Psychiatric evidence on ward and community care
Independent psychiatric opinion on care given on mental health wards and by crisis, home treatment and community mental health teams, and on the harm that followed, for claimant, defendant and single joint expert instructions. Free initial screening call and fixed fees with no hidden charges.
- NHS Consultant since 2003
- Claimant, defendant and SJE
- Structured for CPR Part 35
Care on the ward and in the community
Many mental health negligence claims turn on where the patient was cared for and what the service did with what it knew. On a ward, the questions are usually about observation, leave, absconding and discharge. In the community, they are about the response to a crisis, the decision not to admit, care coordination and follow-up. Dr Pradhan gives the psychiatric opinion on those decisions and on the harm that followed.
The report sets each decision against the records: what the team knew, the plan it made, whether the plan was carried out, and whether the decision was within the range of reasonable psychiatric practice at the time. Where relevant, it also addresses the patient’s capacity and vulnerability as they bore on decisions about detention and discharge.
Dr Pradhan is approved under section 12(2) of the Mental Health Act as having special experience in the diagnosis or treatment of mental disorder, and is dual-accredited for claimant and defendant work.
Decisions commonly reviewed
Claims about inpatient and community mental health care commonly involve:
- Admission, or a decision not to admit
- Use of mental health legislation, or a decision not to use it
- Observation levels, and how they were carried out
- Leave from the ward, and absconding
- The decision to discharge, and the plan for afterwards
- Crisis and home treatment team assessments
- Care coordination and review of the care plan
- The response to relapse or deterioration
- Transfer between wards, services or areas
- Risk of violence, and how it was managed
- Capacity and vulnerability in detention and discharge
- The psychiatric injury that followed, and its prognosis
Send a short chronology of the care, the allegations and the relevant dates, and Dr Pradhan will say whether the issues fall within her expertise and, if they do, confirm a fixed fee.
Submit an enquiryThe questions in each setting
What the psychiatric evidence has to address depends on where the patient was being cared for when things went wrong.
On the ward
Observation, leave, absconding and the timing of discharge, for detained and voluntary patients.
In a crisis
The crisis or home treatment team’s assessment, the decision not to admit, and the safety plan agreed.
In the community
Care coordination, review of the care plan, and the response to relapse or missed contact.
Between services
Handover between ward, crisis team, community team and GP, and the information passed on at each step.
Detained and voluntary patients
A negligence claim does not depend on whether the patient was detained: the care is judged by the standard accepted as proper by a responsible body of psychiatrists at the time. Detention brings further duties. Where a detained patient presents a real and immediate risk of suicide, the hospital owes an operational duty under Article 2 to do all that can reasonably be expected to prevent it, and the Supreme Court has applied the same duty to a voluntary patient.
The Mental Health Act 1983 applies in England and Wales; Scotland and Northern Ireland have their own mental health legislation. For claims in England and Wales the report is structured for CPR Part 35; reports for Scotland and Northern Ireland are prepared to the requirements of those courts.
The House of Lords held that where a detained psychiatric patient presents a real and immediate risk of suicide, the hospital authorities have an operational duty under Article 2 to do all that can reasonably be expected to prevent it.
Related pages
Ward and community care questions
If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.
Call 0121 752 6065The patient was discharged and deteriorated within days. Is that within scope?
Yes. The report examines the decision to discharge, the plan for follow-up and whether it was carried out, and whether a different decision would probably have prevented the deterioration.
The crisis team decided not to admit. Can that be reviewed?
Yes. The review considers the assessment, the information available, the alternatives considered and the safety plan, judged by the practice of the time.
Does Dr Pradhan comment on mental health nursing?
Where the standard of nursing is in issue, the evidence on it comes from a nursing expert. Dr Pradhan addresses the medical decisions, such as the level of observation set, and the psychiatric consequences.
How long does a report take?
It depends on the volume of records. The timescale is confirmed at the outset, once the records and the allegations have been seen. Condition and prognosis reports are usually ready 1–2 weeks from assessment.
Instruct Dr Pradhan on a ward or community care claim
Send a short chronology of the care, the allegations, the funding route and any limitation or hearing dates.
- Phone0121 752 6065
- Emailinfo@
doctorpradhan.co.uk - Consulting Rooms NationwideAbacus Court, Harborne, Birmingham B17 0HH
Please do not include medical records or a detailed personal history in this form. Dr Pradhan will confirm how to send the papers once the instruction is agreed.
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