MINUTES of a meeting of the EXECUTIVE COMMITTEE and REGIONAL
REPRESENTATIVES of the FACULTY FOR THE PSYCHIATRY OF OLD AGE held on 30TH
November, 2006 at The Royal College of Psychiatrists, 17 Belgrave Square, London SW1X
Dr Dave Anderson (chair; until 1.00 p.m.)
Dr Sarah Black (honorary secretary)
Dr Andrew Tarbuck (finance officer)
Professor Susan Benbow, Dr Peter Connelly, Dr Barbara English, Dr
Jane Garner (delayed), Dr Deborah Girling (delayed), Professor Rob
Howard, Dr Dave Hunsley, Dr Rob Jones, Dr Ola Junaid, Dr Mani
Krishnan, Dr Charles Morris, Dr Peter Neville, Dr Gill Pinner, Dr Anand
Ramakrishnan, Dr Shelagh-Mary Rea, Dr Hugh Series, Dr Jerry
Seymour, Dr Charles Sibisi, Dr Nick Sorby, Dr Alison Stewart, Dr
Jonathan Waite, Dr James Warner and Dr Kathryn Williamson.
Dr Stewart was welcomed on her first attendance as SAS representative
and Dr English on her first attendance as a regional representative.
49.06 APOLOGIES FOR ABSENCE
Received from: Professor Banerjee, Dr Bullock, Dr Connolly, Dr
Davidson, Dr Dhariwal, Dr Hillam, Dr Hogbin, Dr Ivbijaro, Dr Jackson,
Dr Katz, Dr Larkin, Dr McLean, Dr Morrison, Dr O’Cuill, Dr Overshott, Dr
Shanks, Dr Starr, Dr Talbot, Dr Theophanus and Professor Wilson.
50.06 PRESCRIBING OBSERVATORY FOR MENTAL HEALTH-UK (POMH-
Mary-Rose Cavanagh from the College Research and Training Unit was
welcomed to the meeting for discussion of this item.
Ms Cavanagh thanked the committee for the invitation to attend and
explained that she was doing so in place of Maureen McGeorge and
Diana Chan, originally invited to discuss the Quality Insurance Network.
50.06 Ms Cavanagh tabled copies of flyers about the first two topic-based
audits, launched just over a year ago, on 1) prescribing high-does and
combination anti-psychotics on adult acute and psychiatric intensive
care wards and 2) monitoring metabolic side-effects for assertive
outreach team patients prescribed anti-psychotics. The aim was to
provide an opportunity for local audit teams to benchmark local practice
against national examples; the CRU team would welcome feedback.
Dr Anderson referred to the Audit Commission’s survey of dementia
care, which would produce an important report, and also to the NICE
guidance recently published, suggesting that the projects could take
these, and their recommendations, into account. The committee felt
that the CRU could improve the projects, and the choice of future topics,
and it was agreed that a small group, comprising Professor Howard, Dr
Waite, Dr Connelly and Dr Warner, would liaise with the CRU over this;
Gill Gibbins would give Ms Cavanagh their email addresses. In the
meantime, members were asked to email Dr Anderson with suggestions
for other audit topics, how they might be undertaken and what the
benefits would be. Ms Cavanagh was thanked for taking the time to
visit the committee, and for her presentation.
Action: RH, JWaite, PC, JWarner, all members
51.06 POSSIBLE JUDICIAL REVIEW OF NICE
Dr Anderson reported on discussion at the strategy meeting, which had
been helpful in clarifying the current position following extensive media
coverage. The guidance and the new guideline had been published.
NICE had not accepted any of the appeal points; nevertheless, the
guideline was helpful and it was the guideline that members should
follow – the committee and regional representatives were encouraged to
read it thoroughly. Dr Anderson explained that he had attended a
meeting two weeks previously with the ministers of health and of social
care, at which it was made clear that the minister would not intervene
in the NICE/appeal process but that they understood the issues
involved. Dr Anderson had also written to the National Director, making
a similar number of selected points; asking for a response; that
ministers be informed; urging some flexibility (which the guideline had
supported); and requesting a statement that the Department of Health
would not want to see any disinvestment in services as a result of the
guidance. He has not yet received a reply. However, one positive
outcome generally had been that there was now greater understanding
in the public arena of dementia issues, despite the poor outcome of the
51.06 A response from NICE had been expected by 28th November, although
Dr Anderson had not yet seen one. If the response was not
satisfactory, there would be a judicial review, some time early in
December – the first time NICE had been taken to that point. The
judicial review would be lodged by Esai, who had approached the
College as an ‘interested person’. Dr Anderson would be discussing the
situation with the President on 1st December.
The committee considered whether or not there was a need for a faculty
statement on the guideline, for example, on the matter of brain-
scanning for everyone – it was thought that this could cause long waits,
which could affect patients who required scans urgently. Members
undertook to review the guideline and the evidence for its
recommendations and to contact Dr Warner with their ideas; Dr Warner
would lead a group comprising Professor Howard, Dr Jones, Dr Connelly
(copying in Dr Anderson) to consider drafting a statement which would
come before the February executive meeting.
Action: all members, JWarner, RH, RJ, PC, DA, agenda
52.06 CHAIR’S REPORT
52.06.1 Report from CEC
Dr Anderson reported on key issues discussed at the October meeting:
the President had said that faculty education committees should become
faculty education and curriculum committees; the President’s campaign
focused on the image of psychiatry – Dr Black was the faculty’s
representative on the College group leading on this; there would be a
new College scoping group on psychological therapies, led by Dame
Fiona Caldicott – it was agreed that Dr Anderson would put Dr Garner’s
name forward as faculty representative, with Dr Seymour as deputy.
The College had a portfolio for competence evidence. Dr Peter Snowden
had been appointed Associate Registrar for issues related to member
support. The CRU had launched its in-patient accreditation service for
working age adults; each service signing up for this would be charged
52.06.2 Regional representation
The ETSC had confirmed the appointments of Dr English for Northern
Ireland, Dr Theophanous for Mersey and Dr Davidson for London south
52.06.3 First assessments in the community; and chaperonage
Dr Anderson had received a letter from Professor Bob Baldwin about his
Trust’s decision to insist on chaperonage on assessment visits, and
asking whether some flexibility could be required by the faculty. It was
agreed that Trusts could and should make their own decisions in this
regard, just as they should formulate robust guidance for emergency
and high-risk visits for the safety of lone workers and trainees. It was
agreed that Dr Anderson would reply to Professor Baldwin on these
52.06.4 Request for a faculty survey on the practice of psychotherapy by faculty
Dr Anderson had received a request via the Registrar from a trainee for
contact details of faculty members, trainees and SAS doctors in England
and Wales in order to undertake a survey. Following discussion it was
agreed not to support this request, particularly as the survey form was
not deemed to be of a high standard. Dr Anderson would reply to the
Registrar and the trainee accordingly, and mentioning the need for a
local ethics committee to have approved the project prior to application
to the faculty executive; he would also suggest that some executive
members might contact the trainee to suggest ways of improving the
It was agreed that the executive should form a ‘rapid response’ group to
assess and reply to future requests of this kind: this would comprise Dr
Anderson, Dr Pinner, Professor Howard, Dr Morris and Dr Malik (the new
52.06.5 Care Services Improvement Partnership (CSIP)
CSIP now had an outcomes group; Dr Anderson had asked Dr Warner to
be involved with this and he would attend a meeting on 17th January.
Action: JWarner, agenda
CSIP had also begun a young onset dementia work programme, with
which Professor Tony Elliott would be involved; and a group working on
alcohol-related brain damage, with Professor Wilson as faculty
NICE were developing a guidelines group for primary care and
residential care institutions on the promotion of good mental health in
older people; Dr Sorby would be involved and would attend the first
Action: NS, agenda
52.06.7 BGS draft document
A BGS group was producing a paper on ‘hospital discharge of older
people with cognitive impairment to care homes’, led by Dr Duncan
Forsyth. Dr Anderson briefly read out a ‘tick list’ from the BGS and his
own response to that. It was agreed that the faculty would comment on
the paper when it was available and that if the paper were endorsed it
would be given a link via the faculty web page.
52.06.8 Faculty documents
Dr Anderson reported on the intention to obtain College Report numbers
for the two faculty documents ‘Who cares wins’ and ‘Raising the
standard’ – the Registrar would bring this to the next meeting of CEC
with the faculty ‘s request that the two papers and any future faculty
papers be adopted in this way, to ensure that information about them
was widely available.
52.06.9 Dementia leaflet
Dr Jones had undertaken to update this and would bring any text to the
executive for a decision as necessary.
52.06.10 OP 45, ‘The interface between the NHS and the independent sector in
the care of older people with mental illness’, February 1999
It was agreed that Dr Anderson should advise the Registrar that this
was out-of-date and should be withdrawn.
52.06.11 Papers not specifically directed to the faculty for response
Dr Anderson listed examples, such as those on asylum seekers;
detention number of patients on the Reform web site; and the
Department of Health consultation on the care programme approach –
he asked whether the faculty should produce a response on the latter or
whether it should be left to individuals. It was agreed that an executive
group would formulate a response – this would comprise Dr Junaid,
52.06.11 Dr Sorby and Dr Black – and that Dr Ramakrishnan would routinely be
asked to place such documents on the faculty web page. The care
programme approach document would be emailed to all four as soon as
Action: OJ, NS, SBlack, AR
52.06.12 Report for parliamentarians on dementia
Dr Anderson and Dr Jones had had helpful discussion with Dr Gopal,
who had been commissioned to write the above report.
52.06.12 Overcoming barriers to clinical effectiveness
Dr Anderson had replied to a letter from Professor Tooke requesting
areas to look into from this point of view, identifying to him general
hospital mental health and dementia care in general; the College would
put forward three other areas.
52.06.13 Bournewood implementation group
Dr Waite was the faculty representative on this group, with support
from Dr Junaid and Dr Jones; he also served on the BGS group on
advance directives. Dr Waite reported on contradictory documents from
the Department of Health on Bournewood issues and on the very
complex Act, outlining the main points Dr Tony Zigmond was proposing
to make in the College response. The main problem was in knowing
how the Act would be applied, as there was no definition in it of
‘deprivation of liberty’. Dr Connelly reported additionally on the Scottish
perspective, and issues of pre-care; a comprehensive statement from
the Scottish Executive was still awaited.
Dr Waite would identify matters requiring clarification so that Dr
Anderson could write to the College with any faculty concerns. Dr Waite
was thanked for his considerable work on this.
53.06 FINANCE OFFICER’S REPORT
Dr Tarbuck introduced his draft business plan and undertook to review
the matter of travelling and accommodation expenses for academic
invited speakers, whether or not they were College members, as they
had no study leave budget to support their attendances.
53.06.1 Revised budget for the Lifetime Achievement Award; text for College
booklet; wording for certificate
The committee approved Dr Tarbuck’s circulated budget for the award,
which had been submitted to the College finance committee. Once
approved, the award wording would need to be submitted to the
postgraduate education department for inclusion in the College booklet
on prizes, lectures and bursaries, and arrangements put in hand for
the production of a certificate for presentation at the March residential
A number of nominees were put forward for the third award in March
2007, and following a vote, it was decided that Harry Caton should be
the recipient. Dr Anderson would liaise with Dr Bullock about
arrangements for inviting Mr Cayton to the conference and dinner.
53.06.2 SpR and SHO bursaries
Dr Tarbuck’s budgeted proposals were approved. It would be necessary
to ensure that information on the bursaries was circulated in the faculty
mailing with the March programme, and submitted to the postgraduate
education department for inclusion in the College booklet on prizes,
lectures and bursaries.
Action: SWalter, AT
53.06.4 Review of College position on commercial sponsorship
Dr Anderson tabled copies of his own response to the circulated review;
members were encouraged to send their own responses to Dr Anderson
by 15th December so that he could co-ordinate a faculty response.
Action: all members, DA
54.06.1 Central policy co-ordination committee (CPCC)
Dr Junaid would attend the committee’s first meeting shortly.
54.06.1.1 Revision of CR 119 ‘Forgetful but not forgotten’, 2002
Dr Jones would report back on this in February.
Action: RJ, agenda
54.06.1.2 Revision of CR 103 ‘Psychiatric services for black and minority ethnic
Dr Ong would report back on this in due course.
54.06.1.3 Faculty guidance on drugs for dementia with Lewy Bodies
This would be discussed at the February meeting.
54.06.1.4 Social inclusion group
Professor Benbow tabled copies of a brief paper on issues for the
faculty; members were asked to email her with their ideas as soon as
Action: all members
54.06.2 English policy committee (EPC)
Dr Junaid would attend the committee’s firs meeting shortly.
54.06.2.1 Payment by results group
Dr Jones would report back on this in February.
Action: RJ, agenda
In Dr McLean’s absence, no matters were raised.
Dr Williamson reported on the first faculty meeting in Wales; she
planned to draw in more attendance from North Wales for the academic
meeting in February.
54.06.5 Northern Ireland
Dr Rea reported on a meeting of the All-Ireland Institute of Psychiatry
on an ovearview of demential management and also on a group
meeeting with the liaison faculty.
54.06.6 Republic of Ireland
No report had been received from Dr O’Cuill.
54.06.7 Regional representatives report; and list of regional reps on English
Dr Hunsley reported on matters discussed at the morning meeting: new
ways of working and age inclusivity; service problems in East Anglia and
Merseyside; NICE guidance on Acetylcholinesterase inhibitors and
dementia; private prescriptions in NHS clinics; NSF for chronic disease;
new community matrons. In addition, Dr Hunsley and Dr Sorby were
updating the faculty job description for regional representative, with
emphasis on the need to attend the London meetings with the executive
committee and to report back from divisional executive meetings; and
the group also discussed appointment committees for non-consultant,
SAS and academic posts.
54.06.7.1.1 London south east: a nomination and CV would be sought for the
54.06.7.1.2 Wales: a nomination was put forward but rejected as the candidate did
not meet College requirements for at least five years as a consultant
before appointment as regional representative. Dr Williamson would
seek another nomination and CV for the February meeting.
Action: KW, agenda
55.06 TRAINING AND PROFESSIONAL DEVELOPMENT
55.06.1 Education, training and standards committee (ETSC)
Professor Howard would attend the first meeting shortly.
55.06.2 Faculty education and currriculum committee (FECC)
This had met for the first time earlier in the day, in particular reviewing
competences for ST4; Professsor Howard thanked all those who had
attended the meeting and for their contribution at the strategy meeting.
55.06.3 Specialist trainees group
Dr Krishnan reported that the group’s conference would take place in
Manchester, 27th – 28th April.
55.06.9 Faculty of academic psychiatry
Professor Howard reported that he would be speaking at the faculty’s
first one-day meeting in February, in Sheffield.
56.06 ACADEMIC SECRETARY
Sonia Walter was welcomed to the meeting for discussion of this item.
56.06.1.1 Faculty residential meeting: 28th February – 2nd March, 2007, Grand
No programme had yet been received for budgeting and mailing out
(with the information on SHO and SpR bursaries), which was leaving
arrangements very short of time before Christmas, and only two months
thereafter to register delegates. Dr Black would ask Dr Bullock whether
a session of media training had been included in the programme, and a
structured debate and a session on legislation.
Following discussion, it was agreed to accept a one-hour breakfast
satellite symposium from Novartis on the Friday morning, which would
be outside the conference programme, and for which Novartis would
pay £5000. However, the executive regretted that they had not been
able to review the proposed symposium programme before agreeing to
its inclusion, and some members remained unhappy about the principle
of accepting sponsored symposia.
56.06.1.2 College annual meeting: 19th – 22nd June, 2007, Edinburgh International
The faculty programming was finalised and looked very promising.
56.06.1.3 Faculty one-day meeting: 26th or 28th September, 2007 (date, venue,
possible joint meeting with TSIG or general hospital issues and multi-
Dr Anderson had written to the Professor Richard Williams with a formal
proposal to present to the Programmes and Meetings Committee for this
new meeting, which would replace the current December one-day
meeting; Dr Ramakrishnan would attend the PMC meeting to support
the faculty’s request. However, it seemed that the meeting would
probably be in late November, as the conference calendar was full for
September. In the meantime it was agreed that Dr Garner would lead a
group to formulate a programme on acute hospital care in liaison with
Age Concern and the Alzheimer Society, along with Professor Benbow
and Dr Ramakrishnan, copying Dr Anderson in. Consideration would be
given to whether the meeting date should tie in with the November
2007 dates for the strategy and executive meetings
Action: AR, JG, agenda
56.06.1.4 Faculty residential meeting: March, 2008, Dublin (joint with IPA)
Professor Benbow undertook to send Dr Anderson email correspondence
on the development of this meeting. It would be necessary to establish
whether the IPA would be organising the meeting and inviting faculty
involvement; comment was made that the IPA frequently made use of
pharmacological sponsorship for their meetings. If the joint meeting did
not go ahead, the committee would consider whether to hold the faculty
meeting in Barcelona.
Action: SBenbow, agenda
56.06.1.5 College annual meeting: Liverpool, 2008
The committee would consider whether to plan some joint programming
with the Transcultural Special Interest Group, and also the learning
56.06.1.6 Faculty one-day meeting: ?November, 2008
This would be discussed further in February.
56.06.1.7 Faculty residential meeting: March, 2009
This would be discussed in February.
57.06 REPORT FROM SAS DOCTORS
Dr Stewart reported that Dr Helen Dougall would serve as deputy
Dr Hillam would be sent relevant information stemming from discussion
at the strategy meeting.
58.06.2 Faculty web page
It had been decided at the strategy meeting to introduce a new web
page as a noticeboard for members to email Dr Ramakrishnan with
news items about what was happening in their area; members were
asked to encourage colleagues about this.
Action: all members
58.06.3 Public education
Members were asked to note the circulated request to become a College
Action: all members
59.06 HONORARY SECRETARY
The minutes of the meeting held on 28th September, 2006 were
approved and signed as a correct record subject to the correction under
item 46.06.1 of the date from 2008 to 2007.
59.06.2 Feedback from strategy meeting on 29th November, 2006
Dr Black reported that the facilitator, Alan Berresford, would be
producing a report on the day and the action plan for 2007 which had
resulted from it. The half-day meeeting had focused on a number of
areas: 1) advancing the role of the old age psychiatrist; 2) promoting
the delivery of high-quality services; 3) collaborating with other bodies;
4) developing the training of old age psychiatrists; 5) improving the
functioning of the executive committee (including helping regional
representatives fit in, and providing induction for new members),
improving its relationship with the rest of the College, and integrating
better with the faculty membership. There would in future be a report
of executive committee work included in the newsletter.
59.06.3 Links to other faculty executive committees
Members holding these roles should provide a report on any matters of
interest or relevance to this faculty for circulation with meeting papers.
Action: executive links
61.06 ANY OTHER BUSINESS
No matters were raised.
62.06 DATES OF 2007 MEETINGS
Please note that the London executive committee meetings will
start over a working lunch and continue into the afternoon
Wednesday, 28th February: p.m. meeting with regional representatives,
Grand Hotel, Eastbourne, followed by dinner at a local restaurant.
Possible meeting of the FEC.
62.06 Thursday, 5th July: a.m. meeting for FEC; working lunch and p.m.
meeting for executive committee and regional representatives
Thursday, 27th September: a.m. meeting for FEC; working lunch and
p.m. meeting for executive committee and regional representatives
?Faculty one-day meeting: November
Wednesday, 21st November: strategy meeting with regional
representatives and facilitator, 15 Belgrave Square, followed by dinner
Thursday, 22nd November: : a.m. meeting for FEC; working lunch and
p.m. meeting for executive committee and regional representatives