Edinburgh in June
Recovery is the theme for the annual conference to be held in
Edinburgh in June and I would like to introduce the concept to
those who are unfamiliar with the way it has begun to be used in
the mental health field. Recovery is not primarily about
cure, but it is about supporting a positive but realistic
acceptance of a person's long term health problems through
empowering individuals to take as much responsibility as they can
for their own lives and their own care.
Professor Sheila Hollins, President
Annual Meeting 2007, 19th – 22nd
June 2007, Edinburgh
The College annual meeting is returning to Edinburgh in June
2007. The conference aims to meet the CPD needs of
participants and is an excellent opportunity to meet colleagues,
update your skills, share ideas and practice and hear about new
research and service initiatives. So please book now: www.rcpsych.ac.uk/events/2007.aspx
Proposals for New Mental Health Legislation
in Northern Ireland
Northern Ireland has its own mental health legislation and the
process of reform has traditionally happened after the rest of the
UK, as we try to learn from developments elsewhere, without feeling
the need to slavishly follow. There has been a lot to learn
from the very different approaches in England and Wales and
Scotland.
In 2002, an independent, comprehensive review of policy,
services and legislation for mental health and learning disability,
the Bamford Review, was established. From the start the
review aimed to include all stakeholders, particularly users and
carers. The College has had significant involvement in the
working groups and these have reported in a phased way.
Legislation is in the final report, presently out to
consultation:
http://www.rmhldni.gov.uk/
The review has worked to a shared values base and the legal
issues working group developed this with specific principles
(respect for autonomy, justice, benefit and least harm) to underpin
new legislation. All the recommendations flow from these
principles, and they should be on the face of the legislation and
guide its operation as in Scotland.
Early stages in the review's work were complicated by the
parallel, but overlapping work in the Office of Law Reform to
introduce capacity legislation in Northern Ireland. The
review recognised the opportunity to take a comprehensive approach
to capacity and mental health legislation reform so that the same
principles, definitions, standards and system of protections can
underpin all these related provisions and avoid gaps and
overlaps.
With the Northern Ireland Legislative Assembly due to go live on
8th May 2007 the process of influencing local
politicians to support the next phase is a priority. There is
cross party support for the Bamford recommendations on policy and
services, although the hard financial consequences, that revenue
needs to double, will be a big challenge. However, the human
rights agenda has a high profile in this jurisdiction and a
principles based approach to mental health legislation may be more
politically in tune with the new assembly than it seems to have
been in England and Wales.
Dr Maria McGinnity, Northern Ireland Division
Dr Roger Banks -
Vice-President
In January I started work as Vice-President with a remit for
developing the College's role in primary care. I soon
discovered the role of Vice-President to be quite challenging,
balancing 'getting to grips' with the remit of the post with the
other responsibilities of a College officer. Starting at a
time of enormous change for the College together with fast
developing internal and external pressures has made this something
of a roller-coaster ride.
At my interview last November, we decided that the primary
care agenda was potentially so huge and complex that it would be
sensible to try to focus chiefly on developing our working
relationships with GPs. I was aware from the outset that
there would be a wealth of ideas, experience and initiatives
already taking place throughout the College and its membership in
all parts of the UK and other countries. I have been trying to make
contact with the faculties and divisions and to begin to pull
together a network of individuals with an interest in taking this
agenda forward. My aim is have tangible initiatives and
practical examples of good practice rather than generating unwieldy
scoping groups or producing reports.
I have been delighted to make contact with individuals from many
different backgrounds and there are more opportunities to come but
soon this will have to crystallise into an action plan.
There are a number of areas in which I would like to see us
develop some initiatives. In identifying these I have been
helped by a report from the Mental Health Foundation, 'Primary
Concerns'1 and discussion with the Foundation's Chief
Executive, Dr Andrew McCulloch and one of the report's authors, Dr
Alan Cohen from the Sainsbury Centre for Mental Health.
- Informing and guiding the role of commissioning in primary
care
- Providing information and expertise on the relationship between
physical and mental health and in particular, medically unexplained
symptoms
- Joint initiatives with GPs for undergraduate and postgraduate
training and CPD
- Assisting in the development of Practitioners with a Special
Interest in Mental Health
- Educating the primary care workforce generally about mental
health
- Developing quality improvement networks related to mental
health in primary care.
- Encouraging research into the interface between primary and
secondary care services
Much work is already going on in some of these areas and I hope
to facilitate this further. It is essential that our
involvement in primary care is thought about across the whole
breadth and depth of the College. What will make most
difference is what happens at your own local level and for all
people, including the young, the elderly, and those with learning
disability.
For this work to have any hope of success we must work in
collaboration with GPs. We must listen carefully to their
views and concerns, however uncomfortable those may sometimes make
us feel. Anyone who has looked through some of the discussion
strands in the forums on Doctors Net will know that our image in
some parts of primary care is poor to say the least.
I hope we can develop a credible and respected profile in
primary care and be able to see each other as allies in
endeavouring to provide high quality and comprehensive mental
health services for all people with mental health problems.
I would be pleased to hear from anyone who has ideas and
examples of good practice with a view to pulling together a
conference some time later this year. rbanks@rcpsych.ac.uk
Reference
1. Mental Health
Foundation (2007) Primary
Concerns http://www.mhf.org.uk/publications/?EntryId=42417&char=P
Comments received from members to the
February e-newsletter 'Diary of a 'new ways of working consultant
psychiatrist': Dr Peter Kennedy summarises
In all there were only five emailed responses. Two were
one liners indicating dissatisfaction with the whole idea –
"drivel" and "odious". Another reported that a consultant
working in exactly these new ways was facing a GMC fitness to
practice inquiry.
A consultant working in an addiction service described a
personal caseload of well in excess of 300, and there being only
four nurses in the team carrying a total caseload of over
600. The opportunities for reducing the consultant's caseload
seemed to be limited by the overall staff shortage. 'I do wonder if
this process will allow Trusts to abandon any cognisance of College
guidelines on team composition (staff numbers etc…)' Comment on the
lack of evidence provided in the Diary about the patient experience
of New Ways of Working, it was suggested that the College Research
Unit might assess the impact on patients seen or not seen by the
consultant in the team.
An SHO gave a clear exposition of concerns about training.
He writes "Most things are positive about New Ways of Working, but
I find the training of doctors is being severely compromised.
It is partly true (as the Diary portrays) that junior doctors
cannot be relied upon because they are generally unavailable.
How can I be expected (on becoming a consultant) to deal with the
most complex and difficult cases when everyone else is clawing away
at my training opportunities? For example, a nurse based in an
A&E crisis team will have far more experience than any SHO. As
a senior SHO, I have seen a lot less cases then a junior nurse who
had been there for one year. She has a lot more confidence
and of experience of dealing with seriously unwell patients – do
you expect me to advise this lady when she presents me with the
most complex and difficult case?"
He concludes: "The concept of shared responsibility and the role
of the consultant as an expert consulting person is great, but it
seems that people at the helm of our profession are forgetting the
training needs of a future generation of doctors."
Psychiatrists' Support Service
The new Psychiatrists' Support Service for College members and
associates will have its formal launch in June at the Annual
General Meeting in Edinburgh.
The service is a confidential advisory and signposting telephone
helpline available for doctors in difficulty over issues such
as
- addictions
- bullying and harassment
- career pathways
- examinations
- exclusion
- GMC/NCAS involvement
- health problems
- homicide inquiries
- internal and external reviews
- serious clinical incidents
- training
- whistle blowing
Psychiatrists contacting the service may be signposted to
another appropriate organisation or service. Some doctors may
benefit from focused support from a senior College member of the
Psychiatrists' Support Service Committee, for example, mentoring or
face-to-face/email/telephone support.
Contact details for the service, tel: 0207 245 0412
Email: psychiatristssupportservice@rcpsych.ac.uk
Alternatively, you can write to the Psychiatrists Support
Service Manager at
the Royal College of Psychiatrists, 17 Belgrave Square, London
SW1X 8PG
May launch of online surveys of the
College membership: a new initiative to improve dialogue,
and inform action
The College is launching an initiative to improve dialogue with
the membership on key policy and practice issues. Beginning in May,
the College will invite members via email to join an online panel
of psychiatrists who will be asked occasionally to share their
opinions and perspectives on a range of issues.
We hope that by opening up an online dialogue with the
membership the College will develop a better understanding of the
beliefs, practices and experiences of its members. This includes
those who are unable to participate in activities such as the
Annual Meeting, or in College committees, as well as members
who are already involved with College activities.
Seeking members' views through the use of online surveys will
give the College a chance to get a response from the
membership on topical issues of the day and on longer term
matters. Online surveys will also allow the College to
speak with a more authoritative public voice.
We will invite the membership to opt-in to the initiative (to
avoid unwanted email communication) and will also restrict the
number of surveys each member receive s per year (to avoid
saturation). There will be a series of incentives
on offer to members who participate.
Chris Fitch, College Research Fellow, cfitch@cru.rcpsych.ac.uk
Special Offer for Members
Subscribe to the new-look CPDOnline at
a special members' rate of £75 including VAT. This
offer is valid until 30th June 2007.
Please go to http://www.maney.co.uk/search?fwaction=show&fwid=748 for
more details. There are lots of new modules now available and
coming soon, including:
- The physical examination in psychiatric practice (parts 1 and
2)
- Adult ADHD
- Managing depression in physically ill patients
- Involving patients and carers in training
- Creating constructive in-patient stays
- The pharmacological management of anxiety disorders
- Working through interpreters