RCPsych Wales - Coming out of COVID

How is the College working with government to reshape mental health services as we look towards a post-COVID world?

This blog is an extract from RCPsych's Insight Magazine Spring edition.

Over the past two years, RCPsych has worked increasingly closely with governments and health services across the UK to meet the challenges of the COVID pandemic. As a result, says Policy and Standards Manager Tommy Denning, ‘the College is in a much stronger place. Our level of engagement and influence is ramped up quite significantly.’ And so, with the ending of all COVID restrictions in England and Scotland and their easing in the rest of the country, the College is in pole position to shape policy in a post-COVID world.

In England, RCPsych President Adrian James has established a close working relationship with the Chief Medical Officer, Chris Whitty. The College leadership also meets regularly with NHS England’s Chief Executive, Amanda Pritchard, its National Director of Mental Health, Claire Murdoch and its Medical Director, Steve Powis. In Scotland, says Tommy Denning, ‘the College has built up strong relationships with both government and parliament. We are the “go-to” organisation, so if the Scottish government is doing anything on mental health, they'll always come to us for advice.’

The situation is more complicated in Northern Ireland, where the devolved government was suspended for three years until January 2020. The resignation of the First Minister this February has caused further administrative upheaval. However, the College has established good relationships with the civil service in Northern Ireland which, says Tommy Denning, ensure that it has a powerful influence on policy. A new Northern Ireland mental health strategy, due to be published this year, has had considerable RCPsych input.

The College has also been very active in Wales. ‘Historically, we've always had a good relationship with the Welsh government,’ says Ollie John, RCPsych in Wales’ Manager. ‘We’ve always been viewed as a sensible, evidence-based organisation. But during the last couple of years through COVID, we’ve made real ground and achieved much more regular engagement with government on matters such as alleviating waiting lists and thinking about how services can be delivered differently.’

Dr Katie Fergus, RCPsych’s Joint Policy Lead in Wales, agrees. ‘Our communication with the Welsh government has gone from strength to strength. We're speaking to them more often and in a more meaningful way than before and there are now some very direct lines of communication that have enabled us to have very direct influence on policy in relation to COVID recovery.’

A case in point is the recent establishment by the College and the Welsh NHS Mental Health Leads of a technical advisory group in NHS Wales. With the emergence late last year of the more transmissible Omicron variant of COVID, the Welsh government asked the group to produce revised guidance on leave arrangements.

Three other key projects illustrate the influence the College has on national policy in Wales. Before the pandemic, Professor Alka Ahuja, with RCPsych support, developed a video consultation project in a CAMHS service in Gwent (see Insight 12, summer 2020). During the pandemic, Prof Ahuja was seconded to the Welsh government and online consultation was rolled out across the country.

In future, as the pandemic recedes, Dr Fergus hopes that ‘we will continue to improve our use of technology to really enhance access to mental health care and support. But, at the same time, there will be a lot of work to be done around raising both staff and patient confidence in returning to busier outpatient clinics and getting that that face-to-face work going again.’

Wales has a relatively elderly population and waiting lists for dementia diagnosis have, historically, been long. But a pilot study at Aneurin Bevan University, supported by the College, has shown that FDG-PET scanners can greatly speed up diagnosis. Their use has since been adopted nationally and the Welsh government has invested in more scanning devices across the country.

The College has also played a leading role in persuading the government to adopt the use of the drug Buvidal (buprenorphine) in the treatment of heroin addiction. ‘Buvidal is an injectable maintenance treatment for at-risk heroin users,’ says Ollie John, ‘which means they can more quickly access psychological therapy to help with their addiction. And what we've seen is that the actual drug death rates in Wales, which across the UK have just skyrocketed in the last few years, have had a complete U-turn. We've got the lowest rates we've ever had since 2014. It's an amazing story.’

Ollie John is understandably proud of what the College has achieved in Wales. ‘The most rewarding part, as a college person,’ he says, ‘is knowing that our members have been at the heart of the recovery in Wales.’