Discuss the relationship between accountability, risk management and user-centered care

For the purpose of this TMA, I intend to look at how the use of risk management may assist and hinder practitioners accountability within the community mental health team I work in, to explore how risk management assists and hinders the relationship between social workers, employers and service users. Within the CMHT risk management is based upon guidance in Clinical Governance which states â€Å"Anticipate and prevent potential problems to learn from critical incidents and complaints and to provide systems to help clinical staff to reflect and develop their practice.† (RCN, 1998 Book 1, Chapter 9, p.3). Risk assessments within the team are seen as positive tools that enable good communication between the social worker and patient. The assessment provides a basis from which a plan can be formulated to protect the patient from risk but also to extend the barriers of risk in a planned way, enabling the patient to explore and develop new coping strategies empowering them to cope with their mental illness. In these situations there is a balance to be drawn between patient's safety and autonomy. There is however another side to the risk management processes in that practitioner's feel â€Å"You've got to watch your step and cover your back! Document everything! Make sure you follow the guidelines and you keep the patient's safe! That's the bottom line – you've got to be safe. (L.Finlay, personal communication, 12 March 1999 Book 1, Chapter 9, p.187). It is this fear of punitive action that dissuades practitioners from exposing service users to avoidable risks, and risk assessments are viewed as documents providing good evidence of assessments to be accessed if ever there were questions about the care of the patient. The British Association of Social Workers gives guidelines for social workers accountability. For the purpose of this TMA accountability can be defined as â€Å"to be in a position to give an explanation for one's actions – with reasons and justifications.†