14DOES STRUCTURED MENTAL CAPACITY ASSESSMENT TRAINING IMPROVE THE CONFIDENCE AND COMPETENCE OF THE MULTIDISCIPLINARY TEAM?

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Abstract

Introduction: Doctors are usually asked for capacity assessment on older patients if there is a clinical suspicion of the lack of capacity by multi-disciplinary team (MDT). However, Mental Capacity Act (MCA) does not lay down professional roles or require certain qualifications to undertake capacity assessments.

Innovation: MDT training on MCA and the assessment of capacity may be seen as one of the new ways of team working and enhanced multidisciplinary teaching in care of the elderly teams.

We proposed structured MCA teaching over four sessions on the introduction of MCA (consultant psychiatrist), routine case discussion (geriatricians), complex case discussion and finally video consultations (both delivered jointly by specialist speech and language therapist and consultant psychologist). MCA online training is not compulsory at present for most MDT members; therefore, we also encouraged online training in addition to four teaching sessions. MCA teaching was delivered twice weekly over 8 weeks and each session was repeated four times to ensure attendance of all interested MDT members.

Evaluation: The Likert 10-cm scale was used to assess subjective confidence and competence at beginning and end of 8 weeks teaching. Forty MDT members attended, 95% completed pre-teaching evaluation and post-teaching assessment was completed by 75%. The mean confidence levels pre- and post-training were 3.06 ± 2.46 and 4.90 ± 2.55 (P = 0.005) and the mean competence levels pre- and post-training were 2.91 ± 2.10 and 4.67 ± 2.42 (P = 0.01), respectively. There was also an increase from 18 to 50% in the number of people who completed the health board online MCA training.

Conclusion: MCA training has shown significant improvement in both perceived confidence and competence levels in capacity assessments skills among MDT members. Whether improved understanding of the MCA shown by this structured training avoids unnecessary capacity challenges and has impact in preventing delayed hospital discharge due to unanticipated requests for capacity assessment needs further research.

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