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The Scottish ECT Accreditation Network

Scottish Healthcare Audits

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Scottish Electroconvulsive Therapy (ECT) Accreditation Network (SEAN)

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Published: 14 November 2017
Scottish Electroconvulsive Therapy (ECT) Accreditation Network (SEAN)
Publication Summary Download pdf file [51kb]
Full Report (external link)

In 1996 the Scottish Electroconvulsive Therapy (ECT) Accreditation Network (SEAN) started out as a national audit project to answer questions about clinical practice, facilities and staffing, training and efficacy of treatment. The initial audit was paper-based and funded by the Clinical Resource Allocation Group (CRAG). The audit ran for three years and the findings were published in 2000.

Since then SEAN has continued to grow and has developed into a national clinical network, membership of which includes:

  • Consultant Psychiatrists
  • Consultant Anaesthetists
  • Clinical Psychologists
  • ECT Nurses
  • Operating Department Practitioners
  • Recovery Nurses

In 2008 a new multi-disciplinary Steering Group was formed with representation from the Scottish Government and the Mental Welfare Commission for Scotland.

By involving user-led organisations in the audit, SEAN is striving to deliver the 'Patient-Centred' ambition described in the Healthcare Quality Strategy for NHS Scotland. The network has invited input from various user-led organisations to ensure a patient-centred focus as we develop further. A Service Users and Carers Reference Group was established in 2009 and is currently co-chaired by Mr Thomas Byrne (Advancing Community Understanding of Mental and Emotional Needs [ACUMEN]) and Mr Chris White (CJ Mental Health Consultancy). This group is user-led and SEAN meets the cost of meetings and travel expenses for 20 individual places. This group organises the programme for the SEAN Conference with presentations being given by service users and carers, attendance at the conference is free to service users and carers.

A key component of the SEAN audit consistent with the 'Safe' ambition described in the Healthcare Quality Strategy for NHS Scotland is the accreditation of ECT Services in Scotland. The first round of accreditation visits using evidence-based standards developed from current national guidelines has been completed. Every clinic in Scotland has been visited in a two-year cycle by a multi-disciplinary team consisting of the SEAN Clinical Co-ordinator, a Consultant Psychiatrist, an ECT Nurse and a Consultant Anaesthetist, assessed against the standards and awarded a level of accreditation accordingly. The Steering Group reviews these standards annually and feedback from voluntary organisations is invited to ensure that the views of patients and relatives with experience are included.

The 'Effective' ambition described in the Healthcare Quality Strategy for NHS Scotland is evident in SEAN's efforts to further enhance the education of nursing staff involved in ECT. It has long been recognised that ECT nurses perform a pivotal role in the delivery of the treatment. In 2007, the CONECTS sub-group (Committee Of Nurses at ECT in Scotland) was formed by SEAN with the aim of enhancing the quality of care that is given to patients receiving ECT in Scotland through improvements in education. Initially this group was unfunded, however since joining ISD in 2008, three meetings take place each year and the group has been expanded to include all nurses involved with the delivery of ECT (i.e. ECT nurses, anaesthetic nurses and recovery nurses).

Following on from the success of CONECTS the Medics sub-group was set up at the end of 2012; this group has representation from psychiatry, anaesthetics and psychology. It examines the data returns and practice in finer detail with a view to quality improvements in patient care and treatment. Junior doctors and medical students are actively encouraged to participate at these meetings to ensure that experience and good practice continue with future generations.

Further information on SEAN can be found at

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