College News
1. Membership of the Royal
College of Psychiatrists tops 15,000: Professor Dinesh
Bhugra
2. Update from the Dean,
Professor Rob Howard
3. The Annual Census of
Psychiatric Staffing for 2007
4. All UK hospitals ‘must have liaison
psychiatry services’: new report No Health Without Mental
Health
5. Scottish Alcohol Needs Assessment:
new report
6. Where does it hurt? An evening with Max
Pemberton
7.
RCPsych Awards Ceremony Announced: Invitation to
attend
Consultations
8. New Horizons: Government consults on mental
health and well-being
9. New
Inquiry: Terms of Reference — Social Care Services
Other News
10. Department of Health's Delivering Same-Sex
Accommodation (DSSA) Campaign
11. Care Quality
Commission: New mental health report
12. National Confidential
Inquiry into Suicide and Homicides by People with Mental Illness:
Homicides by mentally ill has risen
13. Sainsbury Centre for
Mental Health: Community Sentences with mental health treatment
growing but a missed opportunity for most
14. NHS Evidence: new
internet service for everyone in health and social
care
15. PMETB certification
statistics: quarterly results published
16. Annual Deanery
Reports now published 2008/09
17. GMC urges doctors to take
advantage of new route onto the Specialist
Register
18. Doctors fear stigma
of mental illness
19. Updates from the
Department of Health
20.
Time to Change: two new films to tackle the stigma surrounding
mental health
College News
1. Membership of the Royal College of Psychiatrists
tops 15,000: Professor Dinesh Bhugra
The Royal College of Psychiatrists has now more than 15,000
subscribing members – up from just over 14,000 this time last
year. In recent months, more than 600 doctors have registered
online as Pre-Membership Trainees and around 70 have joined as
Specialist Associates/Affiliates and International Associates. We
also have 450 new MRCPsych members.This is a confirmation of the
work all members have put in and an acknowledgement that it is
worth belonging to the College.
I would like to thank the Officers and all the staff at the
College for their concerted drive to bring more young doctors into
psychiatry. I offer my warmest welcome to all our new members.
2. Update from the Dean, Professor Rob Howard
We’ve come to the end of the 2009 National
Recruitment to CT1 and are in negotiations with the Department of
Health about the way in which we will conduct recruitment to CT1
and ST4 in England in 2010. We’ve achieved a higher overall
fill rate of posts than in previous years, and one interesting
statistic suggests we may have achieved a potential further reward
of running a national system.
Of the more than 400 CT1 posts now filled for
2009, 64% have gone to graduates of EU medical schools. The reasons
for this are complex. The DH’s insistence that we could not
shortlist applicants who had already completed more than 12 months
in psychiatry meant that we excluded a disproportionate number of
IMGs. We did, however, resist the Department’s subsequent
ruling that we should not shortlist or interview International
Medical Graduates (IMGs) until the completion of a second
application round – making the process not as unfair to IMGs as it
was for other specialties.
It is too early to place too much significance
on the fact that we appear to have filled almost two-thirds of our
training posts with EU graduates as evidence that we have turned
the corner in psychiatry’s recruitment crisis. But I find it
heartening that enough good quality applicants came forward to give
us this statistic. Our high-profile advertisement in the BMJ,
positively describing psychiatry as “Medicine of the Mind” and a
“Dynamic career for doctors” made us look like a confident and
respectable professional choice for young doctors. We need to
continue to project a positive image to potential recruits because
this does have an effect.
The Education, Training and Standards
Committee has recently approved the training curricula for three
new psychiatric sub-specialties which we plan to submit to PMETB
for approval. Once we have approval – we estimate this will
take around six months – trainees will be able to train towards a
CCT in Neuropsychiatry, Eating Disorders Psychiatry or Perinatal
Psychiatry, as approved sub-specialties of General Adult
Psychiatry. Deaneries will have to demonstrate to PMETB that
they provide training opportunities for psychiatrists for these new
CCTs; I believe that this will help us develop and protect quality
and variety in our specialist training.
Colleagues in Iraq, wanting to rebuild
postgraduate medical training, have asked the College to
collaborate with the Iraqi Board for Medical Specialisations to
help develop training curricula and assessment methods for their
psychiatry trainees. I recently visited Baghdad, following an
invitation from Iraq’s Health Minister, himself a psychiatrist, to
share our core and specialist curricula and details of the new
MRCPsych examinations. Two things struck me forcefully; the
high standards of professionalism and training that Iraqi
psychiatrists have maintained through a period of unimaginable
difficulty, together with the persistence of tremendous respect for
the UK’s medical royalcolleges as the international setters
of gold standards for training. I would like us to do what we
can to build partnerships with our colleagues in Iraq.
Conducting the MRCPsych written papers in
Baghdad with the logistical assistance of the British Council is
feasible, and would be a potent symbol of the College’s will to
work with colleagues there to overcome some of the difficulties
they face. Access to psychotherapy and developmental
psychiatry training is a challenge in Iraq (as it can be in the
UK), and I would like us to try and think of ways to deliver
materials and supervision that would support the acquisition of
curricula competencies in these areas.
Anyone who would like to help with any aspect of this
collaboration is welcome to contact me.
3. The Annual Census of Psychiatric
Staffing for 2007
The College
Census of Psychiatric Staffing for 2007 has now been
published. The return rate from trusts was the highest ever,
and cover the period when MMC was introduced. Consultant
expansion seems now to have come to a halt, but the growth in
Specialty Doctors continues, leading to a significant change in the
shape of the workforce. The use of long term locums was still
a significant feature at the time of the survey. If that has
continued in 2008 and 2009 it may have implications for the
prospects of upcoming CCT holders’ career progression.
Dr. Andy Clark has been appointed the
College’s Workforce Lead, replacing Dr. Sally Pidd as Associate
Dean for Workforce. Dr. Clark brings with him a wealth of
experience on workforce issues, having held the position of
Regional Representative in Child and Adolescent Psychiatry and
North West Regional Advisor as well as serving on the Workforce
Committee as the North West Division representative. Any
comments or questions, should be sent to Charlotte Cox,
Workforce Manager.
4. All UK
hospitals ‘must have liaison psychiatry services’: new report
No Health Without Mental Health
Every hospital in the UK must have a dedicated
liaison psychiatry service, according to a new report from the
Academy of Medical Royal Colleges. No Health Without
Mental Health, warns that the current lack of
provision means the mental health problems of many hospital
patients are going unrecognised and untreated – causing them
unnecessary suffering.
Figures show that 1 in 4 people who
attend hospital for physical health needs will have a mental health
problem. For patients over the age of 65 these figures are
even higher with 60% requiring mental health care during their
hospital stay. At present, however, around 40% of hospitals
have no access to liaison psychiatry services.
Professor Else Guthrie, author of the report,
said: “When mental and physical health problems combine,
the individual is more likely to experience physical complications
and problematic symptoms. They are less likely to access
services and adhere to treatment, and their physical and mental
recovery can be seriously impeded. These complications result
in greater lengths of stay, higher numbers of re-admissions, and
increased healthcare expenditure. The fact that many
hospitals lack liaison psychiatry input means that patients are not
getting a fair
deal and that precious NHS resources are not being
best utilised.”
5. Scottish Alcohol Needs
Assessment: new report
The Royal College of Psychiatrists welcomed the
Scottish Government’s approach to alcohol problems, but expressed
its concerns at the shortage of alcohol treatment services in
Scotland.
The report,
commissioned by the Scottish Association of Alcohol and Drug Action
Teams (SAADAT) and published by the Institute of Psychiatry, King’s
College, London, showed that in 2006/07, approximately
17,000 people in Scotland accessed treatment for alcohol
problems but, according to the research, this represents only 8.2%
of those who could benefit from specialist help.
Dr Michael Farrell, Chair of the Addictions
Faculty said “Alcohol misuse has been a neglected issue throughout
the UK for many years. Since the 1970s there have been rising
rates of alcohol related harm, but little investment in services.
Scotland has shown the way within the UK and in Europe with
innovative, evidence-based approaches to prevention and
treatment.
Scottish services have not fallen as far
behind as those in England. However, a situation where services can
only deal with 8.2% or 1 in 12 people who need help is a serious
one. Effective treatment of alcohol problems helps individuals and
their families and is highly cost-effective.”
6. Where does it hurt? An
evening with Max Pemberton
6.30 pm on Tuesday 22 September
2009
Society of Chemical Industry, 14 Belgrave
Square, London SW1X 8PS
The successful author, columnist and doctor
Max Pemberton, will be discussing the details of his new book
Where does it hurt? at a special evening for College
members.
Following on from the success of his first
book, Trust me, I’m a Junior Doctor, Max Pemberton is back and into
his 2nd year of medicine, but this time he is out of the wards and
onto the streets, working for the Phoenix Outreach Project. Fuelled
by tea and more enthusiasm than experience, he attempts to locate
and treat a wide and colourful range of patients that somehow his
first year on the wards didn't prepare him for.
Places are limited for this event and will be
allocated on a first-come-first-served basis. Please email Nicola Boyce by Friday, 11th
September 2009 quoting ‘Max Pemberton’ in the email subject
bar.
7.
RCPsych Awards Ceremony Announced: Invitation to
attend
Following the announcement of the shortlists
for the RCPsych Awards 2009, we are delighted to announce the
details of the Awards ceremony.
Date: Tuesday, 6 October
2009
Venue: The Royal Society of
Medicine, 1 Wimpole Street, London W1G 0AE
Time: Doors open at 2.15
pm for tea/coffee and registration. Ceremony begins at 2.45 pm and
will be followed by a drinks reception.
The ceremony will be hosted by journalist and
broadcaster Libby Purves, with Phil Hope
MP, Minister of State for Care Services, presenting the
Lifetime Achievement Award.
All winners will be announced at the ceremony.
Tickets for the ceremony are free and anyone
with responsibility for, or an interest in, mental health services
and their provision are welcome to attend, so please do tell
colleagues and friends who may like to come. Admittance to the
ceremony will be by ticket only. Please email Nicola Boyce by
Friday, 18 September 2009.
Consultations
8. New Horizons: Government
consults on mental health and well-being
New Horizons is a new strategy that will promote good
mental health and well-being, while improving services for people
who have mental health problems. It will build on the National
Service Framework for mental health which comes to an end in
2009.
New Horizons sets out a dynamic approach to improving
well-being for the whole population, aiming for the first time to
create a powerful alliance that can target the root causes of poor
mental health.
“The Royal College of Psychiatrists welcomes the consultation,”
said Professor Dinesh Bhugra, President. “We have been involved in
the development and are delighted that two major planks deal with
transitional services and public mental health. As professionals,
our duty is to our patients and vulnerable individuals. Through
working with general public from all walks of life, we would
encourage everyone to look after their own mental health and of
those around them. Mental health is every one's business!”
The
consultation was developed with a wide range of
partners and a number of key themes are being consulted on:
- prevention and public mental health - recognising the need to
prevent as well as treat mental health and promote mental health
and well-being.
stigma - strengthening our focus on social inclusion and tackling
stigma and discrimination wherever they occur.
- early intervention - expanding the principle of early
intervention to improve long-term outcomes.
- personalised care - ensuring care is based on individuals'
needs and wishes leading to recovery.
- multi-agency commissioning/collaboration - working to achieve a
joint approach between local authorities, the NHS and others,
mirrored by cross-government collaboration.
- innovation - seeking out new and dynamic ways to achieve our
objectives based on research and new technologies.
- value for money - delivering cost-effective and innovative
services in a period of recession.
- strengthening transition - improving the often difficult
transition from child and adolescent mental health services to
adult services, for those with continuing needs and issues.
9. New Inquiry:
Terms of Reference — Social Care Services
Following the publication of the Green Paper, Shaping the
Future of Care Together, the Commons Health Committee has
decided to undertake an inquiry into the future of social care
services. The inquiry will look at options for:
- future funding of long-term
residential and domiciliary care for older people and people with
physical or learning disabilities;
- personalisation of social
care services;
- more effective, consistent and
user-friendly social care services.
Organisations and individuals are invited to submit written
evidence. Please send your comments to Claire
Churchill, Policy Administrator.
Other News
10. Department of Health's Delivering Same-Sex
Accommodation (DSSA) Campaign
The
DSSA programme aims to all but eliminate mixed-sex
accommodation from hospitals in England by 2010. Measures
include:
- £100 million Privacy and Dignity Fund to support improvements
and adjustments to hospital accommodation;
- launching the 'Same-Sex Accommodation: Your Privacy, Our
Responsibility' campaign, to provide information and guidance for
hospitals, patients and the public;
- sending an improvement team out to hospitals that need extra
support;
- introducing rigorous and transparent performance objectives for
hospitals via the standard contract from April 2010.
11. Care
Quality Commission: New mental health report
The Care Quality Commission has launched the final
biennial report from their predecessor
organisation, the Mental Health Act Commission. The report says
that care for people detained under the Mental Health Act is in
need of improvement and highlights the main areas of concern.
12. National Confidential
Inquiry into Suicide and Homicides by People with Mental Illness:
Homicides by mentally ill has risen
The number of people killed by individuals
with mental illness in England and Wales increased between 1997 and
2005. The rise occurred in people who were not under mental
health care, and was not found in mental health patients.
The number of homicides committed by people
with mental illness at the time of the offence increased from 54 in
1997 to over 70 in 2004 and 2005. There was also a rise in
the number of homicides by people with schizophrenia – from 25 in
1997 to 46 in 2004 and an estimated 40 in 2005.
The annual
report also found:
- a fall in suicide by mental health patients
overall and a continued fall in suicide by in-patients
- suicide following absconding from the ward
remains a serious problem
- few serious incidents occurred following
absconding from secure units.
13. Sainsbury Centre for Mental Health: Community
Sentences with mental health treatment growing but a missed
opportunity for most
More Mental Health Treatment Requirements are
being issued to offenders on community sentences than ever before,
but less than 1 in 100 offenders in the community get one,
despite high levels of need for mental health care.
Lord Bradley obtained figures from a
Parliamentary Question which show that 918 Mental Health Treatment
Requirements (MHTRs) were given to offenders as part of a community
order or a suspended sentence order in 2008, compared with 848 in
2007; this was the highest number given to date.
Sainsbury Centre policy officer Max Rutherford
commented on the new figures: "The MHTR truly is a missed
opportunity for the many thousands of people with mental health
problems who go to prison each year on short sentences. Instead of
being imprisoned and separated from their families, people could be
getting mental health care as part of a community sentence, and
building more productive lives."
14. NHS
Evidence: new internet service for everyone in
health and social care
NHS Evidence is
an internet-based service for everyone who works in health and
social care to help them make informed decisions about treatments
and resources.
The web portal provides free access to best
practice, clinical and non-clinical information. NHS Evidence has
also developed an accreditation process to help users recognise the
most trusted sources of guidance, which includes clinical
guidelines, clinical summaries and best practice statements. In
future, the accreditation scheme may be extended to other types of
information.
NHS Evidence supports a range of activities
designed to encourage a change in practice. Significant new
evidence is highlighted on a monthly basis in an electronic
bulletin, Eyes on Evidence, for which there is free subscription
via the portal, and annually through annual evidence updates in key
topic areas. This work is supported by 34 specialist collections
which make up NHS Evidence Health Information Resources. The
purpose of the collections is to filter the huge quantity of
published research, identify relevant sources of information and
review new publications.
15. PMETB certification
statistics: quarterly results published
To provide applicants and stakeholders with
more insight into the work done by the certification directorate,
PMETB has published
statistics on the number of applications processed in
each of the medical and surgical specialties. These show that
between March and June 2009, PMETB issued decisions on over 1,200
certification applications.
16. Annual Deanery Reports now
published 2008/09
The Annual Deanery Report (ADR) outlines
deanery activity in the previous year, including how the deaneries
are tackling problems, diseeminating good practice, and goals ser
for the year ahead. The action plan is an annex of the deanery’s
annual
report to PMETB.
17. GMC urges doctors to take
advantage of new route onto the Specialist Register
The GMC is concerned that there may be up to
1000 doctors who have yet to take advantage of the new route onto
the Specialist
Register. The route is for the 1000 to 1500
doctors who, whilst working in the NHS or UK Armed Forces, were
appointed to consultant posts prior to 1997, but are not on the
Specialist Register.
Neil Roberts, Director of Registration and
Resources, said: “Not only is specialist registration necessary if
a doctor wishes to take up a consultant post in the NHS, it will
also mean that doctors will be able to participate in
recertification when it is introduced. For those doctors who are
already registered with the GMC, there is no fee for doing so. We
urge the remaining doctors to get in touch and, if they are unsure
whether they are eligible or not, to contact the GMC to
clarify.”
18. Doctors
fear stigma of mental illness
Only 1 in 5 doctors would seek advice
from colleagues or other health professionals if they developed a
mental illness, according to a new survey published by the
Royal
College of Physicians.
Three-quarters (73%) said they were most
likely to speak to family or friends, while only 13% said they
would speak to professional or governmental organisations, and just
7% would talk to colleagues. A further 7% said they would tell
nobody.
The poll found that:
- A third (33%) of non-psychiatric
doctors said worries about career implications would affect their
decision to disclose their illness.
- 3 in 10 (30%) said they would be
influenced by professional integrity and 1 in 5 (20%)
said they were worried about the stigma of having a mental health
problem.I
- If they required inpatient treatment, they
would choose either a local or distant private facility, while
a further fifth (19%) said they would opt for NHS care, but
away from their local area.
- More than half (51%) said their decision
was influenced by fears over confidentiality.
Dr Alfred White, speaking on behalf of the
research team, said: "Doctors who are reluctant to seek
professional advice for mental health issues may be putting
themselves, and possibly also their patients, at risk. Doctors
suffer higher levels of depression and substance misuse, as
well as higher rates of suicide than the general
population.
“The apparent lack of confidence in the current system protecting
doctors' confidentiality may exacerbate these trends."
Dr White said researchers were concerned
that there was a lack of options for doctors who feel they are
mentally unwell, adding: "Greater emphasis is needed to educate
doctors on mental health and to improve and extend the options open
to them for accessing mental health support."
19. Updates
from the Department of Health
a. Suicide prevention annual
report
On 10 July the
Suicide prevention annual report on progress
2008 was published, outlining what has been achieved
in that year.
b. NHS credit crunch
stressline
Trained health staff are offering
self-care and self-help
advice to people distressed by the impact of the
recession, and sign-posting them to appropriate financial or other
advice. Callers’ levels of distress will be assessed and, if
necessary, they will be referred to local NHS services.
c. Getting the medicines
right
This evaluates key existing medicines
management schemes and their applicability to acute mental health
settings and suggests a five-stage model framework for delivering
better medicines management. This guidance supports
local decision-making in adopting more effective and personalised
medicines procedures in acute mental health
units.
d. MHRA/NPSA agreement to share
patient safety incident data
This
letter from the NPSA provides details on how to
support trusts in safeguarding public health and improving patient
safety, the Medicines and Healthcare products Regulatory Agency and
the National Patient Safety Agency’s National Reporting and
Learning Service have formalised an agreement for sharing patient
safety incident data held by each organisation.
e. New council champions equality
and diversity
A new Equality
and Diversity Council, that will strengthen the
national focus on improving quality in the NHS, was launched on 3
August. Chaired by David Nicholson, its key role will be reporting
on equality and diversity issues to the NHS Management Board.
f. Examination for consent or
treatment
This document updates that issued in 2001, and
provides a revised guide to the legal framework that all health
professionals need to take account of in obtaining valid consent
for any examination, treatment or care they propose to
undertake.
20. Time to Change: two new
films to tackle the stigma surrounding mental health
Time to Change, a mental health anti-stigma
campaign, launched two new
films to coincide with a YouGov poll, reveals more
than a third (34%) of the public believe people diagnosed with
schizophrenia are likely to be violent.
The first film, entitled Schizo, plays on the
negative stereotypes about people with schizophrenia. The second
film, called Kid's Party, has been seeded into video
sites with the title "Schizophrenic man terrifies kids at
party".
Sue Baker, director of Time to Change, said:
"Both films have been designed to attract members of the public who
don't realise they are causing stigma and discrimination.
21.
What’s new online?