Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-29T09:16:32.767Z Has data issue: false hasContentIssue false

The trouble with NHS psychiatrists

Published online by Cambridge University Press:  02 January 2018

Judy A. Harrison*
Affiliation:
Manchester Mental Health and Social Care Trust, Chorlton House, 70 Manchester Road, Chorlton, Manchester M81 9UN, email: judy.harrison@mhsc.nhs.uk
Rights & Permissions [Opens in a new window]

Abstract

Type
The columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2009

St John-Smith et al Reference St John-Smith, McQueen, Michael, Ikkos, Denman and Maier1 provide a useful overview of the political imperatives which have shaped British psychiatry in the past 5 years, but as with other overviews Reference Craddock, Antebi, Attenburrow, Bailey, Carson and Cowen2 it is difficult for the reader to come away with any constructive message.

The authors rightly recognise the original New Ways of Working project as a practical response to a shortage of psychiatrists, but believe this has become a shorthand for cutting the number of medical staff and reducing the psychiatric orientation of the service. The national workforce figures suggest otherwise: between 1999 and 2007, the number of psychiatrists in England rose 3 by 46% and few can argue that recruitment is not vastly improved compared with 10 years ago.

The reality is that new services have grown even faster, with an estimated £2 billion of additional investment since 1999, 3 mainly in specialist teams. The recruitment of medical staff and the establishment of suitable training placements have lagged behind, as outlined by the Audit Commission finding that almost a third of crisis resolution teams had no dedicated consultant sessions. 4

It is inevitable, and many would argue desirable, that non-medical staff will be involved in front-line assessment, as they are now in most other branches of medicine. The solution is not to decry ‘proforma tools and guidelines’, but to argue for these to be used by suitably trained and supervised staff working in teams with ready access to psychiatrists, as originally envisaged in New Ways of Working. 5 The College should lead on an overview of the medical staffing of specialist teams, and trusts and commissioners should be obliged to fund dedicated consultant sessions in order to meet their quality targets.

Although specialist teams provide some benefits, they have undoubtedly led to greater fragmentation of care and may not all survive beyond New Horizons. 3 Our battle should be to ensure that the additional money which came with these teams is not clawed back in times of greater austerity.

References

1 St John-Smith, P, McQueen, D, Michael, A, Ikkos, G, Denman, C, Maier, M, et al. The trouble with NHS psychiatry in England. Psychiatr Bull 2009; 33: 219–25.Google Scholar
2 Craddock, N, Antebi, D, Attenburrow, MJ, Bailey, A, Carson, A, Cowen, P, et al. Wake-up call for British psychiatry. Br J Psychiatry 2008; 193: 69.CrossRefGoogle ScholarPubMed
3 Department of Health. New Horizons: Towards a Shared Vision for Mental Health. Department of Health, 2009.Google Scholar
4 National Audit Office. Helping People through Mental Health Crisis: the Role of Crisis Resolution and Home Treatment Services, 2007.Google Scholar
5 CSIP/NIMHE, CWP, Royal College of Psychiatrists. New Ways of Working for Psychiatrists. Department of Health, 2005.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.