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The Royal College of Psychiatrists Improving the lives of people with mental illness

Chair's Update

March 2017

Malone House, Belfast

Well… one year served as your Chair and during that time, we have been “round the houses” politically with no less than two NI Assembly Elections, two Health Ministers and two Health Committee Chairs… now a vacuum, but talks continue…

So it was that our Spring Conference went “round the houses” also, but in a good way! It was so well supported that we outgrew Clifton House and had to move it to Malone House (pictured)… and in the end we outgrew Malone House also as we were disappointed to have to turn down some members through lack of space in the final days leading in. In this regard, as far as practically possible, please do book early as it is so critical in our choice of venue, catering etc.

(Just as an aside, I am pleased to hear from staff that the online booking problems which had been encountered with the new database systems launched by the College centrally last year are resolving slowly but surely and I understand that about half of you were able to successfully book on line this time round. We are hopefully within sight of total resolution of these systemic issues which have been stressful for staff and members alike. Your patience and cooperation meantime are much appreciated).

 Back then to the “Improving Services for Everyone” Spring Conference at Malone House on 29 March which was described as “a very successful day” and became a fitting way to mark the first anniversary! The venue was good with no car parking issues, the weather was favourable, the attendance was capacity, the topic was Quality Improvement, the speakers (both external and internal) were quality itself and needed no improvement! – and the organisation was excellent, thanks to all our three members of staff. We have received very positive feedback and there is a definite appetite for a continued focus on Quality Improvement issues relevant to Northern Ireland. Afterwards one of our invited guest speakers Dr Geraldine Strathdee had this to say in a note to our staff:

“…thank you for the very warm welcome this week and such an excellently designed and organised QI day. It was really enjoyable; I learned a lot; I made new friends and connections with fellow travellers. Please do remember that I have never forgotten my Northern Irish roots and am only too pleased if I can ever be helpful.”

RCPsychNI Spring Conference ProgrammeBy the reaction to Geraldine’s contribution on the day, we will certainly be keen to welcome her back home once again in the very near future.

Huge thanks to Geraldine and to Dr Kevin Cleary who also made the trip over to address us on the issue of culture change, which is critical if any initiative is to take root and prosper. We are also indebted to our three members Drs Catherine McDonnell, Conor Barton and Francess Doherty who together ensured that the afternoon programme was both lively and instructive. The local perspective on the morning’s stimulating programme was key and it is a tribute to all three that we held our audience right to the day’s end. It is fair to say that both Catherine and Francess employed intriguing titles (click right picture to enlarge) and Conor employed humour in order to hold the attention of all. Feedback was both positive and plentiful! Huge thanks to all three, to all our members who attended, to our staff and also to Dr Gavin Lavery, Clinical Director of the HSC Safety Forum who chaired the afternoon session. We hope the day’s thoughts will lead to improved services for our patients in the short, medium and longer term. Simple changes can make profound differences.

In above photo are Drs Francess Doherty, Geraldine Strathdee, Kevin Cleary & Gerry Lynch – with Dr Catherine McDonnell also featured in photo below.

While some of us enjoyed the Spring Conference in its totality, Drs Michael Doherty, Rowan McClean and Ryan O’Neill were also very usefully occupied for part of the morning at a meeting with Commissioner of Mental Health Services Kevin Keenan and his Team at the Health & Social Care Board offices in Linenhall Street, Belfast. They again raised the issue for us of the 5 Trusts’ October 2015 Strategic Outline Business Cases for Physical Healthcare Monitoring for those with Severe Mental Illness and Eating Disorders (Child and Adult). Whilst it was made clear that resolution of the current political impasse is a pre-requisite for real progress on this issue, there was comfort in the knowledge that this remains a top priority.

In terms of the political impasse, there is no doubt that it is having an effect both on existing services and initiatives and in this regard I was interviewed on 9 March by Marie Louise Connolly for BBC NI. It is precisely the physical healthcare monitoring campaign which I had in mind when doing these interviews which received significant coverage across the BBC News platforms including Radio and Television that day. We can only hope that it all has a cumulative effect for the sake of this vulnerable client group.

Dr Noel Crockett at Altnagelvin

We supported two events in relation to Recruitment and Retention during National Careers Week at the start of the month. The first took place on 7 March at the South West Acute Hospital led for us by Dr Pat Manley and the second was on 9 March in the Centre for Medical and Dental Education and Training at Altnagelvin led for us by both Dr Deirdre McGlennon and Dr Noel Crockett (pictured above with the stand and materials supplied by the College). I will focus here on the Altnagelvin one which was aimed at Sixth Form students from the local area interested in applying to Medicine following their A levels. It was part of the Annual Career Evening which is organised by the Medical Education Department in both Altnagelvin and the South West Acute Hospitals. The aim of the evening was to give the students information on the application process and the types of careers which are available within the medical field. There were several specialities in attendance including Maxillofacial surgery, Cardiology, Neurology, Obstetrics and Gynaecology, Paediatrics, General Practice, Radiology, Orthopaedics and Emergency Medicine, as well as ourselves. Representatives from each of these specialities were in attendance to answer any questions the students had about medicine in general or their speciality. My thanks to all three members for giving focus to this important area. Thankfully we do not face the same problems in this regard as colleagues in other regions, but that level of success can only be maintained by our constant vigilance and the commitment of members such as these.

Aware Mental Health eventI am pleased to report that our collaborative work with Aware continued throughout March with talks delivered at their 8, 9 and 22 March events at Queen’s University (flyer pictured), North West Regional College and Malone House (Impact of Domestic and Sexual Violence on Mental Health) respectively by Drs Maggie McGurgan, Maggie Kelly and Phil Campbell (pictured below) respectively. This continues to be such a worthwhile form of public engagement for us. My thanks to our three members and also to Tom McEneaney in Aware for facilitating this. I am particularly pleased to see third level students being addressed on depression and mental health by Drs Maggie McGurgan and Maggie Kelly, as this can be such a vulnerable time and an appropriate time therefore for early intervention.

Phil Campbell at Queen's University

I was pleased to attend and represent the College at the NI Association of Social Workers Celebration of World Social Work Day on 21 March in the Stormont Hotel. The need for leadership was much discussed and there was a very interesting presentation on how the systematic approach to quality improvement can make a difference in all parts of the health and social services, an idea which was very much in keeping with the theme of our subsequent Spring conference. The event was opened by Sean Holland, Chief Social Services Officer.

Social Work was well represented by Gavin Davidson and Bernadette Hamilton at two meetings which we held in Clifton House on 14 March and 4 April in relation to the Mental Capacity Act (NI) 2016 Code of Practice. In the first of these meetings we were joined by Gavin and Bernadette, together with Dr Louise Sands representing RCGP in NI and Dr Petra Corr representing Psychology – to consider how best to lobby for a change in the Consultation methodology in relation to the Code of Practice for the Mental Capacity Act (NI) 2016. As you know, I think it is essential that there is greater clinical involvement in the process. We then held the further 4 April meeting with Tomas Adell from the DoH Mental Health and Capacity Unit charged with Mental Capacity Implementation. Drs Ian McMaster and Michael Doherty kindly joined me in this meeting, along with Thomas. We were somewhat reassured that the next phase of Consultation will continue to be in the form of a pre Consultation, this time with Tomas Adell willing to attend at least some of our meetings to advise on the Act and to take back practical examples for consideration. It seems as though the aim is to have a shorter Code than England and to have an Annex with scenarios/working examples to run alongside. The Regulations and the Consultation on them will also flesh out the detail of who does what. There is an open awareness that Psychiatry will be a key stakeholder among few, with numerous other stakeholders using the Act less often or less directly. Subsequent to this meeting, on 6 April Thomas met with his Policy Administrator counterpart in RCGP in NI, Clare Higgins, to brief her on the meeting with Tomas Adell, as RCGP in NI representatives had been unable to attend.

The Act continues to dominate my time as Chair, with a request from Dr Jonathan Pimm this month to write on it for the BJPsych publication. In this task, I am pleased to say that I will be joined by Drs Catherine Taggart and Phil Campbell as we are trying to give a thorough overview of its implications. My thanks to them… and you will read more among those hallowed pages (and here!) in the fullness of time! We meet in April to achieve a first draft.

Back in November 2016 at the “Working Together” joint Conference with the College of Psychiatrists of Ireland in County Cavan, we resolved to establish closer links between our respective Faculties and Committees. I am grateful therefore to Dr Margaret du Feu who, as Chair of our General Adult Faculty, met her equivalent Chair of General Adult Faculty Dr Ciaran Corcoran in Dublin on 11 April. Both are keen to strengthen and develop links between their Faculties and share information, research and training. Dr Corcoran is to discuss the matter further at the College of Ireland Council Meeting late April, with further discussions thereafter planned between the 2 Faculties. I encourage similar initiatives to be taken please if possible by other Faculty/Committee Chairs as we will only achieve better links by small steps being taken which will build a collective momentum in this regard. Margaret will be remaining on our Executive (after she stands down as Chair of General Adult Faculty to make way for her successor later this year) – and she has kindly agreed to assist our focus on links with the College in Dublin, given her extensive practice in the Republic of Ireland and contacts there.

Margaret also represented us at the recent breakfast briefing organised by Contact on 30 March at the Crowne Plaza, Shaw’s Bridge, Belfast. Margaret reports that it was well attended by individuals and family members affected by suicide, as well as by relevant organisations – and discussions centred on their Zero Suicide Manifesto and lobby for a NI Suicide Prevention Bill. The latter would seek to implement clinical duties of candour, competence and co-operation. Contact will be presenting at our General Adult Spring Meeting which is scheduled for 27 April at Clifton House.

Our submission was lodged during the month in response to the Department of Education’s Consultation on their Children and Young People’s Strategy 2017-2027. Please see below and my thanks to Drs Maggie McGurgan and also Richard Wilson for their input into this:

Consultation Title Dept/Organisation Documents Deadline
Children and Young People's Strategy 2017–2027 Department of Education Response 31 March

My thanks also to Richard for his contributions to Central College consideration of the Child Abuse and Neglect Consultation and then the Scottish Mental Health Strategy, both being considered by relevant colleagues there. I also understand that Richard was contacted by Baroness Tyler in the House of Lords in respect of advice to Margaret Ritchie MP re Values Based Commissioning. We continue to have influence in many places.

We had a very useful meeting on 14 March in Clifton House with GMC Head of NI Affairs Alan Walker, GMC NI Affairs Officer Marion McCann and Mary Agnew one of the GMC Assistant Directors based in GB and responsible for Standards and Guidance on Ethics - to discuss MCA Code of Practice, confidentiality, Medical Licensing Assessments, Consent etc. Drs Peter Trimble and Michael Doherty kindly joined in this discussion. The GMC are consulting on the Medical Licensing Assessments and I hope to cover our response to this in April’s Monthly Update, as we are currently working on same. We also discussed the Sir Keith Pearson January 2017 Report reviewing medical revalidation entitled “Taking Revalidation Forward”, which is welcome… in particular the proposal that there should be clearer guidance on the information to be supplied to support revalidation and that systems to support appraisal should be better developed by Trusts. The bureaucratic burden of the process could be lessened by the development of good information systems. The recognition of the need to strengthen the system for locum doctors is welcomed. There is merit in the proposal to have a revalidation date approximately 2 years after appointment as a Consultant, as the transition from Trainee to Consultant can on occasions be a time of increased pressure and expectation. However, appraisal and revalidation must continue to be seen as a supportive process. I have communicated this view to the GMC on your behalf.

We were also both pleased and grateful to welcome the GMC to our Spring Conference at which they kindly took a stand. Thanks to Marion McCann who attended on the day.

In staff news, at time of writing we are very pleased to welcome back Nora McNairney who will be phasing back in to her role as Division Manager in the coming weeks after her recent period of illness. It is great to see Nora back. This means that Barry Flynn will be phasing out of his acting up role as Interim Division Manager and taking on the role of Division Administrator to which he was appointed last November. Barry has indeed done a great job as Interim Division Manager. In turn, we are sorry to lose in some weeks time Elaine Walker who has been acting as Temporary Division Administrator over a number of months. Elaine has also done a great job for us and will be missed.

Since Paul Rees became the College Chief Executive, there has been a considerable effort made by Central College to reach out to the Divisions. So it was that on 7 March, Barry and Thomas participated in a Skype link up with the Communications Team in London to deliver, on behalf of the local College, a PowerPoint presentation to brief the Communications Team on Policy and our work more generally in NI. I am reliably informed… not by Barry or Thomas who are both reliable but also very modest!.....that the presentation was very well received and was very professionally delivered. The staff in RCPsych in both Wales and Scotland also participated in this link up. Thomas has also contributed on our behalf to the Editorial Working Group based in Central College who will be rolling out the new Membership magazine planned by Paul for launch in June at Congress. In addition, on 4 April Barry, Thomas and Elaine participated in a Skype Link with Central Office for a Staff Briefing from Paul Rees and on 10 April for a Staff Briefing on the way forward for the College’s new database system. Finally, on 7 April Fauzan Palekar, Director of Professional Standards in the College visited staff in Clifton House – along with Vivine Muckian, Head of Divisions.

Congratulations and welcome to our newly forming Perinatal Faculty which will be chaired by Dr Julie Anderson. It is great to see this development and will assist us in supporting lobbying for Perinatal services going forward. I am sure that Julie and other members will not mind me paying particular tribute to Dr Janine Lynch for her resolute determination over many years to look after this client group and represent their interests. Janine has been central to the forming of this additional local Faculty and will also be a member of same.

So as I conclude my special First Anniversary edition!!!! of my Monthly Update, can I leave you with two recommendations and one worthwhile quotation:

May I recommend to you this short animation which was prepared to mark the recent first anniversary of the publication of the English version of the Acute Adult Psychiatric Care Commission report, "Old Problems, New Solutions: Improving acute psychiatric care for adults in England". It contains a checklist of actions that we as psychiatrists can take to improve acute care in our area. It is really very practical therefore. The NI version of this report even gets a quick mention at the end!

May I concur with Dr Catherine McDonnell’s recommendation at our recent Spring Conference that it is important to find your tribe!!! if you want to do Quality Improvement (click to enlarge):

"Surround yourself with people on the same mission as you."

Finally... the quote used by Geraldine Strathdee at the Spring Meeting:

“If you don’t have the data, you are just another person with an opinion”. This should sum up our evidence based profession and practice, as well as providing a solid basis for Quality Improvement.

 

Dr Gerry Lynch

If you would like to post a response to Gerry's blog, please email the editor, who'll be happy to upload this for you.

 

 

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Dr Gerry Lynch

Dr Gerry Lynch, Chair RCPsychNI