1. Message from the President: Professor Sheila Hollins
Dear Members
It’s been such a busy month and much of my attention has
been devoted to policy matters as the NHS 60th birthday approaches.
Of course this is relevant to the whole of the NHS throughout the
UK, but any initiatives related to this anniversary will have a
different spin for each jurisdiction.
I have attended meetings about the NHS Constitution, which is
seen by Ministers as an opportunity to restate what the NHS is for.
At any meeting of this kind, I emphasise the importance of mental
and physical health being seen as an integrated whole. I wrote to
the Prime Minister on this subject after he made only passing
reference to mental health in his first major speech on health.
The Darzi Next Steps Review (England) will be published in July
at the anniversary celebration, as will the recommendations from
the Expert Panel on Health Inequalities of which I am a member. The
Independent Inquiry on Access to healthcare for people with
learning disabilities (I am also a member of this Inquiry panel)
and the separate report of the Ombudsman into Mencap’s report
'Death by Indifference' will both report in May or June.
On a different matter, you may have seen that with the help of
many people who responded to my request in the last e-newsletter,
the College prepared a statement on women's
mental health in relation to abortion. This was requested by
the Science and Technology Committee for England, but a similar
request was being dealt with from the CMO in Northern Ireland and
we were able to liaise to ensure no inconsistencies. Do look at the
website to read the statement and also to see details of how the
consultation with members was conducted. We will continue to
improve the way we consult. Our aim was to avoid personal views and
focus on the research evidence - I hope you will consider that we
achieved this.
We have also prepared a joint statement with the RCGPs on the
treatment of depression and the use of
antidepressants and hope this will be useful for you to use
with patients.
2. Update from Dr Roger Banks, Vice-President
Over
the past 15 months, the College has been developing close working
links with the Royal College of General Practitioners and other
organisations concerned with mental health in primary care, such as
PRIMHE. Focused and dynamic collaboration has led to a number of
joint initiatives including the creation of a Joint Educational
Advisory Group, and the establishment of a primary care network
within the General and Community Faculty. It is hoped this will
lead to similar networks in other Faculties.
We have established a Forum for Mental Health in Primary Care
which will be a lasting structure to support and develop the work
that is being undertaken in this area by the RCPsych, the RCGP,
PRIMHE, NIMHE and other organisations to be recruited over the
coming months. This network has, over the past two weeks and in
response to the concerns raised within the media and elsewhere
about the effectiveness of antidepressants, produced a joint
statement between the RCPsych and the RCGP about the role of these
drugs in the overall management of
depression in primary and specialist mental health care. This
statement is aimed at the patients of GPs and of psychiatrists. We
hope it brings a balanced summary and appraisal of the various
treatment approaches available that will enable them to have an
informed and open discussion with their doctor in which their own
views and experience are pivotal.
3. Scottish Division attends Liberal Democrats Conference,
Aviemore
The Scottish Division of the College held a joint fringe event
with the Scottish Association for mental health (SAMH) at the
Scottish Liberal Democrats Conference in Aviemore on 1 March 2008.
The theme of the event was the future funding of mental health
services, following the Scottish Government's spending review at
the end of 2007.
Key concerns identified were:
· No statistical information on how the money will be allocated
so this is dependant on local authority priorities.
- More widespread concern over the lack of targets in relation to
mental health. There is a concern that grants to community based
organisations could be eroded over time.
- In relation to Supporting People, most of the community-based
work is from ring-fenced budgets; approximately £2.3bn of this
money will be removed leading to questions about how confident the
sector is that it can ensure mental health will be a priority.
- Local Authorities not monitoring concerns over the strength of
links between local authorities and Community Health Partnerships
(CHPs) with reports of patchy and inconsistent links across the
country.
- CHPs impression of the voluntary sector is also a concern. What
priority will be given to requests for dialogue from the voluntary
sector?
- The Spending Review suggested there is a need to make 2%
savings in 2008/09. The expectation is that there will be cuts to
the voluntary sector.
- The reduction of homeless provision and the link with people
suffering mental health problems in homeless units
Speakers at the fringe event included David Strathearn from
SAMH, Peter Rice from the College and Ross Finnie MSP who is the
Shadow Minister for Health for the Lib Dems in Scotland.
The meeting was well attended and after the presentations there
was time for discussion. A number of themes emerged including the
mental health of prisoners; alcohol and drug problems; social work
services and mental health nursing.
The full
report can be accessed on the Scottish Division webpage.
4. International Psychiatry: call for high-quality
original research and systematic reviews
International Psychiatry now includes
a section dedicated to the publication of high-quality original
research and systematic reviews. Papers will be peer-reviewed
quickly for publication in the next available issue of the
journal.
Although we do not accept all papers for publication, we hope
the journal's peer-review process will assist authors in producing
articles for worldwide dissemination. To ensure rapid peer-review,
articles must be no more than 1500 words long, with a maximum of 2
tables or figures and 12 key references. If possible, our expert
panel of assessors will help authors to improve their papers to
increase their impact when published. International Psychiatry is
committed to the promotion of high-quality research and reporting
from and about low- and middle-income countries, and cross-cultural
and cross-national collaboration in the advancement of clinical
science, education and advocacy in psychiatry and mental health.
Please send your submissions to jcarroll@rcpsych.ac.uk.
5. New RCPsych Associate Registrar for medical management
In January 2008, Dr Neil Deuchar replaced the previous position
holder, Dr Peter Kennedy, Vice
President
of the College.
Neil's role will be to:
- redefine the role of the medical director in mental
health;
- set standards for medical management in specialist mental
health trusts or PCTs providing mental health services;
- develop CPD and other training programmes for psychiatrists in
managerial positions;
- increase the influence of psychiatrists on service development
by enhancing their engagement with chief executives of mental
health trusts.
Neil will be an ex-officio member of the College's Central
Executive Committee and the Confederation of Mental Health Trusts'
Chief Executives. His role also involves establishing links between
the College and the British Association of Medical Managers and
Medical Leaders Professional Council.
6. Newsletter from the Psychiatric Trainees’ Committee: Dr
Ollie White, Chair, Psychiatric Trainees' Committee
The College Psychiatric Trainees' Committee (PTC) is aware of
the need to improve communication to and from local trainees. We
therefore plan to produce regular newsletters to keep both trainees
and trainers up to date with our activities in the College and with
other organisations.
Our first edition is available at
www.rcpsych.ac.uk/training/traineessection/newslettermarch.aspx
It contains an overview of the PTC and outlines various training
issues including:
- 2008 recruitment
- Allocation from ST3 to ST4
- WPBAs and HcAT what are these??
- New Ways of Working (NWW)
- The Tooke Review
- IMG issues.
The College will email the newsletter to trainee members.
Trainers can subscribe via the Members'
Area of the College website (tick 'trainees' under 'areas
of interest').
7. Trainees and trainers give their views on Postgraduate
medical education to PMETB
Over 43,000 doctors have responded to the two PMETB surveys on
postgraduate medical education, taking the opportunity to express
their views about the content of the curricula and the standard of
training. PMETB are now validating the responses.
Over 32,000 trainees responded to the second National Survey of
Trainees, an increase of over 6,000 on last year’s survey. Over
10,000 consultants and GP trainers filled in the first ever
National Survey of Trainers, with a particularly good response rate
from GP trainers.
This year, the results of the surveys will be available online
for the first time on a new website which launches in April 2008 to
Deaneries, and to all other stakeholders in May 2008. This
development means that trainees and trainers will be able to
compare views on the training in their specialty and location with
views on training for the given specialty nationally.
Both surveys will contribute to the PMETB Quality Framework and
inform the work that Deaneries, Medical Royal Colleges and
Faculties and NHS providers undertake to improve doctors’ training.
The results will also enable PMETB to measure training provision
against the training standards and contribute to the quality
management of training programmes.
For further information on either the National Survey of
Trainees or the National Survey of Trainers, please see
www.pmetb.org.uk/pmetbsurveys
8. NHS London release report: Independent review into mental
health homicides
A review of 26 mental health homicides that were committed in
London between January 2002 and December 2006 recommends further
independent investigations into all cases to ensure that
lessons for improving the capital's mental health services are
learned.
NHS London commissioned the independent review when it
discovered that 26 cases inherited from its predecessor
organisations had not been reviewed independently as stipulated
under the terms of Health Service Guidelines (94) 27. The purpose
of the review was to identify common themes and any specific cases
that required further independent investigation. The review did not
examine the circumstances of individual cases.
Dr Simon Tanner, Regional Director of Public Health for NHS
London, said: "These cases are about real people and real lives.
That's why NHS London is committed to learning everything we can
from them. "We will investigate them fully and independently and
use the findings to inform the development of mental health care in
London and continue to improve patient care and public protection,"
he added.
Further investigations into all 26 cases have been commissioned
or are being commissioned. They will be completed by the end of
2008. - www.london.nhs.uk/londonnhs-news.aspx?id_Content=7426
9. Psychiatric patients face ‘home’ smoking ban, court
told
Nottinghamshire psychiatric patients have launched a High Court
test case battle for the right to go on smoking while detained in
hospital.
Two judges were told that, as a result of new laws, patients
held under the Mental Health Act could unfairly become the only
group of people in the country banned from smoking "in the privacy
of their own home".
Paul Bowen, appearing for patients detained at Rampton top
security psychiatric hospital in Nottinghamshire, said others whose
homes are in public spaces, such as soldiers and care home
patients, will still be able to smoke under special exemptions. But
Rampton patients face a total ban that amounts to unfair and
unlawful discrimination.
He told Lord Justice Pill and Mr Justice Silber at the High
Court in London that many patients at the hospital are detained
because they suffer from mental disorders and are considered
dangerous and a risk to the public. From July 1, all mental health
units would have a complete ban on smoking indoors. Smoking in
designated rooms would no longer be permitted.
That would mean a complete ban for psychiatric patients who,
because of the nature of their illness, could not be allowed
outdoors. In other cases the configuration of psychiatric units
would make it impossible for patients to smoke outdoors, argued Mr
Bowen.
Their average stay at Rampton is eight years, though for some it
is much longer, and for some it is for life. For the vast majority,
the hospital is their home under human rights laws.
10. Ill health 'costs economy £100bn' – Dame Carol Black’s
review working for a healthier tomorrow
Ill health costs the British economy over £100bn a year - the
same as the cost of running the NHS for a year, Dame Carol Black’s
review of the health of working age population, working for a
healthier tomorrow, has revealed.
Dame Carol has been looking at ways of helping people who are
sick get back to work on behalf of the Department of Health,
working closely with the Royal College of Psychiatrists.
Measures in the report include replacing sick notes with "well
notes" stating what work somebody who may have health problems can
actually do. Dame Carol is also proposing trials of a new Fit for
Work service to provide access to specialists such as
physiotherapists and counsellors for all employees in the early
stages of sickness. The aim would be to take quick action to help
these people stay at, or return to work.
The report states that the total cost of ill-health to the
British economy is around £103bn. The bulk of that - £63bn - is
made of the benefit costs and lost taxes for people who are not
working due to illness or disability. The rest of the bill is made
up the cost of the care given by family and friends, the cost to an
employer of having someone absent from work and other additional
costs.
11. UK increases funding for improvement in the delivery of
prison drug treatments
Justice Minister David Hanson has made a written ministerial
statement announcing additional funding to improve drug treatment
in prisons.
He also announced additional Department of Health funding for
prison clinical drug treatment. £12.7 million was invested in
2007/08, this will rise to £24.4 million (actual) in 2008/09, £39
million (indicative) in 2009/10 and £43 million (indicative) in
2010/11. This additional funding, further developing the integrated
drug treatment system in prisons, is aimed at improving the volume
and quality of drug treatment with a particular emphasis on the
first 28 days in custody and better integration with the community
services to which most drug-misusing prisoners will return.
He also announced that a national Prison Drug Treatment Review
Group will be established to oversee the continued development of
prison drug treatment, informed by recommendations arising from a
review of prison drug treatment funding conducted by
Pricewaterhouse Coopers (PwC) last year.
The Addictions Faculty of the Royal College of Psychiatrists
welcomes the report on Drug Treatment in Prison by the UK Drug
Policy Commission. "We welcome the call for the need to develop a
more rigorous evidenced based approach to drug treatment in and
after prison, said Dr Mike Farrell, chair of the Addictions
Faculty.
"The College of Psychiatrists strongly supports the position
that the full range of drug treatment interventions in prisons be
rigorously evaluated. The new Integrated Drug Treatment System is
also a welcome development that needs full prospective
evaluation."
12. What’s new