Thursday, 23 February
At our Council meeting last Friday, we were fortunate to have
two excellent presentations. The first came from Professor Eileen
Munro, who gave a most clear and concise overview of
her review of social work and safeguarding. As she was
presenting you could hear a rising tide of resonance from around
the table. Try substituting the word 'psychiatrist' for 'social
worker' - the same issues and challenges arise in this
risk averse world we inhabit. Eileen has kindly agreed to come and
speak at one of our evening lectures later in the year, on 23
October, and I hope she will become a friend of the College.
Dr Jane Marshall and Dr Max Henderson came
to speak about the first three years of the work of the Practitioner Health Programme. Whilst
they and others around the country are doing sterling work, there
is still a deal more to be done. My action will be to ask for
a further meeting with the GMC to find a way of involving
psychiatrists more in the work of the GMC.
From both presentations it again struck me
we need to negotiate harder with our employers, not only to release
us to do college work for the wider benefit of the NHS, but also to
encourage us to skill up in being able to support doctors with
mental health problems; and further, to be able to go out to key
players and parts of our local community, to explain about the
importance of good mental health, what mental illness is about, and
the role we play. This will serve for recruitment going into
schools, and it will evidence the importance of mental health in
improving public health. It will showcase trusts in this era of
commissioning and competition and it will allow, I believe, members
to use some of the undoubted creativity you all have, which at
times is drowned in protocols. I also think it would be good for
our own mental health!
They say there's no such thing as a free
dinner. On Monday night, I was invited to a dinner held by the
Schizophrenia
Commission, as the following day I was giving evidence at one
of their sessions. The dinner was held in one of the most splendid
buildings in the land - Manchester Town Hall, a tribute to
gothic architecture and used by most TV companies producing any
period drama that involves politicians and Victorian drama. One of
the Commissioners is a user from my trust and the discussion over
dinner was searching and thought-provoking.
On Tuesday I gave formal evidence on your
behalf and many thanks to all the Faculty Chairs who at short
notice contributed to this. We will be submitting detailed formal
written evidence in due course. What was most sobering for me was
questions raised afterwards. At this hearing, and in all evidence
collected to date, users and carers had highly varying experience
of treatment and care, not just geographically but across different
wards in the same hospital.
There are two definite ‘take home’ messages
for us:
1) How do we sit with patients and explain
carefully and fully the risk benefits of the medication we
prescribe, not just at first point of contact, but as over time we
may change medication? And how do we set this in the context of
overall interventions and all the often unmet need in their
lives?
2) Why is it that the atmosphere, routine,
and ethos on two wards with the same function, sat across the
corridor from each other can be so different? Could it be about how
doctor psychiatrists lead in such settings working with senior
staff? I have heard the College Centre for Quality Imrovement
(CCQI) comment on this, but the real question is what can and are
we doing about it?
Today I am meeting with our Communications
and Policy department to make sure we are pulling together all the
varying strands of work we are doing, and making sure we are using
all efforts to best effect. The Health and Social Care Bill will
clearly be one area of discussion.
On the subject of the Bill, I was watching
the TV on Monday night with my grandson. It's clear he understands
something of the reason why I spend time in London, because he
asked me why I wasn't at the meeting at ‘that house in London where
important people are’ (No. 10). Even grandma didn't have an answer
for that one!
Sue
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