A busy start to the year

Well, 2025 is already well and truly here. It’s been a busy month of Government announcements, meetings with Ministers and College elections. 

I have just returned from the RCPsych in Northern Ireland Residential Conference, where Professor Sir Michael Marmot delivered our President’s lecture on Social justice and Health Equity, and the new RCPsych NI Policy Strategy Time to Bridge The Gaps (PDF) was launched.  

The day started with a fabulous review of the evolutionary development of emotion by Derek Tracy – our feelings are ancient! Talks from Resident doctors, Claire Potter, Amy Duncan, Sarah Davidson and Cedar Andres showed the incredible talent bursting out of Northern Ireland. And Fiona Gaughran gave her usual tour de force on difficult to treat psychosis. Later we held a panel discussion with the Health Minister Mike Nesbitt, MLA. It was a truly great event.  

NHSE publishes new planning guidance – giving greater autonomy but also risking the deprioritising of mental health  

The latest NHS planning guidance was published last week and gives commissioners more autonomy to focus on local population healthcare needs, which should, if done in accordance with the prevalence and severity of healthcare need, benefit those with mental illness. However, I am deeply concerned that without mandated guidance about how to prioritise investment, this autonomy will come at the expense of people who have a mental illness.  

We’ve seen in the past that people’s long-term health and that of the economy is put at great risk when funding is diverted away from mental healthcare, particularly during a time of chronic under-investment. The Government must ensure commissioners prioritise the significant mental health needs of their local population and allocate resources appropriately.  

I’m also concerned that targets which require services to provide essential care to those with severe mental illness, such as annual physical health checks, have been cut from the planning guidance. While the removal of excessive numbers of targets is necessary, they can help drive improvements in patient safety and quality of care, therefore it is crucial that the right targets are kept.   

The exclusion of targets to diagnose dementia, the leading cause of death in England and Wales, as well as the removal of mandates to roll out women’s health hubs is particularly worrying. It is crucial that some of these ambitions are retained and reinforced elsewhere, such as in the upcoming NHS 10-Year Health Plan.  

The Mental Health Investment Standard (MHIS) has helped services meet some of these targets in previous years and the Government’s commitment to it is reassuring.  

The College will continue to argue for mental healthcare to be prioritised in line with the actual prevalence of mental illness in the population and work with services to support the implementation of this new guidance, but more than anything, what is needed for people with mental illness and those who support them to thrive. You can read the College’s full statement here:  

Representing your concerns to Parliament on Assisted dying/assisted suicide  

On behalf of the College, Dr Annabel Price, Consultant Liaison Psychiatrist in Palliative Care, gave expert evidence, and shared the membership’s concerns, during an oral evidence session in front of the Public Bills Committee for The Terminally Ill Adults Bill. You can watch this again on Parliamentlive.tv.  

It is important that Parliamentarians give careful consideration to the safeguarding of patients and their doctors, as well as to the reliability of consent procedures. 

There are a number of unanswered questions about whether it is possible to provide adequate protections and safeguards for all individuals and, if so, what these measures would be.  

The College is actively undertaking work on this complex subject, focusing primarily on the possible impacts on those with mental illness, intellectual disabilities and neurodevelopmental conditions, and implications for the psychiatric profession.  

Members can access more detailed material and information about our engagement with policymakers on this topic. 

1.6 million waiting for mental health treatment left out of Elective Care Plan 

On 6 January Government published its new Elective Reform Plan to tackle hospital backlogs by cutting waiting lists and improving access to more appointments. While it was positive to see the Government is prioritising the reduction of waiting lists to give people the care they need as soon as possible, I was bitterly disappointed to learn that mental health patients have not been afforded the same attention. 

When the Government came into power, they inherited a waiting list of 9.2 million elective referrals. It is unacceptable that only the 7.5 million now waiting for physical health care will benefit from the new plan, while the forgotten 1.6 million mental health patients are still left waiting for the same prioritisation. 

There is no reason why elective care shouldn’t cover both physical and mental health care moving forward. Failing to attend to mental illness is bad for individuals and their families, but also bad for productivity and the economy. The College will prioritise our influencing work on this injustice. You can read my statement on this issue here: 7.5 million referrals on waiting lists doesn’t include mental health patients, cautions RCPsych. 

Promoting your views as UK Government builds 10 Year Health Plan  

I have recently attended a workshop on the 10 Year Health Plan. I urged Wes Streeting, the Secretary of State for Health and Social Care, to allow us in the NHS to implement and embed the evidence-based interventions we know work, not to simply reform for reform sakes. I reminded the 10 Year HP team that psychiatry has gone from hospital to community (from 154K inpatient beds to 18K inpatient beds and delivery of most of our care in the community); we’ve done analogue to digital and we are doing sickness to prevention and they should learn from our successes as well as our challenges. To do this they must properly consider the views of psychiatrists in the 10 Year Health Plan for NHS England. 

During the meeting, I made it abundantly clear that it is essential to see a commitment to deliver parity of esteem between mental and physical health when the plan is published later this year. 

Additionally, I called for a focus on achieving the full suite of waiting time standards, renewed focus on workforce recruitment and retention, and investment in the mental health estate. Without comprehensively addressing the core components of service delivery, the NHS will continue to face challenges in ensuring the best standards in therapeutic care and patient safety are met. 

Above all else, I called on the Health Secretary to avoid reinventing the wheel and instead focus on investing in evidenced-based services that provide effective and efficient support to people when they become unwell, and to work on preventing mental illness from arising in the first place.  

Could you be the next RCPsych Registrar? 

I’m sorry to say that our current Registrar, Dr Trudi Seneviratne OBE, will be finishing her term after a phenomenal five years in post, this summer. Nominations for the next RCPsych Registrar will remain open for just under two weeks.  

The dynamic Registrar role involves leading campaigns, influencing stakeholders and shaping policy at a national level. You can listen to Trudi telling us more about the role and why this could be the one for you. 

Members who would like to take up this exciting but challenging position will have until midday on 14 February 2025 to put themselves forward find out more on our website. 

That’s all for now but I look forward to seeing more of you in the coming year ahead. In the meantime, take good care of yourselves, your patients and of course, your loved ones. 

Your President  

Lade