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

RCPsych in Northern Ireland monthly update

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January 2018 – Report

 

 

As a New Year begins, it can be a time for reflection on the past……and this historical photograph captures the scene from Clifton House in days gone by……..

 

Frederick Street

 

 

 

 

 

 

 

 

 

 

 

 

2 January: College office re-opened after the Christmas and New Year break.

 

5 January: Chair Dr Gerry Lynch met with Dr Niall Corrigan, as well as Dr John Simpson and Pat Convery from Regulation & Quality Improvement Authority, to discuss the Part 2 Doctor training needs arising out of recent surveys on this topic – and also the forthcoming Joint Conference between the College and RQIA scheduled for 19 January.

 

10 January: Perinatal Faculty was represented by the attendance of Dr Janine Lynch at the Maternity Strategy Implementation Subgroup on Perinatal Mental Health at the Public Health Agency Headquarters in Belfast.

 

10 January: Staff participated in Policy and Campaigns Liaison Group Central College Meeting via Skype from Clifton House.

 

10 January: Carer representative Noel McKenna participated in Co-ordination Group for the RCPsych Championing Autism Programme 2018 via tele-conference.

 

11 January: Policy Lead Dr Peter Trimble and Staff participated in Policy and Public Affairs Committee Central College Meeting via tele-conference from Clifton House – with Dr Trimble reporting in particular on the Mental Capacity Act (NI) 2016, Brexit and the negative effects of our current political impasse on policy progress.

 

12 January: Dr Gerry Lynch attended Central College Council meeting at 21 Prescot Street, London where, amongst other things, the review of the Mental Health Act in England and Wales was discussed. Many office holders from the College centrally will be coming to our Spring Conference event in Belfast Waterfront Hall on 22 March, which takes our Act as its theme. The question of financial capacity assessments being increasingly requested (or directed), was also discussed. This is an issue in GB as well as here in NI and is something which the President is taking forward. In addition, the plan to change the regulations so that the devolved nations will have a representative on the Board of Trustees is being taken forward. Dr Lynch regards this as a very welcome development.

 

12 January: SAS & Affiliates Group held their first meeting of the New Year chaired by Dr Liz Dawson and focussing particularly on development of SAS Doctor careers and forging links with SAS Doctors working within other specialties in order to maximise learning opportunities. Final preparations were also made for the forthcoming SAS Doctor Conference which is to be held within Clifton House on 2nd February 2018 and will feature a number of excellent speakers from across the UK.

 

12 January: CAMHS Faculty Chair Dr Richard Wilson met with staff to plan the Joint UPS/RCPsych in NI Annual Learning event 2018. This year’s focus will be Adolescent Psychiatry. The keynote Speaker will be Dr Elaine Lockhart (Glasgow) who led her Adolescent Mental Health Liaison Team to victory in the 2017 RCPsych Awards (beating our local CAP Eating Disorder team in the process...so concrete evidence, says Dr Wilson, of no sour grapes whatsoever!) It is hoped to have contributions from local Adolescent mental health specialists in a diverse programme focussing on topics such as Gender Identity, Acute CAP & Substance Use. The Conference will hopefully take place in early May at Riddel Hall, Stranmillis, Belfast - with full programme available in due course.

 

12 January: Psychiatrists in Private Practice Special Interest Group (PIPSIG) held their first meeting of the New Year chaired by Dr John Sharkey, following which the meeting approved by Central PIPSIG and originally proposed for March 2018 has been moved to Thursday and Friday 20 & 21 September 2018. To be held in the Ulster Reform Club Belfast, Dr Sharkey anticipates that this will be of broad interest to all Psychiatrists, as its main emphasis will be on the preparation of Psychiatric reports of all sorts. Senior legal figures and Psychiatrists will present on a range of topics - likely to include Medicine during the Troubles, Incapacity legislation, the psychological effects of sexual abuse - amongst other subjects.  A number of local Solicitors and Barristers have agreed to present their experience of Psychiatric Reports under the title of "Psychiatric Reports: the Good, the Bad and the Ugly". The membership of PIPSIG NI grows year by year and provides a continuing forum for colleagues to discuss the challenges their work presents. Meetings occur four Friday afternoons per year. One of the group prepares a presentation, which usually provokes lively discussion at each meeting. For those wishing to join, please contact Dr John Sharkey (yekrahsj@gmail.com)

 

Belfast Telegraph

 

 

 

 

12 January: “How I Became a….” section of the Belfast Telegraph featured Trainee Psychiatrist Dr David Mongan. This forms part of the local participation in Central College’s Choose Psychiatry campaign.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15 January: Vice Chair Dr Michael Doherty attended NICVA Briefing on NI Budget 2018-2020 and heard Department of Finance Budget Director Julie Thompson outline the situation. Essentially funding for Northern Ireland comes from the block grant plus Rates and other miscellaneous sources. Not only is our average rate the lowest in the UK, but we have no separate water charges either. It seems that the block grant is not increasing by enough each year to keep pace with inflation. For example, the block grant is to increase by 0.7% in 2018-2019, whereas inflation is much higher than that, leaving us with a deficit of 0.9%. The block grant is then frozen for 2 years after that, leaving us with a deficit initially of 2.4%, and what will happen thereafter is unclear. All of this is creating a considerable downward pressure on funding, which either a Devolved Minister or a Direct Rule Minister will have to decide how to deal with in terms of local revenue raising. This raises topics such as charging for water separate from the rates, town centre/hospital car parking charges (both new and increased), scrapping free prescriptions/various elderly benefits etc. Dr Doherty afterwards commented that the meeting was “sobering” in terms of the funding reality and deficit.

 

17 January: MRCPsych Class re convened for 2018 with Dr Conor Barton teaching the students today.

18 January: Staff attended a meeting with Policy colleagues to discuss a proposition that local Medical Royal Colleges come together to work in greater partnership and improve interfaces, in the absence of funding for a local Academy. A fuller explanation of the long-term aim of this interface work is available.

Belfast Castle

19 January: The annual Joint RCPsych in NI and RQIA Part II and Part IV Consultant Psychiatrist Workshop was held in Belfast Castle and attracted a large attendance. Proceedings were opened by Olive Macleod OBE, Chief Executive of RQIA. The audience then heard from former Chair Dr Philip McGarry on how to address risk in Psychiatric practice. Philip concluded that what to do is to deliver comprehensive, good quality care for all patients and to focus on good history, examination, biopsychosocial formulation and treatment plan – and ensure easy accessibility. 

Belfast Castle RQIAThis was followed by Northern Trust Divisional Medical Director Dr Uzma Huda addressing the strengths and constraints of Rapid Assessment Interface & Discharge (RAID) in her Trust. Immediate developments include Delirium care pathway in Direct Assessment Unit, initiative to reduce re-attendances to the Emergency Department, detection and intervention pathways for medically unexplained systems, embedding of alcohol screening in the acute environment and establishment of brief intervention pathway. Longer term aims include the impact of improved detection on mental health services, further development of Mental Health liaison (e.g. primary care), better services for ARBI and embedding of Alcohol Disorder Care Pathway. Following refreshments, current Chair Dr Gerry Lynch and ST6 Dr Niall Corrigan presented the interesting findings from the recent survey on Part II Training and Regulation, which gave rise to a very active and constructive discussion led by Drs Lynch and Corrigan, along with Dr John Simpson and Patrick Convery both representing RQIA. The morning concluded with a moving and instructive personal perspective provided by Hamish Elvidge, Founder of the Matthew Elvidge Trust, with follow up discussion led by Dr Lynch. Pictured below left to right are Dr Philip McGarry, Olive Macleod, Dr Gerry Lynch, Dr Uzma Huda, Dr Lourda Geoghegan, Hamish Elvidge, Dr John Simpson and Patrick Convery.

 

 

 

 

 

 

 

Hamish told the moving story of his son’s death by suicide and the lack of family involvement at any stage in his care. He also spoke of the preoccupation with completing risk assessment forms, to the potential detriment of care. As the Coroner said: “they ticked the risk assessment, but did not look into his eyes”. He stressed that even when authority has not been given to share information, professionals can still listen to families. In his view, we do not need new legislation, but simply professionals need better training in how to involve families. A conversation opener could be: “Should we contact someone and should we do it now together?” He called for a change in practice, with more families involved in assessment and care. Fundamentally, he was asking for the Consensus Statement to be implemented. He asked, in conclusion, that 3 things be done:

1.   Review how trusted friends and family can be involved in P’s assessment, treatment and care;

2.   Review how consent is sought;

3.   Implement the Consensus Statement.

A discussion around the importance of professional curiosity about a patient harming followed.

Dr Lynch agreed to circulate the 2014 Information Sharing and Suicide Prevention Consensus Statement, which is available here for your perusal.

22 January: Staff participated in a Lunch and Learn by Skype led by Central Professional Standards Department, which is the College Department which our local College staff sit within. The topic was the College’s Perinatal Project and the session was led by both staff member Dee Noonan and also by Dr Liz McDonald.

25 January: Dr Claire Potter, CT3 Psychiatrist, was an invited speaker as part of the South Eastern Regional College's Resilience programme held at their Space Conference Centre in Bangor. The programme, co-facilitated by the mental health charity AWARE NI, was delivered to educators within the SERC and Dr Potter's talk focused on what resilience is, why it is needed and methods to improve resilience. Her presentation was described as “excellent” and the Conference was a great success. This is a continuation of the College’s much valued collaboration with Aware.                                                                                  

C PotterClaire Potter

 

 

 

 

 

 

 

 

 

 

 

 

26 January: Dr Gerry Lynch and Dr Michael Doherty met with Drs Saleem Tareen, Jo Minay and Stephen Moore at Clifton House re our further input into the You in Mind process. Afterwards, Dr Lynch said: I would like to thank Saleem, Jo and Stephen for their patience, tenacity and persistence in this complex, controversial and slow moving process.  Having met with officials recently to express our extreme disquiet about the You in Mind documentation, after which we agreed to work with others to try to make the process work for patients and clinicians, I would encourage members to discuss this issue with your colleagues from other disciplines in your places of work- the documentation will be expected to be used by all professionals working in mental health services.”

26 January: Dr Gerry Lynch and Dr Michael Doherty hosted a meeting in Clifton House with Mark Lee from DoH in relation to accessing mental health services from primary care - and also involving Drs Deirdre Shields, Paddy Moynihan, Rowan McLean and Saleem Tareen. Dr Lynch commented: “This was a useful meeting in which we emphasised the importance of NOT diverting resources from secondary care, but rather expanding capacity both in primary and secondary care.  We also discussed the importance of an integrated approach to the management of chronic severe mental illness across primary and secondary care - and the fact that prevention and early intervention also occurs in secondary care (for example, in CAMHS and early intervention in psychosis). We have concerns about the lack of emphasis on mental health in the ‘Delivering Together‘ transformation programme, so this meeting with Mark Lee from DoH who is leading on the development of the Primary Care transformation programme work stream, was very opportune. This was a useful preliminary discussion and a further meeting will be held, with Rodney Morton also to be present.”

26 January: Dr Gerry Lynch and Dr Michael Doherty met with Professor Gerry Leavey from University of Ulster who is keen to involve College members, particularly Trainees, in various research projects. Dr Lynch said: “There are several potential opportunities in the pipeline and I will be keeping members posted”.

 

26 January: Dr Gerry Lynch also had an opportunity to meet and discuss with Dr Margaret du Feu the shortage of interpreters, particularly those with specialist experience in mental health. Dr Lynch said: “This is an important rights issue which I hope to raise at a meeting next month with NI MPs in Westminster.”

 

POA

 

26 January: Our Psychiatry of Old Age Faculty Joint Annual meeting with the British Geriatrics Society took place at Riddel Hall, Queen’s University, with depression and dementia as the main focus for speakers. Delegates heard from Dr Chris Kelly on options for treatment of Depression, followed by a useful Case Presentation from Dr Louise Alexander, COE, Specialist Trainee from Western Trust. Dr Stephen Todd, Consultant Physician, COE, Western Trust later addressed improving quality of life for those with dementia in Nursing Homes, which was followed up with learning derived from a very practical Audit of anticholinergic use in new patients attending Memory Clinics presented by Dr Liz Dawson. A Psychiatry of Old Age Faculty Meeting took place at the conclusion of this very useful afternoon event.          

 

 

26 January: Deaf Child and Adolescent Mental Health group met in Clifton House chaired by Dr Holly Greer.

 

29 January – Friday 2 February: Bernadette Hamilton representing Social Work, together with Drs Caroline Donnelly, Peter Sloan and Roinin McNally spent the week at Clifton House working intensively on the update of the GAIN Guidelines for use of the Mental Health (NI) Order 1986, assisted by Patrick Convery of RQIA and staff. This project is at the request of RQIA.

 

29 January: Dementia Conference Planning Meeting at Antrim Area Hospital re 17 May 2018 event at Hilton Hotel - was attended by Chair and Staff.

 

30 January: Perinatal Faculty Sub Group met in Clifton House to plan for their Multidisciplinary Meeting at Malone House on 13 April at which the local Faculty, chaired by Dr Julie Anderson, will also be formally launched.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Dr Gerry Lynch

Dr Gerry Lynch, Chair RCPsychNI

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