1. Tackling psychiatry's recruitment
crisis head on
2. RCPsych Awards 2009 launch
3. RCPsych Annual Meeting 2009 - call
for papers
4. Consultation document - revised
Good Psychiatric Practice
5. Update from the Northern Ireland
Division
6. New penalties proposed for cannabis
users
7. Welfare Reform Bill - a
briefing
8. WHO report shows wide variations in
European mental health services
9. New BMA guidance for private
practitioners
10. Disability driving
assessments
1. Tackling psychiatry's recruitment crisis head on
College Dean Professor Rob Howard, Psychiatric Trainees
Committee (PTC) Vice-Chair Dr Clare Oakley, and Dundee medical
student Jude Harrison explain how they hope to tackle the
recruitment crisis.
This year, just 6% of candidates sitting Paper 1 of the MRCPsych
were UK graduates - a stark warning that the longstanding
recruitment difficulties facing our specialty are becoming a
crisis. The College must address this issue and make every effort
to remedy it. We seek the support of the entire membership, and
thought that we would let you know what actions the College is
initiating - many of which we hope that you might want to get
involved in.
On 1 December 2008 the College will launch a
new grade of membership, the Student Associate. This will be free
of charge to any interested medical student who applies and will
offer:
- a dedicated section of the College website
with a discussion forum
- an e-newsletter run by the Student Associates
and the PTC
- a one-day annual conference specifically for
undergraduates
- the opportunity for two Student Associates to
be co-opted onto the PTC
- electronic subscription to the Psychiatric
Bulletin and the British Journal of Psychiatry
- reduced prices for College events
- information on medical student bursaries and
prizes
- elective opportunities
If you teach undergraduates, please let them
know about becoming a Student Associate and encourage them to join
us.
Through a network set up by the PTC, the
College will work to encourage the formation of psychiatry interest
groups and societies in each of the UK's medical schools and to
link up existing undergraduate psychiatry societies. We will
strengthen the links between these groups and local trainees and
more senior College members. The aim is to provide local mentors;
signpost research, elective and audit opportunities; offer careers
advice and organise evening meetings or lectures. We'll encourage
all interested students to become Associates.
The College now has a group page on Facebook.
Medical students and College members can use this page to share
information relevant to undergraduates, such as the details of
local seminars and events, and opportunities for research
experience and electives. It will raise the profile of the College
among medical students, and in particular advertise the Student
Associateship. Go to www.facebook.com and search for
the Royal College of Psychiatrists group.
In collaboration with the Institute of
Psychiatry and the South London and Maudsley NHS Foundation Trust
the College will organise an annual Summer School for medical
students who are interested in psychiatry. This will consist of a
week of interactive teaching and research introduction, designed to
build on core undergraduate subjects and highlight the scientific
basis of psychiatry. The remit of the Summer School will be social
as well as educational, allowing interested medical students to
make valuable connections with potential role models as well as
future contemporaries in psychiatry.
We already send trainees to represent the
College at careers fairs and encourage students to consider
psychiatry as a career. We are looking for consultants who would be
willing to give up a day of their time to help with our
presentations at these events. We can pay for expenses and as part
of the College's recruiting team you'd have the stimulating and
rewarding experience of selling our specialty to the next
generation of doctors.
We are planning work with the Academic Faculty
and the Association of University Teachers of Psychiatry to address
some of the structural issues that have adversely affected the
image of our specialty within the undergraduate experience but we
can only improve recruitment into psychiatry with the support of
all of our membership. We urge you to get involved. Please offer to
be a mentor for students in your area through the local
undergraduate psychiatry society, attend a careers fair with us,
promote the Student Associateship locally and organise events that
can capture the enthusiasm and imagination of your students
locally. You can contact dgoka@rcpsych.ac.uk to offer your help
with any of these or to be connected with colleagues who are
already doing so locally.
Finally, we don't imagine that we have all the
answers. We want to hear any ideas that you may have about how the
College and our colleagues can do more to help recruitment. Please
contact Clare (clareoakley@doctors.org.uk)
or Rob (robert.howard@iop.kcl.ac.uk)
with suggestions. We're looking forward to working together with
you on this.
2. RCPsych Awards 2009
launch
November sees the official launch of the new
RCPsych Awards, an annual event designed to give national
recognition to the contribution made by individuals, teams and
organisations, boost staff and service morale, reward excellence
and innovations in research, teaching and clinical services, and
raise public awareness of excellent mental health services.
There
will be eight categories in the RCPsych Awards 2009:
- Psychiatric Team of the Year
- Psychiatrist of the Year
- Mental Health Services Provider of the
Year
- Core Psychiatric Trainee of the Year
(CT1-CT3)
- Advanced Psychiatric Trainee of the Year
(ST4-ST6)
- Medical Manager/Leader of the Year
- Psychiatric Academic of the Year
- Public Educator of the Year
Look out for a Call for Entries form in the
November issue of the Psychiatric Bulletin. Full
information is also available at www.rcpsych.ac.uk/rcpsychawards.
Once applications have been received, they will be read by a panel
of judges. A shortlist of winners will be published in May 2009,
with the winners announced at an awards ceremony in London in
September 2009.
3. RCPsych Annual Meeting 2009 – Call for
Papers
The 2009 Annual Meeting of the Royal College
of Psychiatrists will take place on 2-5 June at the BT Convention
Centre in Liverpool. Members are reminded that the closing date for
submissions of abstracts for new research sessions and posters is 9
January 2009. Submissions must be returned, fully completed, to
conference@rcpsych.ac.uk. A
full
guide on submitting abstracts is available on the College
website.
4. Consultation document – revised Good Psychiatric
Practice
College members are invited to comment on a
revised version of Good Psychiatric Practice. The document
has been revised by the Special Committee for Professional
Governance and Ethics, and updated in line with the GMC’s Good
Medical Practice document. It is also written with the
requirements of revalidation in mind. The draft
document is on the Members' section of the College website –
the text of Good Psychiatric Practice is in black type,
while extracts from Good Medical Practice are highlighted
in red.
The aim of the revision has been to set
standards for practice. In doing so, it has been important to cover
standards common to all aspects of psychiatry, enabling
interpretation to be made for specific practice, subspecialties and
different settings. The temptation to be over-inclusive has been
resisted as the document could otherwise set the threshold of
practice at an unattainable level.
In addition, the document does not elucidate
competencies or specify a knowledge base. The curriculum (also
available on the College website) provides such information. It is
intended that the document will reference a framework for
assessment, indicating what sources might evidence practice in line
with the standards. This is in line with the approach being
developed by the GMC. The framework will be drafted once Good
Psychiatric Practice has been finalised.
The Committee would welcome comments on issues
that have not been covered, or that need to be expanded to provide
clearer standards in particular settings, subspecialties or
circumstances. Comments should be submitted by 10 November 2008 to
Liz Fellow-Smith, chair of the Special Committee, via egould@rcpsych.ac.uk.
5. Update from the Northern Ireland
Division
The Northern Ireland Division has been raising
its profile in the media and in the Stormont Assembly over the past
month. In early October, the College initiated and coordinated a
joint media release with the Royal College of Nursing, British
Psychological Society, British Association of Social Workers and
College of Occupational Therapists to mark the end of consultation
on the Bamford Review of Mental Health and Learning Disability
Services. The statement, which was critical of the lack of progress
in the six years since the review was commissioned, was used in all
the Northern
Ireland media, including interviews on commercial music radio
stations.
The College’s lobbying at Stormont is paying
off. After success in increasing the budget allocation for mental
health earlier this year, we were pleased to see the Health
Minister respond to our calls by
announcing perinatal mental health services for the Province.
Representatives of the College are frequently meeting with MLAs
interested in mental health.
On a lighter note, the College’s World Mental
Health Day event for secondary school children received extensive
coverage, as teenagers discovered that African drumming and salsa
dancing can improve mental wellbeing. It was the first time that
the College featured on Radio Ulster’s Arts Extra programme.
When free prescriptions were announced in
Northern Ireland, the College issued a media statement that was
picked up in several
newspapers.
After a year of proactive working with the
media, journalists are frequently approaching the College with
requests for interviews or background discussions around mental
health. Most recently BBC Ulster sought an interview for a negative
story on the lack of personality disorder services in Northern
Ireland, and is likely to follow this up with a more positive story
looking at a developing service.
6. New penalties proposed for cannabis
users
Cannabis users will face new penalties if the
drug is upgraded to class B from January 2009, home secretary
Jacqui Smith has announced. Under current rules, anyone caught
twice with cannabis can still walk away with a warning. However,
Miss Smith said the new guidelines would see police introduce £80
spot fines for the second offence and arrest for any further
offences.
The drug was downgraded to class C in 2004
under then home secretary David Blunkett. After the change,
prosecutions and jail sentences for using and supplying cannabis
fell. However, police began to report that drugs seizures were much
more likely to involve skunk than resin or lower strength
marijuana. According to the Home Office, skunk has swept other,
less potent, forms of cannabis off the market, and now accounts for
81% of cannabis available on our streets, compared with 30% in
2002. In 2007 after Gordon Brown became PM he announced a review of
the law.
Despite the Government's drugs advisory board
recommending cannabis remain in class C, Miss Smith said in a
Commons statement in May she planned to upgrade it. The Advisory
Council on the Misuse of Drugs warned using high strength cannabis
could increase the risks of mental health damage, especially among
youngsters who "binge smoke".
Miss Smith said: "While cannabis has always
been illegal, reclassifying it to a Class B drug reinforces our
message to everyone that it is harmful and should not be taken.
Fewer people are taking cannabis, but it is crucial that this trend
continues. I am extremely concerned about the use of stronger
strains of cannabis, such as skunk, and the harm they can cause to
mental health." The process for changing the classification of the
drug requires votes in both Houses of Parliament.
7. Welfare Reform Bill – a briefing
The Welfare Reform Bill is one of 18 proposed
bills to be brought before Parliament in the Queen’s Speech in
December. The College has submitted a response to the recent
consultation on this issue. Claire Churchill from
the College’s Policy Unit summarises the Bill’s key themes.
Over 2.6 million people currently receive
incapacity benefit. The Government wants to reform the benefit and
encourage this group of people to undertake work. In October 2008,
Incapacity Benefit (IB) was replaced by Employment and Support
Allowance (ESA). Due to this, in 2009-2013, all claimants will be
reassessed using a medical assessment, referred to as a Work
Capability Assessment.
Following assessment, claimants will go down
one of two routes. Some of the claimants will no longer qualify for
ESA, but will instead qualify for Job Seekers Allowance (JSA) and
gain support in going back to work. The remaining claimants will
qualify for ESA and be placed in one of two groups: either the Work
Related Activity Group, where claimants will be expected to enter
the Pathways to Work scheme, or the Support Group, where claimants
can undertake the scheme voluntarily. The Pathways to Work scheme
will be run by a mixture of voluntary, private and public
providers, who will be paid on the basis of outcomes.
Currently, the highest proportion of claimants
on IB is people with mental health conditions. There are doubts as
to whether the reforms - which will require IB claimants to engage
with the Pathways to Work scheme - will be successful for these
claimants. This is partly because mental health conditions tend to
be fluctuating in nature and mixed results have already been seen
from the scheme to date. There are also concerns about employers’
understanding of mental health issues.
The College believes the new Welfare Reform
Bill should put more emphasis on improving employers’ understanding
of mental health issues. In addition, more effort is needed to
place claimants with mental health conditions in employment that
corresponds directly to their capabilities.
The new Welfare Reform Bill will also provide
an opportunity to improve the uptake of the existing Access to
Work, which aims to provide suitable adjustments in the workplace
for people with mental health problems or learning
disabilities.
8. WHO report shows wide variations in European
mental health services
A World Health Organisation (WHO) report,
published on 10 October to mark World Mental Health Day, has
revealed major variations in mental health services and treatments
across Europe.
The report,
Policies and Practices for Mental Health in
Europe, provides country-by-country comparisons on a
wide range of indicators including numbers of psychiatrists,
financing, availability of services, workforce training,
prescribing, and representation of service users and carers.
For example, there is a more than 10-fold
difference in numbers of psychiatrists across the European Region.
The median number of psychiatrists per 100,000 population in the 41
countries that provided information is nine. However, this figure
ranged from 30 per 100,000 population in Switzerland and 26 in
Finland, to just three in Albania and one in Turkey. England and
Wales have 13 and Scotland 10 – both above the European
average.
England and Wales was also identified as being
the region that spends the largest proportion of its total health
budget on mental health services – almost 14%. Scotland came sixth,
spending 9%.
WHO marked World Mental Health Day by
launching a new worldwide Mental
Health Gap Action Programme (mhGAP) to scale up services for
mental, neurological and substance use (MNS) disorders. According
to WHO, the resources that have been provided to tackle MNS
disorders are insufficient, inequitably distributed and
inefficiently used, which has led to a treatment gap of more than
75% in many countries with low and lower middle incomes. mhGAP has
already identified 48 such countries which would qualify for
intensified support as part of the project. The programme will help
countries develop and implement an essential mental health package
to improve service delivery, and tackle priority conditions such as
depression, schizophrenia and other psychotic conditions, suicide,
epilepsy, dementia, disorders due to alcohol and illicit drug use,
and mental disorders in children.
9. New BMA guidance for
private practitioners
The BMA’s Private Practice Committee has
produced new guidance on requirements for registration with the
Healthcare Commission. According to the BMA, any private medical
practitioner who also undertakes a form of NHS practice does not
now need to register with the Healthcare Commission.
Registration IS required:
- For exclusively private medical practitioners providing medical
services to private patients at an establishment – unless the
nature of the arrangement is made on behalf of patients for medical
services, such as health screening or insurance medicals.
- If a medical practitioner, in many cases a consultant, who has
been granted practising privileges to work at a registered
establishment, sees private patients separately at another
premises, then that part of his/her medical practice does need to
be registered.
- If a medical practitioner leases a room(s) in a building in
which other medical practitioners also provide private medical
services, then unless the doctor is working in a legal partnership
agreement with another doctor, each practitioner will need to
register his practice individually. The nature of the 'ownership'
of the service will determine whether a registration under an
individual or a partnership will need to be applied for.
Registration is NOT required:
- If a medical practitioner is working under practising
privileges in a registered establishment, such as a consultant in
an acute hospital, and he/she carries out all elements of that
private practice at that establishment, then there is no
requirement for that individual to register that part of his/her
practice as it is already covered under the hospital's
registration.
- If a medical practitioner is directly employed by an
establishment which provides private medical services, then it is
the establishment which provides medical services, then it is the
establishment that must be registered, not the individual medical
practitioner.
- If a medical practitioner is providing NHS services at an
establishment and also sees private patients at that establishment,
then he/she will not need to register with the Healthcare
Commission.
- If, a medical provider provides NHS services at an
establishment, and provides additional services for private
patients at a separate establishment then his/her medical practice
does not need to be registered.
More information is available at www.bma.org.uk/ap.nsf/Content/HCcommssion
and www.bma.org.uk/ap.nsf/Content/setupprivprac.
(You will need to be logged in as a BMA member to view the full
guidance).
10. Disability driving assessments
The Regional Driving Assessment Centre (RDAC)
has launched a new campaign to raise awareness of their services
among doctors and other healthcare staff. The RDAC is a charity
that specialises in providing assessments for people who want to
learn to drive or return to driving with a disability, or following
a debilitating illness. This can include older people, or people
with a medical condition that impacts on their ability to make
appropriate decisions with regard to safe driving. Fees for a
driving assessment are subsidised, and currently cost £80.
Sharon Reynolds, RDAC customer liaison and
information officer, said: “The centre is staffed by a team of
dedicated and experienced professionals - including specialist
driving instructors and occupational therapists. Doctors and
medical staff can suggest to their patients that they attend the
centre for a practical assessment of their ability to drive,
providing they meet the current DVLA regulations of medical fitness
to drive. We can also supply doctors with information leaflets for
patients to take away with them.”
The RDAC has centres in Oxford, Birmingham and
Cannock. Other parts of England, as well as Scotland, Wales and
Northern Ireland are covered by a network of 17 organisations
(including the RDAC) which together make up the Forum of Mobility
Centres. For more information, visit http://www.rdac.co.uk/ or http://www.mobility-centres.org.uk/.
Leaflets about the RDAC’s services are available from Sharon
Reynolds: 0845 337 1540 or sreynolds@rdac.co.uk.