26 - Statutory consultees

Statutory consultees

950 The Maudsley® Prescribing Guidelines in Psychiatry CHAPTER 14 If a patient consents to treatment, the RC completes a form T2. If a patient has not given consent or has not got the capacity to consent, a Second Opinion Appointed Doctor (SOAD) is called. The SOAD then completes a form T3. A copy of the forms T2 and T3 should be kept with the patient’s medication chart as recommended in paragraph 25.75 of the Code of Practice.1 Completion of forms T2 and T3 The following should be stated on the forms: ■ ■The name of the drug or the class of drug. ■ ■If the class of drug is stated, the number of drugs allowed at any one time. ■ ■The route of administration. ■ ■The maximum dosage with reference to BNF guidance. For example: Antipsychotic,second generation 1 oral within B ( ) × NF maximum dose limits. For a patient who has capacity and is consenting to treatment and is only willing to take a particular drug, it is appropriate for the RC to write the name of the drug instead of the name of the class of drug on the T2. For example: Olanzapine tablets only(oral)within BNF maximum dose limits. Psychotropics not found in the BNF may be written on a T2 or T3  with their indication. For example: Melperone tablets oral up to a maximum of 25mg dai ( )

ly for the treatment of schizophrenia.

Non-­psychotropics used for the treatment of mental disorder should be included on the T2 and T3, for example omega-­3 fatty acids (fish oils) in schizophrenia. Antimuscarinics used to treat hypersalivation and the extrapyramidal side effects of antipsychotics should be included too. Arranging and preparing for SOAD visits The Code of Practice 25.51 states: ‘Clinicians should consider seeking a review by a specialist mental health pharmacist before seeking a SOAD certificate, particularly if the patient’s medication regime is complex or unusual.’ Statutory consultees The SOAD should consult with two people before issuing a T3. One must be a nurse. The other must not be a nurse or a doctor. Both must have been involved with the patient’s treatment. These two people are known as statutory consultees. Mental health pharmacists can perform this role where they have been involved in any recent review of a patient’s medication.