Review of the role of MPACs
Following concerns formally raised by the Psychiatric Resident Doctors’ Committee (PRDC) regarding MPACs* (Multi-Professional Approved Clinicians), the Royal College of Psychiatrists has acknowledged the importance and sensitivity of the issues presented.
The PRDC’s submission recognised the historical context underpinning the introduction of these roles through the 2007 amendments to the Mental Health Act (1983), which aimed to address workforce shortages and strengthen multidisciplinary care. However, the Committee highlighted that significant changes in psychiatric recruitment, workforce composition, and service delivery over recent years warrant renewed scrutiny of how these roles are now functioning in practice.
In particular, concerns were raised regarding:
- The adequacy, consistency, and governance of training and qualification standards for these roles
- The potential impact on consultant psychiatrist roles, responsibilities and medical accountability
- Implications for resident doctor supervision, particularly where prescribing occurs under non-medical oversight
- Medico-legal ambiguity and associated professional risk to resident doctors
- The possible erosion of structured consultant-led training, as referenced in the Silver Guide
- Broader patient safety considerations, especially for individuals with severe mental illness and complex physical health comorbidities
In response to this submission, the College agreed that these concerns merit structured and balanced review. As a result, a Task and Finish (T&F) Group has been established to examine the issues in detail.
*It is acknowledged that the term Non-Medical Approved Clinicians (NMACs) and Non-Medical Responsible Clinicians (NMRCs) are also in use to refer to MPACs. NHSE, Approval Panels and Employers use the term MPACs. Hence, for the purpose of this group, we are using the term MPAC to enable consistent communication with wider stakeholders.
Frequently asked questions (FAQs)
The Multi-Professional Approved/Responsible Clinician (MPAC) Task and Finish Group has been established to undertake a review and to create guidance on how Multidisciplinary teams, which involve MPACs (Multi Professional Approved Clinicians) can work best in the delivery of good quality safe mental healthcare to patients.
It is acknowledged that the term Non-Medical Approved Clinicians (NMACs) and Non-Medical Responsible Clinicians (NMRCs) are also in use to refer to MPACs. NHSE, Approval Panels and Employers use the term MPACs. Hence, for the purpose of this group we will use the term MPAC to enable consistent communication with wider stake holders.
- To review the role of MPACs and how they can safely contribute to the work of the multi-disciplinary teams (MDT) with their profession specific clinical expertise along with the statutory approval in delivery of Mental Health care.
- To review the scope of practice and limitations of MPACs working in Mental Health to clarify legal/clinical lines of responsibility and supervision
- To review and clarify supervision arrangements for Resident Doctors who work in teams which involves MPACs in RC (Responsible Clinician) Role.
- To review and clarify the position regarding intersection with roles/responsibility of Psychiatrists and other doctors while working with MPACs, particularly regarding safe evidence based prescribing practices and provision of physical health care for patients under their care
- To develop an action plan for the College’s future work regarding MPACs practice, development and sharing of review outcomes with stakeholders.
The group consists of the following members:
- Associate Dean for Advanced Learning: Dr Abdul Raoof (Chair)
- Associate Registrar for Policy: Dr Mayura Deshpande
- Associate Dean for Curriculum: Dr Indira Vinjamuri
- PRDC Chair: Dr Nermeen Ahmed
- PRDC Rep Wales: Dr Kok Keong Leong
- PRDC Rep Northern and Yorkshire: Dr Harry Waterman
- PRDC Rep South West: Dr Jonathan Gibb
- Heads of School rep: Dr Debasis Das
- Dean: Prof Subodh Dave
- Registrar: Prof Owen Bowden Jones
- SAS Committee Chair: Dr Lily Read
- SAS Rep: Dr Mike Groves
- Devolved Nations Representative(Wales): Dr Rahim Safeer
- Divisions Rep: Chair of Chairs Dr Nishanth Babu Mathew
- Medical Directors Representative: Dr Asif Zia
- Other Stakeholders will be invited to join the meetings to share particular experiences and evidence as required
- Administrative support staff.
The RCPsych MPAC Review Task and Finish Group reports to the RCPsych Education and Training Committee and the RCPsych Policy and Public Affairs Committee.
The group shall meet regularly, with meetings scheduled as necessary.
A Task and Finish Group is a time-limited group established for the purpose of conducting an in-depth review of any service, policy or issue that affects an organisation, in this case the College.
Its size is restricted to those who have the responsibility and knowledge to deliver the objective, from within the membership, however, evidence can be gathered through a variety of ways, including (but not limited to):
- written evidence
- oral evidence and interviews with external and internal stakeholders
- discussions with other organisations - partners, experts by experience, other Colleges
- talking to people who are affected by the issue
- research
- seeking public views on the issue.
Once the evidence is gathered, the Task and Finish Group will produce a report outlining details of the review process, evidence gathered, conclusions and any subsequent recommendations.
No. Under the current and 2025 amended frameworks of the Mental Health Act 1983, applications for detention still require medical recommendations from registered medical practitioners (Section 12 approved doctors).
The Royal College of Psychiatrists does not support extending Section 12 approved doctors' functions to non‑medical professionals. The College maintains that these initial assessments and decisions require medical expertise in differentiating, diagnosing and treating mental as well as physical health problems through a bio-psychosocial formulation, as required explicitly in the legislation.
The College prioritises patient safety, clinical robustness, and legal safeguards, and therefore supports maintaining the current medically anchored framework for mental health act assessments.
Contact us
If you would like to contact us regarding this topic, please email us at MPAC@rcpsych.ac.uk