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

The President's Blog

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09/11/2018 14:46:54

Journey to the future mental health workforce

Journey to the future mental health workforce

I am writing this in extreme discomfort on a delayed, slow running, tightly packed train from Leeds to Birmingham.

A problem shared… On the plus side I do at least have a seat (more than many of the other passengers) and I’m making the journey for a good reason.

I’m on my way to see how the liaison psychiatrists in the Rapid Assessment, Interface and Discharge (RAID) team work with Physician’s Associates.

I’ve been hearing increasingly positive reports of how these roles support services and am looking at how we might recruit more of them to expand the Mental Health workforce.

Talking genomics and neuroscience

It’s been another busy round of conferences for me this month. One of the best was the World Congress of Psychiatric Genetics in Glasgow.

It’s always a pleasure to visit Scotland and this trip had the added bonus of a wonderful mixture of geneticists and psychiatrists working together to unravel the mysteries of how psychiatric conditions are inherited.

This is a field that is advancing rapidly and I’m excited by places that are implementing genomic medicine at unprecedented scale. I was there to talk about the Gatsby Wellcome Neuroscience project which is now attracting International interest.

The project’s third Neuroscience Spring Conference will focus on genetics and epigenetics of the brain and behaviour and will be held in London on 15 March 2019. If you are interested in attending please email neuroscienceproject@rcpsych.ac.uk.

Royal reception

I also attended the first ever Global Ministerial Mental Health Summit in London. This brought together the world's political leaders, innovators, experts by experience and policy makers to share innovative approaches to improving mental health.

The way that this is moving up the National agenda was demonstrated by the attendance of the Duke and Duchess of Cambridge and by Theresa May hosting a reception for delegates at 10 Downing Street.

Sadly Larry, the Number 10 cat, was nowhere to be seen, I think it was probably too large a crowd for him.

The Red Box

The big news over the past month was the budget announcement by the Chancellor of an extra £20.5bn for the NHS over the next five years with a minimum extra £2bn a year for NHS England mental health services.

We are cautiously optimistic about this and are looking forward to hearing details of how the money will be used in the NHS 10-year which we expect to be published before Christmas. We are working hard to influence those writing the plan and are emphasising the need for more money in the core CMHTs and inpatient units as well as funding for new services.

Local spending

I know that at the moment everyone is feeling over-stretched and under-resourced. For some of you in England that is partly due to your CCG not investing enough in mental health services.

Our policy team has carried out research which shows that your CCG has cut mental health spending (that includes spending on services for dementia and intellectual disabilities) if you work in any of the following constituencies: Dartford, Gravesham, Cheltenham, Forest of Dean, Gloucester, Stroud, Tewkesbury, The Cotswolds, Clacton, Colchester, Harwich & North Essex, Ludlow, North Shropshire or Shrewsbury & Atcham.

If you live in those constituencies you may have recently received an email from our communications team with a letter for you to send to your MP. I know how stretched your time is, but I’d really appreciate it if you could take a couple of minutes to email the letter on to your MP to encourage them to play their role in holding your CCG and the Department of Health and Social Care to account and help us secure the funding our services desperately need. If you haven’t received a letter please email Jeremy.Gale@rcpsych.ac.uk who will supply you with all the information.

New recruits

I hope you all noticed the launch of our latest Choose Psychiatry recruitment campaign following the success of the last one.

As well as a hard hitting news story on the impact waiting for services can have on patients (that you may have spotted some College reps talking about this on the BBC) we launched another film with moving accounts of how psychiatrists have helped patients to recover.

The stories in it are true. The patients are played by actors but the psychiatrists play themselves (you might even recognise some of the stars!).

It’s a great reminder of how the work we do really does change lives for the better, and importantly shows the wider world and the next generation of doctors why they should #ChoosePsychiatry.

24/09/2018 09:57:01

Creating conditions to attract the next generation of psychiatrists

As I move through my second year as President the work has increased with my involvement in more areas.

Most of my time is now spent on College business although I still cling to my one day’s clinical work in Leeds.

One of the biggest things on most people’s agenda at the moment, both in Leeds and when I’m at the College, is workforce.

 

BYOC (Bring Your Own Caffeine)

I spend a lot of time in various meetings discussing this and how we can recruit and retain the staff that will enable us to provide the services that our patients deserve.

These meetings take place in nicely decorated rooms with comfortable chairs and air conditioning. Sometimes (if arranged at short notice) they are even in hotels. There is free tea and coffee, snacks and mineral water and wifi access.

On Mondays I do my clinic in Leeds. The building is well past its sell by date. I have to take my own coffee and milk. There is no food available even to purchase.

There is wifi but neither I or the patients can use it. There is no air conditioning. One room does not even have a window although you’ll be pleased to hear that after a year I have graduated out of that one.

The computers are on their last legs. This, as you will all know, is massively stressful, and far from efficient. I always arrive 30 minutes early to allow mine to warm up and to log on to all the sites I need but today it wouldn’t start at all.

Doing a clinic without access to a computer would be very difficult if not dangerous, even for someone like me who remembers the days when we only had paper with nostalgic wistfulness. Luckily IT agreed with me that this was an emergency and were able to fix it.

 

“Little” things could make a big difference

As I go about the UK I hear the same from the psychiatrists I meet. What I have learnt to call “hygiene” factors are hugely important. These include parking, access to some personal space and the issues I have already mentioned.

If we could sort these out I’m convinced that retention rates would improve.

I am doing all I can to change things but please talk to your Trusts about this and emphasise the importance. Both staff and patients deserve it.

I’m aware as I write this I can sound as if I don’t enjoy my job, that’s not the case.

After all these years and despite the grotty surroundings and grumbling about IT failures, I haven’t lost my enthusiasm for psychiatry and happily encourage medical students to choose psychiatry with genuine enthusiasm.

I still find the work fascinating and even after over 30 years I meet new situations and every clinical day is interesting.

One of the things I love most about my work as a psychiatrist is the unique combination of the social, the psychological and the physical. Two very different experience illustrated that recently.

 

Inspirational

My first trip was to Northampton for the official opening of the Centre for Neuromodulation. This Trust has just been rated as Outstanding by the CQC and you can see why.

From the CEO and the Medical Director downwards the staff are exceptionally warm, enthusiastic and welcoming.  I met patients whose lives have been changed by rTMS and was even able to try a little treatment myself…

As part of the College’s interest in social prescribing I visited Fieldhead hospital in Wakefield, near home for me. They have been working in this area for years. I was shown around by an inspirational woman who became unwell as a child and was on a huge amount of medication.

She discovered a talent for painting and now sells her artwork, some of which is displayed in the hospital. She was gradually able to reduce and stop her medication and has remained well. Other patients have taken up gardening, music and sculpture. 

It was really good to see this work supported at the highest level within the Trust, another example of leadership allowing development that benefit patients.

Our new Secretary of State has an interest in Social Prescribing and it’s something that the College will be exploring. As we do this we mustn’t forget the basics. Many of our patients live in poverty, not helped by the recent changes to the social security benefits system.

We are producing a guide for Mental Health Staff who are supporting their patients in applications for these benefits but meanwhile I recommend an excellent article in the magazine Asylum, Supporting Claimants: a practical guide by Jay Watts.

We may not be able to do all that she suggests but every little helps and there isn’t much point in prescribing medication for our patients if they can’t afford food or a roof over their heads.

Enjoy the last few days of summer and I hope to see some of you on my travels this autumn.

Professor Wendy Burn
President

30/07/2018 10:56:59

A year of living dangerously

Well here I am at the end of my first year as President. I have somehow navigated through the hardest 12 months of my career and survived. At times its been enjoyable, at times terrifying but never ever boring.

One of my biggest worries when I started was speeches. I have never been a person who can just stand up and talk without preparation or notes.

I was reassured by my son who said "Mum, they probably voted for you because you don’t make long speeches." In fact, the speeches have been the least of my worries and for my first Presidential Address at congress I felt confident enough to insert a short recording of some rap music...

Best Congress ever

Congress this year was for me the best ever.

It’s hard to pick out the highlights as everything was so good but introducing Baroness Hale, the first woman President of the Supreme Court, was a huge privilege. Her speech was entitled "Is it time for yet another Mental Health Act?". It was thought provoking and uncompromisingly direct and honest.

Read Baroness Hale’s speech (PDF).

Another highlight was hearing Joanna Cannon, psychiatrist and best-selling author, talk about how she became a writer and the connection between storytelling and Psychiatry.

As she said "the thing I have learnt since being published is that we all have a story to tell. Stories connect us".

And of course, Psychiatrists love stories and we are lucky to hear so many of them.

Althea Stewart, President of the American Psychiatric Association, produced my favourite quote of the conference: "It’s easier to build strong children than repair broken men". 

This was originally said by Frederick Douglass, an African-American statesman who, having escaped from slavery, became a leader of the abolitionist movement. It is as relevant today as when he first said it.

I could go on about Congress for ever. I hope you were lucky enough to have experienced it for yourself.

I am really sorry that we sold out and that some of you were disappointed. The increased numbers took us by surprise and we will try out best to ensure this doesn’t happen again. Next year we will be in a larger venue in London from 1st to 4th of July.

Recommended reading

Another excitement for me was the publication of a book that I have a chapter in, Women’s Voices in Psychiatry: A Collection of Essays, edited by Gianetta Rands.

If you want to find out how I ended up as President, and the trouble I had with carrots at school, you’ll need to buy it to find out.

Any profit will go to the College to be used towards bursaries for trainee women psychiatrists.

After Congress the next big event was the 70th birthday of the NHS. 

My mother was a practising doctor in 1948 when the NHS was formed and she gave me a vivid description of how wonderful it was for ordinary people to know that they could get whatever treatment they needed, free at the point of delivery. 

One of the first patients she treated was so overwhelmed that he gave her a present of 12 dozen (i.e. 144) turkeys’ eggs. At this time food was still rationed so this was very exciting.

She managed to take them home on the train to her mother who preserved them in Isinglass.

NHS has changed – but more change needed

The NHS now is unrecognisable from how it was when it began but the principles are the same, including "comprehensiveness within available resources".

But the needs of people with mental illness have not been truly considered part of that "comprehensive" healthcare.

It’s time now that Mental Health Services are resourced to the same level as physical health services and we truly do implement parity of esteem.

We need to invest in staff and infrastructure and to encourage a greater number of medical students to choose psychiatry.

That way we will finally be able to provide comprehensive care that our patients deserve.

Professor Wendy Burn
President

20/06/2018 16:53:58

A magical month, even without a Tardis

This last month has been spent in the UK which is something of a relief after my recent travels to the other side of the world. The furthest I have been is Belfast.

Warm weather and a warmer welcome

While there I was lucky enough to be shown around Clifton House, the Head Quarters of the Royal College of Psychiatrists in Northern Ireland.

This was originally built as a poor house in the 18th century and has some fascinating artefacts and stories about people who lived there. If you go to Belfast please do book yourself onto a tour.

I also met members who were there for meetings and talked to a group of trainees about the Neuroscience Project.

The sun shone brightly (I bring it with me) and the welcome was even warmer. I look forward to returning there.

A President and Prince

A big excitement was a trip with a group of College staff and volunteers to Buckingham Palace for a garden party to celebrate the 70th birthday of Prince Charles, our patron.

It was a beautiful afternoon and we walked in the gardens and beside the lake to the sound of a brass band.

Sri Kalidindi (ex-chair of the Faculty of Rehabilitation and Social Psychiatry) was our VIP representative and was in the front row in an eye catching red dress which can be clearly seen in the photos of the event which went viral.

Nice to see Psychiatry take a position at the forefront…

Improving our learning

I spent a day near home in the North of England when I made a trip to Durham for a meeting of the Northern Alliance of Trusts to talk about how we can improve our ability to learn from those very sad occasions when our patients die.

I shared the work the College is doing on Learning from Deaths and heard of the progress being made in different Trusts. We need a way of ensuring that learning is shared across the whole of Mental Health Services and I’m keen that the College supports this.

I also visited Chester to talk about my priorities as President. I caught up with some old friends and made some new ones.

It’s really helpful for me to get out and about and to check that the College is truly representing the views of its members so please do invite me to your meetings and your Trusts.

Fighting for parity

Back in London, the Prime Minister announced that the NHS in England would get an average three point four percent funding increase above inflation for five years, with increases in the devolved nations too.

Even better, she highlighted mental health services as a priority for the increased spending.

College Officers and staff have been working really hard to make the case for Mental Health and we look forward to working with the Government and NHS England to ensure that this money is well spent and that Mental Health Services are funded to the same standard as physical health.

One very good piece of news is that the Government sees research into Mental Health as a priority area and is keen to engage with us to take this forward.

Choose psychiatry!

This month we have relaunched our Choose Psychiatry recruitment campaign. Last year the success of this saw the number of core trainees starting with us in August up by a third from last year.

We really need to maintain this expansion. Please continue to do all you can to encourage medical students and Foundation doctors to join us.

We have updated the heart-warming film which shows the positive benefit we bring to our patients.

Magical Fellows

The best event of the whole month was the first ever New Fellows evening to be held at the College.

This was a magical evening. First, we heard a little about each Fellow and the amazing things they had done. Each Fellow bought a guest with an age range of 11 to 86.

Then we all sat down to dinner together and enjoyed the wonderful food from the College catering team. I was honoured to be able to celebrate with a group of people who have done so much for our patients.

Congress round the corner

As I write this there are just a few days to go to the International Congress in Birmingham, the biggest event in the College calendar.

The programme looks fantastic, I have no idea how I am going to get to all the talks I want to hear or how to choose between them.

From cutting edge neuroscience, to Joanna Cannon the best-selling author talking about her books, to Jonny Benjamin, an award-winning mental health campaigner talking about his own experiences of mental illness, the range and variety of sessions is infinite.

Oh for a Tardis!

I have been asking (in vain) for a Tardis since I started, what I need for congress is a Time-Turner like the one that enabled Hermione Granger to take every subject available in Harry Potter and the Prisoner of Azkaban by going back in time and choosing a different lesson to attend. That would be perfect for Congress. 

If you are going I’m sure you will enjoy it. Please come and say hello.  Catch me as I walk past or contact me by email president@rcpsych.ac.uk or Twitter. I’m looking forward to meeting many of you there.

Professor Wendy Burn
President

22/05/2018 14:01:21

Talking psychiatry in three time zones – and meeting Larry the Downing St cat

This past month has definitely been the most exciting since I started as President.

I frequently get asked if I enjoy the role. It’s hard to know what to say.

The truth is that it’s an incredible privilege, that I’m constantly out of my comfort zone and I never know what will happen next.

So “enjoyable” doesn’t really cover it...

This month I’ve not just been out of my comfort zone, I’ve been in entirely different time zones.

 

Taking Neuroscience to the Big Apple

My first stop in a very international month was New York to attend the American Psychiatric Association Annual Meeting.

I was there to talk about the Gatsby Wellcome Neuroscience project and also about how we as a College work with the government to develop policy in the UK.

The Neuroscience project was really well received and prompted lots of interesting comments and questions from the audience.

The one that really stood out for me was from an American trainee who said that he and a group of colleagues had been teaching themselves neuroscience from online resources and would like this to be formalised.

This of course is exactly what we are already doing in the UK!

If you are involved in delivering training and want to learn more about how to teach the latest in neuroscience please keep up with our next Braincamp in Birmingham on 1 June.

Also have a look at the short video “Connecting brain and mind” from the 2018 Spring Neuroscience conference in Cambridge. Look out for full videos of talks from the conference which will be available soon.

 

NY-LON

There was fascinating feedback and discussion on the policy talk I gave.

The other speakers and the audience came from many different countries but nowhere had the access to the key decision makers that we enjoy.

Indeed, in the USA you sometimes even have to pay politicians if you want to meet them. We are very lucky that our democratic system and the respect with which the College is held allows us opportunity to influence at the top.

And influence at the top was exactly what I had to do at very short notice.

I had to fly back early from New York to attend a dinner at 10 Downing Street to talk about the future of the NHS together with the Presidents of the other Royal Colleges. It seems likely that there will be some good news on this soon.

 

Purr-fect visit

We were entertained in the State Drawing rooms and it was hard for me to believe that I was a visitor in a place where so many influential and important events have taken place.

One of the items of discussion was the interim report of the Independent Review of the Mental Health Act, led by Simon Wessely.

This is well worth reading, though it contains no surprises, and reflects the need for improvement in the care we provide for detained patients.

We (meaning many members across a range of College Faculties) will continue to collaborate closely with Simon’s team over the next few months to help develop solutions in the areas identified as needing work.

And did I mention that I met Larry the cat? The evening was purr-fected by the resident cat in Number 10, Larry. Not only did I get a photo of him outside on my way in, when I left he was curled up in the hall and he let me stroke him.

 

To the Southern Hemisphere

After a quick 24 hour turn around at home to do the laundry and to stroke my own cats I was off again. This time to New Zealand to attend the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Congress in Auckland.

While there I took part in a ‘Women in Leadership’ symposium chaired by RANZCP President, Dr Kym Jenkins. Myself and three other women were on stage to be asked questions.

This was rather nerve racking but to my surprise I actually enjoyed it. Even better was the conference dinner where we were treated to a traditional Māori haka or war dance.

 

College successes on the home front…

Back in the UK the College team, staff and volunteers have been hard at work. In particular the Perinatal Faculty, headed up by Trudi Seneviratne, has had some notable events.

The first of these is the change in the licence for Valproate, used to treat bipolar disorder, so that it can no longer be prescribed to women of child-bearing potential unless she is on a pregnancy prevention programme.

This is because children born to women who take Valproate during pregnancy are at significant risk of birth defects and persistent developmental disorders.

It is important that all clinicians are aware of this and that all women are better informed about the risks of Valproate. We will be working with other Royal Colleges and government bodies to make sure changes are implemented and affected women are supported.

There has also been huge progress in the provision of Perinatal services. Seven thousand more women have received specialist support for perinatal mental illness from expanded services.

As part of this we have worked closely with NHS England and HEE to deliver a perinatal bursary scheme to train up more psychiatrists to become perinatal specialists. 100% of the psychiatrists who completed this now have, or will have, perinatal consultant psychiatric jobs in their local areas which is fantastic.

This, together with the new wave of targeted funding, will help ensure that new and expectant mothers will be able access specialist perinatal community services in every part of England by April 2019.

This is a great example of how extra funding, innovative thinking and determination enables improvement in psychiatric services.

Here’s hoping that before too long there will be more good news on the financial front.

19/04/2018 12:29:32

Working conditions, world-leading mental health legislation and work to combat racism

Very unusually I’m writing this blog in my NHS clinic room, as one of my patients has cancelled his appointment.

I still do one day a week of clinical work. This keeps me firmly in touch with reality and away from any ivory towers.

 

The view from the NHS

Back to the NHS. My clinic room used to be a cupboard and has no windows. I’m delighted that summer seems to have suddenly arrived, but this means that the broken radiator that won’t turn off is more of a problem than usual.

I need to arrive half an hour before the clinic starts. Why? To allow the computer to warm up of course, and to remember all my various passwords. The computer monitor only works if it’s at exactly the right angle and there’s that moment of fear every week that this might be the day it gives up the ghost.

The room I use would benefit from a coat of paint. The chairs are old and mismatched. There are no pictures on the wall. 

None of this is the fault of the trust I work for, it’s a result of the constant need to save money year on year. It’s due to putting patient care above buildings, to spending money on staff rather than paint or chairs.

If you’ve worked in the NHS as long as I have you will have become used to shabby surroundings and like me, will hardly notice them.

But today I did see them and can’t help wishing we could do something better. How much difference does the environment make when you are visiting a psychiatrist? I think it might be more than we realise…

 

Over to Belfast

As well as my clinical work I have had another busy month with conferences and member events. I went to Belfast where the first President’s Lecture ever to be held outside London was delivered by Sue Bailey.  

She covered new approaches to prevention and sustainability in the care we deliver. As always, she was interesting, thought provoking and inspiring. You can watch her talk on the college website. 

I then attended the Northern Ireland Spring Meeting which was brilliantly organised by Gerry Lynch, Chair of RCPsych NI and his team.

The subject was the Mental Capacity Act (Northern Ireland) 2016 which is due to be introduced and will cover both physical and mental health. The room was so packed that it really was standing room only unless you arrived early.

I know this won’t be straight forward and I’m not underestimating members’ concerns around implementing the new Act, but I can’t help feeling that this is the way forward.

NI psychiatrists will be on the same footing as any other doctors in deciding when to treat someone who is not consenting, a further step towards treating patients with physical and mental illnesses equally.

I know that we all in England, Scotland and Wales (and further afield, no doubt) will be watching closely how things in NI progress.


Important steps forwardOther exciting events over the past month have been the issuing of two College statements. The first of these was on racism.

Racism is one area where there has been a dramatic improvement in the time I have worked in the NHS but there is still a long way to go. The statement is the first step in the College’s plan to improve things, the next step is to work on ensuring action is taken.

The second statement was on supporting transgender and gender-diverse people.

This is another area where work is much needed and will be done. Thanks to all the people who contributed to getting these statements completed.

I look forward to working with members and with other organisations to ensure that the important recommendations are followed through.

 

Cambridge, at last

My latest conference was the Gatsby Wellcome Neuroscience Spring meeting in Cambridge.

As someone who grew up in Oxford, you won’t be surprised that I’ve been ingrained with the belief that Cambridge was a pretty poor sort of a place but this turned out to be completely wrong.

It is actually lovely with beautiful buildings and a wealth of history, as I’m sure you know. 

The most interesting thing was the Corpus Clock,  worth a visit in itself.

The conference was fascinating with research so new that it hasn’t been published yet and some very interesting sessions on the theory that inflammation may be what underlies depression.

 

Keep on Choosing Psychiatry

Being back in a University setting made me all the more conscious of routes to becoming a psychiatrist. Before our next set of new trainees even start, we begin the new round of our recruitment campaign, Choose Psychiatry. 

We will be working hard on this centrally but what really attracts people into our profession is all of you. Please do fly the flag for our specialty. Let trainees and students see what a rewarding career Psychiatry is.

A particular part of the first campaign’s success was the willingness of psychiatrists up and down the country to record short clips on ‘why I chose psychiatry’ to share on social media.

It really created a buzz and I loved seeing so many of you talk about your passion for our work.

We’re after your support again from May onwards this year and I look forward to seeing your contributions.

20/03/2018 13:48:50

Beast from the East can’t prevent progress for President and RCPsych

I've learnt three things in the past few weeks.

Conferences are like buses - they all come along at once; prisons are fascinating, and our members are doing great work there, even in difficult conditions - but I don't want to be in one; and, as much as I hate to admit this, it turns out that the tube really does come in handy in a blizzard.

My first conference was the Forensic Faculty’s annual meeting. Despite the Beast from the East attempting its worse everything went smoothly in Nottingham thanks to the excellent work of Pamela Taylor, Chair of the Forensic Faculty, and her team.

I was particularly interested in a talk about prisons but pictures of cells made me determined not to end up in one. 

Next for me was a journey back to London during “Storm Emma”.

After complaining endlessly about the unreliability, the heat and the crowds of the London tube since I have been spending so much time in the capital I have to concede that in snow it comes into its own. 

 

Fostering European links

Then it was over the Channel to Nice for the European Psychiatric Association (EPA) meeting. Don’t be too jealous.

Although Nice was free of snow, it was cold, wet and miserable. Luckily the company wasn’t!

I caught up with the Presidents of other Psychiatric organisations and was able to compare how we practice.

I’m conscious that now more than ever, it is essential to foster European links wherever we can.

 

Lessons from Europe

I also heard about the first “Massive Open Online Course” (MOOC) the EPA is set to launch, an introduction to Cognitive Behavioural Therapy.

This free online course will be open to an unlimited number of participants, and available in open access via the web.

The MOOC will provide course materials such as mini-lecture videos and recommended readings, as well as interactive user forums.

You can sign up to the MOOC: it starts on Monday 9 April.

 

MindEd for Older People

Nice to Newcastle was next for the Old Age Faulty meeting. I spoke on International Women’s Day and was introduced by Amanda Thompsell, who is doing a great job as Chair of the Faculty.

I was able to show a sneak preview of MindEd for Older People which launches on 28 March.

This is an online resource with advice and guidance aimed at older people with mental health difficulties (other than dementia) and their families.

The two Faculty conferences gave me a chance to catch up with members. The overwhelming messages to me were how hard it is on the frontline and how desperately we need more funding and a larger workforce.

Back at the College the staff and members have been working to make progress on both these issues.

 

Campaigning College

The HEE mental health workforce plan committed to an extra 100 consultant CAMHS psychiatrists by 2021, this is the number needed to deliver the Five Year Forward View. 

Although the pilot run through training programme in CAMHs has increased recruitment dramatically we can’t train enough Consultants to meet this target, especially given a 6.3 per cent drop in the number of specialist child psychiatrists in the last four years.

So we have been pressing the government to add CAMHS consultants to the shortage occupation list to enable us to recruit from overseas more easily. 

Without more CAMHS psychiatrists, we are worried that it will not be possible to deliver the potential benefits within the recent government green paper on children and young people’s mental health, particularly a four week waiting time target. We also performed an analysis of the money going to Mental Health Trusts over the past few years.

You won’t be surprised to learn that this research showed that Mental Health Trust income is lower now than it was in 2011/12.

NHS England were eager to respond to these findings and to assure us that this is changing, that we have turned the corner, and that things will improve.  

I really hope that this is true. 

 

“Allocated money must be spent on mental health”

RCPsych has and continues to support NHSE England in its role in implementing the Five Year Forward View for Mental Health.

But to do this we need to ensure that every penny of the extra money allocated for mental health is spent on our services.

We need to be able to track the money to the frontline far more clearly so that we can hold commissioners to account for how they allocate funding.  At the moment this is very difficult to do and we are calling for a more transparent system.

The College will be watching the money carefully in the months to come and will be holding the government to account if things don’t change for the better.
16/02/2018 16:03:16

Time flies when you’re President of RCPsych

Usually the months after Christmas drag for me but this year time has flown past.

We have been busy at the College with our submission of evidence to the Mental Health Act 1983 review which is now finished.

I have been testing out our ideas with various groups of members on my travels and am pleased to see that on the whole we have captured what the majority of Psychiatrists think.

This is only the first stage of the review, there will be lots more work to do so do get in touch if you want to contribute.

 

Highest ever applicants

As you know we had the highest number of applicants ever to core training this year.

We aren’t resting on our laurels but are already working hard for the future. On a bitterly cold day in January I attended the National PsychSoc conference in Brighton.

Over 130 keen medical students spent their weekend listening to speakers of a calibre that wouldn’t have been out of place at any International meeting, thanks to all who gave up their time for this.

The lowlight of the weekend was the journey home which involved a rail replacement bus, the only thing that would get me on one of these is the chance to speak to so many potential recruits.

We also held an event for medical students in London where Stephen Fry talked eloquently of his own mental illness (I would just like to casually mention that he agreed to do this when we met at Buckingham Palace).

The students were enthralled. After the talk he spent time mixing with them, encouraging them to choose psychiatry and submitting to numerous selfies.

 

Retaining psychiatrists

Recruitment is no good without retention, so this year we will be looking at how this can be improved. We are going to do this with NHS Improvement who have already started work.

I think I know what factors are driving people out of the workforce but if you have anything you want me to address please get in touch.

 

Investment Standard

A piece of very good news involves the Mental Health Investment Standard (the MHIS).

Six months ago, I wouldn’t have known what this was but I’m now extremely excited by the fact that this year’s NHS Planning Guidance says that all CCGs must meet the MHIS.

The MHIS requires local areas to increase their spending on mental health services in line with their overall increase in budget allocation each year.

This means they have to invest in our services and will be audited on whether they do or not.

 

Instrumental

We have been instrumental in keeping the spotlight on mental health spending in every clinical commissioning group (CCG) and lobbying for stricter rules on how they invest in mental health services.

As a result of our efforts, we have stopped the MHIS from being scrapped.

It’s another step towards real parity of esteem for our patients.

16/01/2018 16:24:48

New year, and an even more resolute RCPsych

Each year we see January as a fresh start and make resolutions to improve ourselves. These usually include taking more exercise and eating less in an attempt to undo the damage done by Christmas.

This year please remember your mental health as well as your physical. Psychiatry can be stressful so look after yourself and be sure that you set aside some time for relaxation. I can hear those who know me sniggering but I’m determined to set a good example (also, for the record, Twitter isn’t work).

My resolutions for 2018 include working on three major areas with the College:

  • Recruitment

  • retention

  • the Mental Health Act 1983 Review.

Huge amounts of energy already go into recruitment. I’m delighted to say that we have had the highest number of applicants ever for core training this year, but we can’t afford to rest on our laurels and will keep on with the #ChoosePsychiatry campaign.

We need to make sure that as many medical students and Foundation doctors experience Psychiatry as possible so that they see what a great career it is.

 

Training, retaining

While we are busy telling the outside world how interesting it is to train as a psychiatrist, we also need to work to make sure that trainees, specialty and associate specialist (SAS) doctors and consultants stay in the profession.

The College is holding a workshop with Health Education England at the end of the month to firm up arrangements for the implementation of the workforce plan that came out last summer.

When I speak to trainees and members in different parts of the UK the same themes come through repeatedly.

Trainees want to be treated with consideration. This means thought being given to where they live when placements are allocated, access to food and rest when on call and ability to take leave for important events when they give reasonable notice. Or in other words, to be supported and valued (PDF) as the Psychiatric Trainees’ Committee has set out.

Fortunately, our trainees already report being treated better than most specialities, via the GMC national training survey, but there is still room for improvement.

Consultants and SAS doctors describe a lack of resources but also a blame culture and excessive bureaucracy. These issues must be tackled to improve morale and increase retention.

 

Mental Health Act review

The College is about to submit evidence for the review of the Mental Health Act 1983. This will feed into the interim report of the review, expected to be published in spring this year, and will be posted on our website soon if you want to read it.

The whole of the morning of the January Council meeting was devoted to discussing key areas relating to the review.

Some very useful points were made and we came to a consensus. The College will be working closely with the review team and you can continue to feed in your opinions:

We will keep you informed as the Review progresses.

All of us at the College wish you a very Happy New Year.

15/12/2017 11:40:15

Cheer at the end of the year

There have been some worrying moments in the past month when it looked as if the extra money for mental health was hanging in the balance.

But, I’m pleased to say, we campaigned hard openly on social media and behind the scenes, and fortunately Simon Stevens confirmed his commitment to our funding.

As I go about the UK I am hearing of places where new money is helping, particularly in Perinatal and Liaison services.

I am also aware of concerns that our workforce is moving into these new services and away from our community teams and the wards which can’t do without them. We will be watching this carefully.

 

Success in Wales

A highlight of the month was a trip to Swansea to speak at the RCPsych in Wales and the Welsh Psychiatric Society joint meeting.

Even the people on the ticket gates at the station were friendly, the sun shone brightly (apparently it always does in Swansea), I tasted deep fried cockles for the first time and the academic content was varied and interesting.  I will definitely be returning.

 

Good news and a big thank you

I’m not allowed to share the numbers with you but there is some exceptionally good news about how many applications we have had to core training this year. 

Of course, there is a long way to go before we know how many will actually join us next August but things are looking hopeful.

A big thanks to everyone who helped with the Choose Psychiatry campaign this year.

The College recruitment campaign will only work if Psychiatrists on the frontline show medical students and Foundation Doctors what a fantastic job we have, despite the struggle with lack of resources – many of you volunteered your time to help us this year and we will need more of the same in 2018. 

There was also an overwhelming response to our pilot of CAMHS run-through training. Again, I can’t give you the numbers but it makes getting a surgical post look easy...

 

Gathering momentum

The review of the Mental Health Act is gathering momentum and they have put out a call for evidence.

We will use the Membership survey results to inform our response and will devote the whole of the morning of the January Council meeting to discussing this.

Two particular areas where we need to clarify our position are on whether we believe the Act should be based primarily on Capacity or on Risk, and the use of CTOs.

You can feed in your opinions directly using the email address MentalHealthActReview@rcpsych.ac.uk or via your Faculty and Divisional reps on Council.

 

Season’s greetings

As always at this time of year Christmas is approaching fast and will be here before we know it.

I’m very grateful to all those who will be working over the holiday to keep our services going, I hope that you get some time to relax with your families.

From all of us at the College we wish you a very Happy Christmas and all the best for 2018.

 

 

 

 

 

 

 

 


 

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Professor Wendy Burn

Professor Wendy Burn FRCPsych

President


Professor Wendy Burn became a consultant old age psychiatrist in Leeds in 1990 and now works fulltime in a community post. Her main clinical interest is dementia.

She has held a regional leadership role in this area from 2011 and was co-clinical Lead for dementia for Yorkshire and the Humber Strategic Clinical Network between 2013 and 2016.

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