meeting, various events during the morning had resulted in a rather more radical approach than I had intended.

The law makes the DAMHS responsible for ensuring that every patient has a Responsible Clinician. Simple enough one would think. However, a mechanism for tracking a change of RC (called the Transfer of Care Form) has been given great power by psychiatrists. Claiming that they can't accept the transfer of care until they have seen the patient, psychiatrists decline to accept that they are the RC for (sometimes) a number of weeks.

I pointed out to my colleagues that by not accepting immediate transfer of the role of RC, they essentially make me break the law. having said that I stated that if a signed transfer of care form with the name of the new RC was not received within 48 hours, I would appoint someone.

Lead balloon time. eventually there was a discussion and by the end of it I think they were reassured that this is a legal requirement, that in the early stages their responsibility is limited to ensuring that the team provides the appropriate assessment and treatment, and does not require them to accept clinical responsibility for what others have done. 

It was an interesting meeting in that few if any of them have seen me behave as directively as I did this afternoon. I think it worked out, but the proof of the pudding is in the eating (not the baking, let alone the mixing).