Dr Todd Mitchell, Consultant Psychiatrist

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment, provided advice and support, reviewed care and worked with other services to achieve good outcomes.

At our last assessment, we rated this key question as good. At this assessment, the rating remains good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The consultant psychiatrist completed comprehensive mental health assessments with each patient over 2 to 6 sessions after accepting a patient into the service. Assessments considered clinical, psychosocial, mental health and communication needs.

The service also offered pharmacogenetic testing using a cheek swab to provide information about genetic variability that could affect how a person processes medicines. Patients said the consultant psychiatrist took time to understand their individual needs when discussing diagnosis and treatment. Patients felt that their needs were assessed in a person-centred way.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Care records showed that the consultant psychiatrist assessed immediate and ongoing needs and used relevant National Institute for Health and Care Excellence guidance. The service worked with GPs, NHS services and specialists to support physical health assessment and monitoring. For example, we saw records where the consultant psychiatrist had used his clinical judgement and referred an at-risk patient to perinatal services and a specialist team.

Patients could be referred for psychological interventions, including cognitive behavioural therapy and dialectical behaviour therapy. The consultant psychiatrist reviewed side effects and discussed whether patients wished to continue treatment or consider alternatives.

The service worked effectively with external healthcare professionals to deliver coordinated, person-centred care and treatment.

Care records showed communication and referrals involving GPs, psychologists and perinatal psychiatrists. Before prescribing or starting treatment, the consultant psychiatrist sought relevant medical history, test results and information about current medicines. Treatment was not started when essential information was unavailable and safe care could not be assured, and patients were signposted to more appropriate services to ensure safe care.

The service sought consent at each consultation before sharing consultation outcomes and prescribing information with a patient’s GP. Where consent was declined, the consultant psychiatrist discussed the risks and considered whether treatment could safely continue. The service audited compliance with its consent process.

The service supported people to manage their health and wellbeing and maximise their independence.

The consultant psychiatrist promoted self-care and gave personalised advice about anxiety reduction, stress management, sleep hygiene and lifestyle measures. Individual risk factors were discussed and reflected in care plans. People were referred for specialist assessment where appropriate. For example, patients presenting with symptoms consistent with attention deficit hyperactivity disorder were referred to specialist services.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service had audit systems in place so improvements could be made. For example, the consultant psychiatrist had recently reviewed clinical records for evidence of recorded consent, which demonstrated that consent had been documented in 100% of cases. The service also completed audits relating to patients who did not attend appointments.

Patients we spoke with said the treatment they received had positive outcomes on their mental health and overall wellbeing.

Where patients required specialist treatment not provided by the consultant, such as dialectical behaviour therapy, they could be referred to appropriate specialist services.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The consultant psychiatrist understood how to manage consent to care and treatments and gave patients information about this. Records indicated that all patients had provided their consent to treatment and this was clearly recorded.

The service had a consent form for remote consultations that explained the potential benefits and risks of telepsychiatry, the alternatives available, including face-to-face appointments or no treatment, and patients’ rights.

Patients told us they could choose between in-person and virtual appointments, depending on their preferences and circumstances.