Dr Adrian James, President of the Royal College of Psychiatrists, said:
‘… as the pressure on services continues to ratchet up, the silence from government continues to be of grave concern for the College, the wider mental health workforce and, most importantly, our patients.’
Well, whoever he is, he’s not wrong.
He went on;
‘… the most recent data on children and young people’s eating disorders found record numbers are waiting for routine care…’
Only just over half are seen in a week. There’s more;
‘Hundreds of adults are also being sent far from home for treatment because of a lack of beds in their area…’
Just for the record, here are a few factoids;
- In December ’21, almost 425,000 youngsters were in contact with mental health services, nearly 16% up on 2019.
- Over the same period 642,303 adults were service users, up about 5% on 2019.
- Mental health appointments attended were up by 234,553, about 15%.
- There were 1,834,137 appointments attended across mental health, learning disability and autism services compared with December 2019, a 14.7% increase.
Amiable Adrian said;
‘… with 1.4 million people waiting for treatment the Royal College of Psychiatrists is calling on the Government to urgently publish a mental health recovery plan to reduce waiting times. The plan must include funding to expand services, train more psychiatrists and replace crumbling mental health facilities across the country.’
Adrian… don’t hold yer breath.
At their last NHSE Board meeting, in January (can you believe they can only be bothered to meet bi-monthly), the puppets were asked ‘to note’, (there was no debate), the following;
- the number of children and young people being able to access mental health services continues to increase and is on track to achieve the 2021/22 target.
- the Urgent and Emergency Mental Health pathway continues to be under significant pressure … bed occupancy remains very high (over 85%), which in turn impacts out-of-area placements.
- detentions under the Mental Health Act have increased by 4.5% between 2019/20 and 2020/21 [usually an annual increase of 2% is expected].
All of which is true, but somehow doesn’t resonate with the sense of urgency our mate Adrian is trying to get across.
- How close to on-track and when?
- How many out of area placements and how far?
- Why are detentions up and how many are challenged?
- Where is the risk register?
It’s not what you say, it’s the way that you say it.
The Board were also asked ‘to note’…
- crisis referrals have increased, by 30% compared to 2019, and a 74% increase compared to 2017.
What does that mean? That’s 10% a year since 2019 but 14% a year since 2017. Is that a lot, in line with expectations, something we can cope with?
If you and I were Board members we’d have said; ‘I ain’t gonna ‘note’ this. I want a full discussion’.
No one did. That’s why they’re on the Board and we’re not.
The Board ‘noted’;
- It is crucial that the focus on discharge remains ‘strong’.
What does ‘strong’ mean? Is it ‘strong’ enough. Too, ‘strong’, how many readmissions are there… is there a trend? Are there any suicides?
None of the puppets asked.
- Increasing mental health prevalence, acuity and complexity will create further challenges to reducing the treatment gap.
What gap? How big is the gap? What damage is it doing? How do we close it? What are the risks, can they be mitigated?
No one pulled a string. None of the puppets moved.
Adrian, my old mate, you are too amiable and you are wrong. It is not ‘… the silence from government continues to be of grave concern for the College…’ it is the silence of the NHSE Board.
They don’t meet frequently enough to get a sense of rhythm and progress and feel for the challenge.
They don’t ask questions and if they are getting private briefings…. the public meetings are not reassuring the public and staff and stakeholders that they are any good…
… that’s why they are obliged to have public meetings… so they can show us they know what’s what.
This is a council of despair. They don’t ask because they don’t know what to do with the answers.
If I were you, Adrian, I’d ring up the new chair of NHSE, Richard Meddings, and ask him if it is intention to continue to preside over this puppet show or is he going to get some real people in…
… people who are interested in looking interested, in doing the very interesting job they are paid to do.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
