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The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act (2007), can enable clinical leadership in mental health settings.

A questionnaire was completed by clinical psychology and mental health nursing practitioners in a mental health trust in the UK working towards or having gained approved clinician (AC) status, identifying barriers to implementation of the roles and enablers. Qualitative interview data were also gathered with psychiatrists, clinical psychologist and Mental Health Nurse ACs (three in each group).

There are a number of barriers and enablers of distributed leadership promoted by the MPAC role. Themes identified focused on enabling person-centred care, clinical leadership and culture change more broadly within mental health care. The AC role is supporting clinical leadership by a range of professionals, promoting patient choice by enabling access to clinicians with the appropriate skills to meet needs. Clinical leadership roles are promoting links between organisational priorities, teams and patient care, fostering distributed leadership in practice.

This project reflects the views of a limited number of practitioners within one organisation which limits generalisabilty.

Organisations need clear strategies linked to workforce development and implementation of the roles to capitalise on their potential to support clinical leadership and person-centred care.

This study provides initial qualitative data on potential benefits and challenges of implementing the role.

The new Mental Health Act 2007 substantially amends the Mental Health Act 1983. In this article, some of the most important changes are highlighted, including changes to the definition of mental disorder, the new professional roles of approved mental health practitioner and responsible clinician, and the new powers for Supervised Community Treatment. The likely impact of these changes for people with learning disability and professionals working with them is discussed.

The purpose of this paper is to review policy or guidance on the implementation of Section 5(4) written by NHS mental health trusts in England and health boards in Wales.

A Freedom of Information request was submitted to all trusts in England (n=57) and health boards in Wales (n=7) asking them to provide a copy of any policy or guidance on the implementation of Section 5(4). Documents were analysed using content analysis. Specific attention was given to any deviations from the national Mental Health Act Codes of Practice.

In total, 41 (67.2 per cent) organisations had a policy on the implementation of Section 5(4). There was a high level of consistency between local guidance and the Mental Health Act Codes of Practice. There were however; different interpretations of the guidance and errors that could lead to misuse of the section. Some policies contained useful guidance that could be adopted by future versions of the national Codes of Practice.

The research has demonstrated the value of examining the relationship between national and local guidance. Further research should be undertaken on the frequency and reasons for any reuse of the section.

Greater attention should be given to considering the necessity of local policy, given the existence of national Codes of Practice.

This is the only research examining the policy framework for the implementation of Section 5(4).

The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and treatment generally not amounting to a deprivation of their liberty (although such could be authorised under its powers by the new Court of Protection). From a planned date of April 2009, the MCA is to be enlarged by the provisions of the Mental Health Act 2007 (MHA 2007) to encompass deprivation of liberty, with the addition of a new framework of Deprivation of Liberty Safeguards (DOLS). The MHA 2007 also revised significant aspects of the Mental Health Act 1983 (MHA), which were implemented in November 2008. The interface between the MCA, as amended to include DOLS, and the revised MHA is complex and potentially ambiguous. This paper describes in detail some issues that may arise at the interface of the two acts, and seeks to inform professionals involved in the use of these legal frameworks of the resulting complexity.

Major changes are taking place in the law for those working in the mental health field. This article looks at the impact of the Mental Capacity Act (2005) (most of which was implemented in October 2007) and the Mental Health Act (2007) (the main provisions of which came into effect in October 2008). Key elements of each of these two acts will be covered. The ‘Bournewood Safeguards’ inserted into the Mental Capacity Act (2005) by the Mental Health Act (2007) will also be described.

Institutional theorists treat law and regulations as external factors that is part of the organization’s environment. While institutional theory has been criticized for its inability to recognize the role of agents and to theorize agency, the growing literature on institutional work and institutional entrepreneurship, partially informed by and co-produced with practice theory, advances a more dynamic view of processes of institutionalization. In order to cope with legal and regulatory frameworks, constituting the legal environment of the organization, there are evidence of organizational responses in the form of bargaining, political negotiations, and decoupling of organizational units and processes. The purpose of this paper is to report how legal and regulatory frameworks both shape clinical practices while at the same time they are also informed by the activities and interests of professional communities and commercial clinics.

This paper reports an empirical study of the Swedish-assisted conception industry and is based on a case study methodology including the use of interviews and formal documents and reports issues by governmental agencies.

The empirical material demonstrates how scientists in reproductive medicine and clinicians regard the legal and regulatory framework as what ensures and reinforces the quality of the therapies. At the same time, they actively engage to modify the legal and regulatory framework in the case when they believe it would benefit the patients. The data reported presents one successful case of how PGD/PGS can be used to develop the efficacy of the therapy, and one unsuccessful case of regulatory change in the case of patient interest groups advocating a legalization of commercial gestational surrogacy. In the former case, scientific know-how and medicinal benefits served to “push” the new clinical practice, while in the latter case, the “demand-pull” of patient interest groups fails to get recognition in regulatory and policy-making quarters.

The study contributes to the literature on agency in institutional theory (e.g. the emerging literature on institutional work) by emphasizing how legal and regulatory frameworks are in a constant process of being modified and negotiated in the face of novel technoscientific practices and social demands. More specifically, this process include many scientific, technological, economic, political and social relations and resources, making the legal environment of organizations what is the outcome from joint negotiations and agreements across organizational and professional boundaries.

An enormous amount of change has occurred in the last six years for the mental health system in England and the workforce within it. We have seen the 10‐year National Service Framework for Mental Health (Department of Health, 1999) gradually make its impact felt in the form, in particular, of new community mental health teams and structures for delivering care in the community. We have also, most recently, experienced the passing of the Mental Health Act 2007 (HM Government, 2007), after many turbulent years of controversy and argument, extending to nurses and non‐medical practitioners who have been given statutory powers to act as approved mental health practitioners and approved clinicians.Alongside these important developments has been a gradual revolution in traditional ways of working, in the form of the New Ways of Working initiative. This article considers the impact of New Ways of Working on mental health nursing ‐ the single largest professional group within the mental health workforce ‐ and the continuing implications for the profession. The development of nurse prescribing is used as an illustration of the challenges and opportunities that have commonly arisen when new roles and skill sets have been introduced in mental health settings.

The modernisation of mental health legislation took time in England and Wales, and resulted in an amendment to the law through the Mental Health Act 2007. The changes under way are extensive, and will affect the mental health workforce. This article outlines some of the changes and new roles, and argues that workforce changes are important features of the new legislation that confirm policy goals of integrated working and practice.

The Mental Health Act 2007 (HM Government, 2007) replaced the approved social worker (ASW) with the approved mental health professional (AMHP), opening up the role to some nonsocial work professions. AMHP training, however, remains linked to the General Social Care Council (GSCC) post‐qualifying social work framework, with AMHP training now incorporated into the higher specialist social work award, set at masters level (level M) rather than first degree (level H) (General Social Care Council, 2007).Analysis of data from the first year of AMHP training at Bournemouth University illustrates some of the challenges that have arisen particularly in relation to the masters level study. Evaluation of the first year highlights some important areas for future consideration in terms of student selection, pre‐course preparation and student support. The data also demonstrate that there have only been a very small number of non social workers enrolling on programmes at the present time. This article will explore some of the possible reasons behind this.