The standard of psychiatric care
Expert psychiatric evidence on what reasonable psychiatric practice required at the time of the care in question, applied to the facts of your case under the Bolam test and the cases that followed it. Free initial screening call and fixed fees with no hidden charges.
- Section 12(2) approved
- Claimant, defendant and SJE
- NHS Consultant since 2003
What reasonable psychiatric practice required
Whether care was negligent depends on whether a responsible body of psychiatrists would have accepted it as proper at the time. Dr Pradhan has been an NHS Consultant Psychiatrist in Birmingham since 2003, and her reports set out the practice, guidance and policies that applied when the care was given, and whether the care in question met them.
The opinion is given without hindsight. The report considers what the clinicians knew or ought to have known, the information recorded at each decision point and the range of responses that reasonable psychiatrists would have regarded as acceptable, before saying whether the care fell outside it.
Dr Pradhan is section 12(2) approved and dual-accredited for claimant and defendant work, and addresses the psychiatric aspects of the Bolam test and the Bolitho analysis while remaining within her role as an independent expert.
How the standard is judged
The courts judge clinical care by a settled set of principles. The report gives the psychiatric evidence on each one that is relevant to the care in your case.
Bolam
Care is not negligent if it accords with a practice accepted as proper by a responsible body of medical opinion, even if other doctors would have acted differently.
Bolitho
The body of opinion must be capable of withstanding logical analysis. A practice that cannot be justified on reasoned grounds does not protect the clinician.
Montgomery
Patients must be told of material risks and reasonable alternatives. Whether the patient had capacity to take part in that decision can be a psychiatric question.
McCulloch
Which treatment options were reasonable to offer is judged by the professional practice test, before the duty to explain them arises.
What the report covers
Standard of care reports on psychiatric practice commonly address:
- The service involved and the clinicians’ roles and grades
- The guidance, policies and practice in force at the time
- Each decision point in the chronology, and what was known
- Assessment, diagnosis and the recording of mental state
- Risk assessment and management, including observation and leave
- Use of mental health legislation, admission and discharge
- Prescribing and monitoring of psychiatric medication
- Consent, capacity and the information given to the patient
- Communication with GPs, families and other services
- Whether, and where, the care fell outside the range of reasonable practice
- The psychiatric evidence relevant to causation
- Joint statements, supplementary questions and second opinions
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 enquiryGuidelines, local policies and the three jurisdictions
Clinical guidelines, such as NICE guidance, and local policies are evidence of what reasonable practice looked like, but they do not fix the standard on their own. The report explains whether the care followed the guidance in force at the time and, where it did not, whether the departure was one a responsible body of psychiatrists would have accepted.
Northern Ireland applies the same tests as England and Wales. In Scotland, the test from Hunter v Hanley asks whether the doctor failed in a way that no doctor of ordinary skill would have done if acting with ordinary care. For claims in England and Wales the report is structured for CPR Part 35 and Practice Direction 35.
The Supreme Court held that doctors must take reasonable care to make patients aware of material risks and reasonable alternatives. A risk is material if a reasonable person in the patient’s position would be likely to attach significance to it, or if the doctor is or should reasonably be aware that this patient would. Materiality is not judged by the Bolam test.
Related pages
Standard of care questions
If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.
Call 0121 752 6065What is the Bolam test?
The test the courts use to decide whether a doctor was negligent: care is not negligent if it accords with a practice accepted as proper by a responsible body of medical opinion. After Bolitho, that opinion must also have a logical basis.
If the care did not follow NICE guidance, was it negligent?
Not necessarily. Guidance is evidence of reasonable practice, but a departure can be justified. The report explains whether a responsible body of psychiatrists would have accepted it.
Is the standard judged by today’s practice?
No. The care is judged by the practice, guidance and information available at the time it was given.
Can Dr Pradhan comment on nursing or GP care?
She gives opinions on the standard of psychiatric care. The standard of nursing, GP or other care is for an expert in that field; she can address the psychiatric aspects and the consequences.
How long does a standard of care 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.
Instruct Dr Pradhan on the standard of care
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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