The new Mental Health Act 2007 (Department of Health, 2008) takes New Ways of Working (Royal College of Psychiatrists & National Institute for Mental Health in England, 2005) to a new level. For the first time in history, nurses, psychologists, social workers and occupational therapists may take on the role of responsible clinician (previously responsible medical officer), but will first have to undertake initial training and demonstrate the competencies laid out to be an approved clinician.

Transitional arrangements are in place for current responsible medical officers to become approved clinicians on 3 November 2008, when the provisions of the Act come into force, as long as they have carried out the functions as responsible medical officer in the past 12 months. Therefore, not all Section 12-approved doctors will be automatically approved as approved clinicians and therefore cannot act as responsible clinicians. This leaves trainees applying for their first consultant post and newly appointed consultants who have not acted as responsible medical officers in the past 12 months in a place of uncertainty. Provisions have not been made for these doctors who may be taking over the care of service users who may require a responsible clinician after the 3 November 2008. New appointments could be jeopardised if trusts realise potential candidates will not be able to take over as responsible clinicians after 3 November.

It is unclear whether Section 12-approved doctors first have to undertake the training and demonstrate the competencies as for other professionals seeking approval as approved clinician. It is unclear how long this process would take. Interim responsible clinician arrangements have not been outlined for these doctors and it appears that trainees aspiring to become responsible clinicians have been forgotten. Clarity is urgently required.