1. Update from the
President: Professor Dinesh Bhugra
2. Fair Deal
by Dr Martin Deahl. Chair, Fair Deal Steering Committee
3. The College of
Psychiatry of Ireland by Dr Justin Brophy, President
4. Primary Care
practitioner information leaflet on smoking and mental
health
5. Review of College
Research and Training Unit (CRTU)
6. New College
guidance for people growing older with mental illness
7. Should young
people be taught to talk about their feelings?: the Royal College
Annual Debate for Young People - by Dr Jim Bolton
8. Do you know if
your Trust is working with local PCTs to ensure that advocacy
services are available for those detained under the Mental Health
Act?
9. Department of
Health: First NHS constitution launched
10. Department of Health: New
measures for better quality, personal health care
11. Vulnerable Deaths Inquiry
Set Up: A confidential inquiry to investigate premature deaths of
people with learning disabilities in England is to be set up by the
Department of Health
12. General Medical Council:
Doctors urged to take part in licensing regulations
consultation
13. General Medical Council:
Tomorrow’s Doctors are in your hands
14. Care Quality Commission
consults on proposals for 2009/10 assessments of health and social
care
15. Unique collaboration between
the Almeida Theatre London N1 and the Royal College of
Psychiatrists
16. What's new?
1.
Update from the President: Professor Dinesh Bhugra
In early January, I travelled to India for the
61st Annual Conference of the Indian Psychiatric Society
(IPS). I was accompanied by the College Registrar Professor Sue
Bailey and Chief Executive Vanessa Cameron, and together we
delivered a session on professionalism and the role of the
psychiatrist.
Over 1,500 psychiatrists attended the
conference in Agra – the home of the Taj Mahal. Perhaps unusually
for this sort of event, many came with their children and families,
which gave the conference the feel of a festive occasion. Children
ran around during the presentations and were also part of the
evening social activities held outside in the open air.
The conference provided a number of important
opportunities to strengthen the College’s links 
with the
international community – one of my key priorities as President.
During the meeting, the College discussed the possibility of
signing a memorandum of understanding with the IPS which would
focus on training and examinations. It is my fervent hope that this
will not only raise the College’s profile internationally, but also
allow us to conduct MRCPsych examinations in more places as well as
move towards international bench-marking of examinations.
Also of significance was an agreement between
the College, the President-Elect of the IPS and the President of
the America Psychiatric Association to write an open letter to the
Hindustan Times calling for the decriminalisation of homosexuality
in India. As an emerging global power, India cannot continue to
rely on archaic laws introduced almost 150 years ago when India was
under British rule.
The conference offered an inspiring start to
2009, and I now look forward to an exciting and productive year at
the College.
RCPsych Awards:
Nominations for Psychiatrist of the Year now accepted from all
members
Following many requests, nominations for the
Psychiatrist of the Year category can now be made by:
- the person/team being nominated
- their colleagues
- their trust/service provider
- their Faculty
- their Division
plus:
- service users and/or carers
- voluntary organisations
Application forms, category criteria and rules
of entry are available to download from the College website at
www.rcpsych.ac.uk/rcpsychawards
To receive hard copies by post, email Nicola Boyce, Campaigns and Communications
Manager.
These awards are a real opportunity to
recognise excellence within our profession, and we would encourage
you to enter these awards and/or nominate your
colleagues.
The deadline for all awards nominations is
Monday 16 February 2009.
2.
Fair Deal by Dr Martin Deahl. Chair, Fair Deal
Steering Committee
The Fair Deal campaign has now been underway
for six months, and I have recently been appointed to Chair
its steering group, so it is perhaps timely to provide an update on
our achievements so far.
“Fair Deal” is the College’s platform
to initiate and coordinate work carried out throughout the
College to promote equal rights and fairness for mental service
users. Across eight broad areas affecting every aspect of the care
pathway, from first contact with services to recovery, employment
and beyond, 20 projects are currently underway. These range
from the clinical, operational and strategic, to the social and
political, diverse in detail, but all addressing the overarching
theme of equality and fairness.
Fair Deal is not simply another committee
directing operations in Belgrave Square; it aims to inspire and
encourage the membership, across the United Kingdom and Northern
Ireland to look beyond their every day work and pursue the Fair
Deal manifesto for the benefit of all.
Although Fair Deal has initiated projects, the
steering group seeks to coordinate the wealth of activity
already taking place throughout the College to achieve maximum
effect. Where appropriate we liaise and work with Government, the
third sector and other agencies to drive forward the Fair Deal
agenda.
Details of the Fair Deal campaign are
available on the College
website. If any members want to become involved or have ideas
for local activities and would like the support of the Fair Deal
steering group, please let us know (email: dhart@rcpsych.ac.uk). College
Officers are there to advise and support, but it is for you to lead
this campaign. We need to involve as much of the membership
as possible if Fair Deal is to succeed in its aims; we will
update you regularly, and hope that you will give some thought as
to how you might contribute, locally or nationally, in the months
and years ahead.
3. The
College of Psychiatry of Ireland by Dr Justin Brophy,
President
For the first time, all the different
groupings in Irish psychiatry are aligned together and from the 1
January 2009 a new, College of Psychiatry of Ireland has
begun.
Under a logo incorporating the Greek
capital Psy (for Psyche) the Serpent (Physic) and the 3 Candles of
Illumination (Celtic) and a motto of ‘Wisdom, Learning &
Compassion’, we set out by claiming for our guide, these ancient
traditions which profoundly underpin the work of our specialty.
The creation of the new College marks a
turning point in the development of the profession and its role in
mental health services here. Dr Consilia Walsh made a singular
contribution to achieving this by chairing the Steering group which
diligently worked on the project for the last
three years. The Royal College linked predecessor has
been formally dissolved on good and happy terms. We received very
substantial assistance from the Government in terms of a foundation
endowment, and our mission now is to ensure we will deliver on this
for our community and society.
This new departure crucially provides an
opportunity to locate the development and training of Irish
psychiatrists throughout their careers within the context of mental
health policy and practice here.
As systems increasingly diverged between the
UK and Ireland, and because of the need to develop a strong
indigenous organisation, the break with the Royal College became
inevitable. I had the great honour to be elected as the first
President and together with the Executive, Council, Staff and
Members we are tasked now to build a College, develop training and
accreditation, devise and execute an exam, roll out CPD and
competence assurance and build regional and faculty networks. This
will take some years during which we will continue to facilitate
trainees toward taking the UK Membership Exam.
As a fledgling body we intend to grow and
develop by our own efforts, but by also supplementing our
deficiencies with the assistance of the diaspora of Irish
psychiatrists practising worldwide, and continuing good
relationships between our natural fraternal counterparts in the UK
and Europe, through Faculties and sub-speciality groups.
To encourage engagement by our own members, we
will develop networks of practitioners with common interests giving
them the opportunity for personal development and contributing
personally to the new College. Every member from trainee to
retiree should know they individually have a task, a role, a
contribution and a value, so as to share the craic,
camaraderie, friendship and support that active belonging to a
College brings.
We must also build alliances and develop
policies, positions and standards we can achieve and
defend. Towards that aim the College will establish an
Advisory Group consisting of persons of the highest standing from
broad range of sections of society and opinion to inform, advise
and support its Council. They will serve as our wind vane, our ally
and our trusted critics. This opens up our future to the concerns
of the body politic but also becomes a channel through which to
relay our message and mission.
We see a need to rebuild and develop a
pride among our profession here about our work, and try and
communicate its value and its constraints to those who come into
contact with our services. Most importantly, we must support,
defend and protect the environment, culture and discourse around
our work and around our person. Our work is difficult and can only
operate in safety and mutual respect. This is so that the courage,
compassion and trust which we need to do our job will not be robbed
from us and ultimately from our patients’ benefit.
As doctors, we must assert and uphold at
all cost the unique contract we have with our patients, protecting
the healing strength and ethical standards that the professional
relationship between doctor and patient confers. We have a big
task, but have confidence and trust that a solid foundation and an
able membership will help us achieve this. Our website will in due
course keep abreast of developments and all further offers of help
will be very welcome.
http://www.irishpsychiatry.ie/
4.
Primary Care practitioner information leaflet on smoking
and mental health
Dr Jonathan Campion (Consultant
Psychiatrist on secondment to Department of Health), Dr David
Shiers (GP Advisor and Joint National Lead on Early Intervention in
Psychosis Programme to National Institute of Mental Health in
England)
Guidance for Primary Care practitioners to assist those with
mental illness stop smoking was published in December 2008 by the
Forum for Mental Health in Primary Care which is jointly hosted by
the
Royal College of Psychiatrists and Royal College of General
Practitioners.
Smokers die an average of 10 years earlier than non-smokers.
Those with mental ill-health smoke much more than the general
population and as a consequence experience more smoke-related
ill-health and loss of life than smokers without mental
disorders.
Regarding overall tobacco consumption, those with mental illness
are strikingly overrepresented; 44% of cigarettes smoked in a
nationally representative sample of over 4000 participants were
by people with a mental disorder in the previous month.
Smoking is responsible for half the difference in survival to 70
years of age between social class I and V. An interplay
occurs between mental health disorders, long term physical
conditions and socio-economic disadvantage to generate a negative
spiral in which smoking acts as one of the principle agents of
health inequality. The physical health of people with mental
illness has often been overlooked, in part driven by mistaken
beliefs that smoking is somehow helpful for them. This causes a
continuum of co-morbidity seen at its most extreme in those with
severe mental disorders who may suffer a 20% reduction in life
expectancy, with most of this excess mortality due to smoking.
People with mental illness experience
significant health inequality and there is a real risk that such
inequality will widen further without effective action. Investment
of higher levels of smoking cessation resources to this group
compared to the general population will result in significant
improvements in health. To be effective this must be part of a
wider, coordinated strategy to help this group access such support.
Primary Care practitioners and organisations are ideally placed to
help with their knowledge of those at risk and their skills and
capacity to offer such prevention and health promotion
activity.
5. Review of College Research and
Training Unit (CRTU)
The President has asked Dr Denise Coia, Vice
President to lead a review of the CRTU with
the support of Dr Paul Lelliott, the CRTU Director, and his
staff. The purpose is to examine the role of the CRTU within
the College as a whole, and to plan for future
developments.
The review team has posted a questionnaire on
the College website, and would be grateful if members
could complete it to provide input to the team's
work. Even if your knowledge of the work of the CRTU is
indirect or limited, please give us your views.
The questionnaire is at http://www.rcpsych.ac.uk/college/reviewofcrtu.aspx
6. New
College guidance for people growing older with mental
illness
The College has updated its guidance on
service transitions for people growing older with existing mental
illness. The new report, CR153: Links not boundaries: service
transitions for people growing older with enduring or relapsing
mental illness, makes 20 recommendations to help improve the
care of people moving between psychiatric services. Recommendations
fall into six main areas: the use of transition protocols,
assessment, the process of transition, the care plan, monitoring
and commissioning.
The report has been produced by a working
group including representatives from the College’s Faculties of Old
Age Psychiatry, General and Community Psychiatry, Rehabilitation
Psychiatry, the Faculty of Old Age Psychiatry consumer group and a
RMN. It recognises that transition between services can be a
difficult and worrying time for users and their families, and
provides both a user’s and a carer’s perspective.
CR153 updates CR110 Caring for people who enter old age
with enduring or relapsing mental illness
(‘Graduates’).
7. Should young
people be taught to talk about their feelings?: the Royal College
Annual Debate for Young People - by Dr Jim Bolton
Every year the Communications Department of
the College holds a debate with an invited audience of young people
from schools from across the south of England.
The most recent debate in December was on
“This house believes that young people should be taught to talk
about their feelings”. The motion was proposed by Drs Margaret
Murphy and Mark Salter, and opposed by Drs Alice Lomax and Dan
Hayes with Dr Jim Bolton in the chair.
The debate was lively and heated. Both
teams used research evidence, as well as emotion and persuasion, to
try and convince the audience of their side of the argument.
Margaret and Mark advocated for the teaching
of “emotional literacy” in schools. This encourages school children
to consider both their feelings and those of others. Greater
empathy would make the world a better place, the speakers argued,
and anything that helped young people to develop their emotional
sensitivity should be encouraged. Dan and Alice argued that there
were many ways in which young people learned how to get in touch
with their feelings, especially through adult role models and the
use of art, such as music and poetry; formal school teaching was
not necessary.
After the speakers had laid out their
arguments, there were questions and comments from the young
audience. Although the opposers doubled their support after
the debate, the eventual winners, by a narrow margin, were those
who spoke for the motion.
However, it is not really who wins or loses
that is important, but the chance for young people to meet
psychiatrists and to consider subjects relevant to their mental
health. This annual event is always oversubscribed with over
400 in the audience. There have been similar events in other
parts of the UK and Ireland and these present important
opportunities for education and destigmatisation.
8. Do you
know if your Trust is working with local PCTs to ensure that
advocacy services are available for those detained under the Mental
Health Act?
The National Institute for Mental Health in
England (NIMHE) welcomed Health Minister Phil Hope’s recent
announcement that Primary Care Trusts (PCTs) will be responsible
for ensuring that independent advocacy services are available to
patients subject to the Mental Health Act.
NIMHE has worked with advocates, community
organisations and PCT commissioners to prepare for the introduction
of this new service. For the first time in England, patients
subject to certain aspects of the Mental Health Act will have
access to an Independent Mental Health Advocate (IMHA).
NIMHE will be providing guidance designed to
help PCT commissioners establish this statutory service by next
April. This guidance will also:
- support advocacy providers in tendering
processes
- establish clear arrangements with mental
health services on how advocacy will work
- give information on advocacy for service
users and carers
- suggest practical steps for implementation,
monitoring and review
- provide examples of service specifications
and engagement protocols.
http://mhact.csip.org.uk
9. Department of
Health: First NHS constitution launched
An historic signing ceremony to mark the launch of the NHS
Constitution for England has taken place at Downing Street. The
Constitution, the first of its kind in the world, was signed by
Prime Minister Gordon Brown, Health Secretary Alan Johnson and NHS
Chief Executive David Nicholson.
The Constitution will give power to patients and the public by
bringing their existing rights together in one place so they know
what they are legally entitled to - and how they can exercise their
rights as well as understanding their responsibilities. It also
contains a range of pledges to patients, public and staff, which
the NHS is committed to achieving. For NHS staff, the Constitution
will mean an NHS-wide commitment to equipping them with the tools,
training and support they need to deliver high quality care for
patients.
The Constitution is the result of extensive consultation with
staff and patients, which was led by strategic health authorities
and overseen by independent experts on the Constitutional Advisory
Forum (CAF). In response to the consultation and report published
by the CAF, the final Constitution includes:
- A right to makes choices about your care and to information to
help exercise that choice
- A new legal right to receive the vaccinations that the Joint
Committee on Vaccination and Immunisation recommends that you
should receive under an NHS-provided national immunisation
programme
- A right making explicit your entitlement to drugs and
treatments that have been recommended by NICE for use in the NHS,
if your doctor says they are clinically appropriate for you
- A right to expect local decisions on funding of other drugs and
treatments to be made rationally following a proper consideration
of the evidence
- Clear and comprehensive rights to complaint and redress.
The Health Bill, published last week, will underpin the new
Constitution by creating new legislation to ensure that the
Constitution will be reviewed every 10 years and a duty on NHS
bodies, as well as independent sector and third sector providers of
NHS services, to have regard to the Constitution.
www.dh.gov.uk/nhsconstitution
10. Department of Health: New measures for
better quality, personal health care
New measures that will permit for the first time, direct
payments for healthcare to patients, were published in the Health
Bill. The Bill sets out proposals that will give patients more
choice, greater control over the care they receive, and improve the
quality of health services.
It will also place a legal duty on the NHS and its providers to
have regard to the NHS Constitution, which will safeguard the
principles and values of the NHS for the future, and sets out the
rights and responsibilities of patients and staff.
The Health Bill includes proposals to:
- Pilot direct payments to give patients greater choice and
control over their health care.
- Place a duty on all NHS bodies, private sector and third sector
providers of NHS services to have regard to the NHS
Constitution.
- Create new quality accounts that will help improve the quality
of health services.
- Introduce innovation prizes to encourage an enterprise and
innovation culture within the NHS.
- Increase powers of suspension to strengthen our ability to hold
to account those who fail to meet the requirements of public
office.
- Establish a regime for unsustainable NHS providers to protect
patients and staff from failing services.
- Strengthen tobacco control to protect children and young people
from the harm caused by smoking.
- Reform pharmacy services to ensure that pharmacies are
providing high quality services based on local needs.
The Bill also contains measures to extend the adult social care
complaints procedure and a framework to allow HMRC to continue to
share summarised and anonymised information on GP and dentist pay
with the Department of Health.
The
Health Bill was published on 16th
January 2009 and will proceed through the House of Lords over the
next few months.
11.
Vulnerable Deaths Inquiry Set Up: A confidential
inquiry to investigate premature deaths of people with learning
disabilities in England is to be set up by the Department of
Health
It comes in response to an independent
inquiry, published in July 2008, into the deaths of vulnerable NHS
patients highlighted by Mencap. Cases include Martin Ryan, 43, who
went 26 days without food before he died after staff did not fit a
feeding tube. Mencap said it was an "important step
forward". Other cases in their report "Death by Indifference"
include Emma Kemp of Newbury, Berkshire, who was not treated for
cancer because doctors said her communication difficulties meant
she was unable to consent.
The independent inquiry into the deaths, led
by Sir Jonathan Michael, said laws to protect
people with learning disabilities were being ignored by the NHS in
England.
A report from the Parliamentary and Health
Service Ombudsman is due later this month. The DoH said it will
also commission a new Public Health Observatory to provide data on
learning disabilities and would work to ensure medical students and
NHS professionals receive training on learning disabilities,
equalities and human rights. A spokesperson said this would build
on other work to introduce annual GP health checks for people with
learning disabilities.
The announcement comes as part of Valuing
People Now, a three-year strategy to improve services for people
with learning disabilities across health, housing, employment and
community care. This includes plans to support more people with
learning disabilities into paid work, and giving them more
opportunities to study.
To read more about Valuing People now, click
here -
http://www.dh.gov.uk/en/SocialCare/Deliveringadultsocialcare/Learningdisabilities/index.htm
12. General
Medical Council: Doctors urged to take part in licensing
regulations consultation
The General Medical Council (GMC) has launched a
three-month consultation on its draft Licence to Practise
Regulations and supporting guidance for doctors.
The consultation covers the GMC’s proposed
arrangements for granting, withdrawing, refusing and restoring
licences to practise.
Licences to practise are being introduced in the
autumn of this year. In future, all doctors wishing to practise
medicine in the UK will need a licence to practise.
Chair of the Council, Sir Graeme Catto, said:
“Licensing represents a significant change in medical regulation,
and the publication of the draft regulations and guidance shows
that we are making real progress in our work to deliver the licence
to practise later this year. It is the first tangible step towards
the introduction of revalidation.
“This consultation will give doctors, employers
and others who will be affected by these regulations and guidance
the opportunity to say whether they are clear, fair,
straightforward and in the public interest.”
The consultation runs until 21st April 2009. Now
see: https://gmc.e-consultation.net/econsult/default.aspx
13. General
Medical Council: Tomorrow’s Doctors are in your hands
A three-month consultation into the review of
Tomorrow’s Doctors, the General Medical Council’s guidance for
undergraduate medical education in the UK, was launched in December
2008.
The guidance, first produced in 1993, sets out
the standards for the knowledge, skills, and behaviour which
students are required to meet in order to graduate from UK medical
schools. Since the guidance was last produced in 2003, there have
been many fundamental changes to medical education and
training.
The revised guidance will be published in
Summer 2009. To take part in the consultation visit http://www.gmc-uk.org/tomorrowsdoctors%20
14. Care
Quality Commission consults on proposals for 2009/10 assessments of
health and social care
The Care Quality Commission (CQC) has set out its approach to
reviewing the performance and activities of health and social care
organisations in 2009/10 and is embarking on a consultation with
stakeholders. The approach is underpinned by the CQC's aim of
ensuring better care for people and its focus on high quality
health and social care.
This consultation puts down a firm marker about the CQC's work
as a new independent regulator: it will look across health and
social care in an integrated way and bring people who use services,
patients, families and carers to the heart of what it does.
The
CQC is consulting for 12 weeks until 12th
March 2009 on the proposals, which have three main elements:
- Reviews of health and social care commissioning (by PCTs
and local authority adult social services departments)
- Reviews of providers of health and social care services (such
as hospitals, and mental health services).
- Special reviews and studies of aspects of health and social
care, separately and together.
- The subjects being considered for special reviews in 2009/10
include:
- Meeting the physical health needs of people with mental health
problems and learning disabilities in hospital and residential
settings.
- How well is the health and social care pathway working for
a)people who have stroke and their carers; b) people with
dementia?
- The impact of commissioning and health promotion on health
inequalities.
- How well are health and social care services addressing
equality and human rights - focussing on commissioning in two or
three service areas?
- Child and adolescent mental health services.
- A review or study focussed on value for money that covers both
quality and cost of care in the areas of a) diagnostic services in
acute hospitals; b) commissioning c) services for older
people.
15.
Unique collaboration between the Almeida Theatre London N1 and the
Royal College of Psychiatrists:
5 March 2009: Post-Performance Panel Discussion
following Duet for One with Henry Goodman and Juliet
Stevenson
The Spring 2009 Season at the Almeida Theatre, Islington, London
N1 includes a major revival of Tom Kempinski's Duet For
One. Stephanie Abrahams, a brilliant concert violinist, who
seemingly has it all, is forced to re-evaluate her life when struck
down by an unforeseen tragedy.
Two of Britain’s finest actors, Juliet Stevenson and
Henry Goodman, will perform this gripping and deeply
moving psychological drama in its first major revival.
On 5th March, the play will be followed by a
post-performance panel discussion chaired by the President,
Professor Dinesh Bhugra, which will focus on media representations
of psychiatry. The panel will also include Dr Cleo van Velsen, a
psychiatrist and consultant forensic psychotherapy and Dr Peter
Byrne, Associate Registrar (Public Education).
Cost: £75 (including membership of the Almeida Theatre’s Circle
of Supporters at the Friends (350) level for one year), or £110 for
two tickets and a joint membership.
Contact Lizzie Sallybrass on 020 7288 4935 or email: lstallybrass@almeida.co.uk
16. What's new?