Welcoming Sonia Walter as the College’s interim CEO

On 15 November, the College said goodbye to its CEO of seven years, Paul Rees. He has been a positive force for the College, which evolved and modernised under his leadership, as a result of his strategic vision and effective management. Looking forwards, I am very pleased to announce that our Director of Professional Standards, Sonia Walter, will be taking up the post as the College’s new interim CEO. Many of you will know Sonia as she has been with the College, in a variety of roles, for a phenomenal 23 years. Sonia has a great understanding of the needs of the members and affiliates; how the College works and the values at the core of everything we do. I know she will be brilliant in managing how the College navigates this period of change.

Sonia’s focus over the next six months as interim CEO are to:

• Build on the excellent work that has already been done to establish the College as a values-led organisation and continue to champion Courage, Innovation, Respect, Collaboration, Learning and Excellence.
• Offer the best possible support and service to members and affiliates so you can secure the best outcomes for people with mental illness, intellectual disabilities and developmental disorders.
• Challenge the perception that the College is London-centric and ensure that our work benefits members, affiliates and patients across the four UK nations and internationally.
• Embed the organisational competencies of fairness, allyship and co-production.
• Launch and implement the new three-year Presidential strategy, in collaboration with the entire staff team. The strategy will prioritise addressing the treatment gap; nurturing psychiatrists; fairness for all; promoting research in mental health; advancing international psychiatry and ensuring an excellent member experience and engagement.
• Develop our income generating activities to ensure we achieve our budgeted surplus.

Changes to the political landscape

Politically, there has been lots going on over the past month.

The King’s speech was delivered on 7 November. It outlined the Government’s legislative agenda for the next session of Parliament. Many of you will be aware, the speech failed to include legislation to reform the Mental Health Act (MHA); did not include enough support for children and young people’s mental health, and did not move forward any plans to ban conversion practices. It was disappointing that Government has not prioritised the passing of the draft Mental Health Bill, which was first proposed six years ago. Enormous amounts of work and co-operation from across the mental health sector has gone into this legislation.

The underlying causes that prompted the legislative reform in the first place, remain unaddressed. Detention rates continue to rise at an unprecedented rate and the number of people from Black and minoritised ethnic communities detained under the MHA remains disproportionately high. There is cross-party agreement for these reforms and therefore between now and the general election we will continue to lobby the main political parties to honour their pledges to reform the Act, alongside making additional investment into services a priority.

The Chancellor delivered his Autumn Statement on 22 November. Since starting my Presidency, I’ve spoken with senior members of Government and the Opposition including Rt Hon Stephen Barclay MP, Maria Caulfield MP, Wes Streeting MP, Abena Oppong-Asare MP and even Rt Hon Michael Gove MP, to raise the issue that mental illness is the reason that record numbers of people are unable to work. Unsurprisingly, a key focus of the Autumn statement was improving productivity, with announcements about reforming the benefits system.

We were pleased to see that Government has accepted our recommendation to use evidence-based NHS services when supporting people with a mental illness back to work. However, there were still many concerns over the changes announced to the benefits system.

It is important that with the Back to Work Plan, people with mental illness and severe mental illness should return to work when it is right for them to do so. When they do, they should have access to specialist support that helps them overcome any barriers they might face.

Prime Minister, Rishi Sunak, also announced changes to his Cabinet this month. The key moves affecting the mental health sector include, Rt Hon Victoria Atkins MP taking up the role of Health and Social Care Secretary; Rt Hon Andrea Leadsom MP taking up the post of Parliamentary Under Secretary of State in the Department of Health and Social Care and Rt Hon Andrew Stephenson MP taking on the post of Health and Social Care Minister. We have written to all of them and others to offer our expertise and advice in developing their plans as they settle into their new roles.

I assure you that I will continue to engage with these decision makers to ensure that mental healthcare and psychiatry remain at the forefront of Government’s priorities.

Key policies affecting mental health and psychiatry

I have been working with key stakeholders to look at the next stages of the critically important NHS Long Term Workforce Plan (LTWP). On 9 November, I

joined the LTWP Delivery Summit, hosted by Amanda Pritchard and other senior leaders in NHSE, alongside other Medical Royal Colleges, NHS Employers and Patients Associations. It was useful to discuss how the plan is working in practice, feedback on immediate challenges and consider how we move forward to effectively implement the plan.

We held discussions on three themes - Train, Retain and Reform. It is really important that we work together across all of these areas so that our workforce is supported and strengthened.

Psychiatrists play a central role in the mental health multidisciplinary team and so it’s vital that we do everything we can to not only grow but also retain our workforce. I will continue to engage with implementation planning, and calling for adequate resources to back the LTWP plan. You can do your bit too, by supporting our Choose Psychiatry campaign.

In July, the Department of Health and Social Care launched the National Partnership Agreement: Right Care Right Person. The implementation of this approach across London started at the beginning of this month. This initiative was designed to ensure a better balance between police and mental health services in responding to people in crisis. In principle, it is positive to see police forces across the UK working with mental health providers to ensure the scheme is as successful as possible. However, I know that there have been issues in its implementation, with short timeframes for NHS leaders to prepare for this new system and challenges in understanding the scope of roles and responsibilities.

This approach will take time to embed and will require a monitoring mechanism where both NHS Trusts and the police can report problems to and get advice from.

I will continue to call on the Government to provide mental health services with additional resources and the funding needed to support Right Care Right Person so that we can provide continuity of care; prevent more people from experiencing a crisis and ensure timely support for people in crisis. Right Care Right Person must be evaluated appropriately with regular and timely reviews to determine whether the programme is working.

Question Time with the Officers

Remember that we run monthly QT with the officers. These are sessions where we answer all the questions you put to us and if we have time, outline some of the suggestions made by the membership. We answer every question that comes in, and if we don’t get round to a question, it will be answered in the next session. So, please do submit any queries you have. The next session is at 3.30pm on 15 December and you can register online.

MHRA alert on valproate

The Medicines and Health Regulatory Authority have issued an alert asking organisations to put a plan in place to implement new regulatory measures that are being introduced for sodium valproate, valproic acid and valproate semisodium (valproate).

Due to the known significant risk of serious harm to a baby after exposure to valproate in pregnancy, these measures aim to ensure valproate is only used if other treatments are ineffective or not tolerated, and that any use of valproate in women of childbearing potential who cannot be treated with other medicines is in accordance with the Pregnancy Prevention Programme (PPP). Given these and other risks of valproate, these measures also aim to reduce initiation of valproate to only those patients for whom no other therapeutic options are suitable.

The College will be providing more detailed advice on the potential implications of these new measures for you in your clinical practice. Please keep an eye out for this in the near future.

Strokes of inspiration with our new Artist-in-Residence

And finally… I’m so pleased to announce the College has appointed Adam Hines-Green as our new Artist-in-Residence. This programme of work is being led by College Registrar, Dr Trudi Seneviratne. Watch this space for more information in the coming months!

That’s all for now, wishing you the best for your work and homelife,

Lade