Dr. Amanda Burke:

This is a very particular situation and it is regrettable what happened here. I want to reassure people that in the vast majority of teams there is robust governance around prescription of medication. It is not arbitrary whether somebody can go to supervision or not. In fact, if somebody is on a training scheme, he or she will not be signed off as a competent doctor unless there is documentary evidence of weekly supervision from a consultant colleague.

Standard practice would be that an non-consultant hospital doctor would only prescribe under the supervision of a consultant and in consultation with a multidisciplinary team and that all cases would be discussed at multidisciplinary team. That gives an additional check in that you have other professionals discussing whether or not medication is appropriate.

To reassure people at home, medication is not prescribed lightly. It is prescribed in line with the evidence base and we look at all other options before we prescribe medication. This is a particular case. I am confident that in the vast majority of teams this is robust and it is done under a specialist's supervision.

We have robust cross-cover arrangements in some areas. In my own area, we have to do a cross-cover arrangement where we were unable to get a consultant but supervision is done on a weekly basis, both face to face and using e-mental health solutions.

As Ms O'Connor said, we may need to look at this across the areas. It is not popular because people feel as if their service is being denuded but actually what we are doing is providing a safer service under consultant specialist supervision.