Postcode lottery for psychiatric care

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New research by the Royal College of Psychiatrists reveals large inequalities across the NHS in the UK in the access that people have to the most senior doctors in mental health – consultant psychiatrists.

In England alone, the number of NHS consultant psychiatrists varies dramatically. For every 100,000 people in North Central and East London, there are approximately 13 consultant psychiatrists available to provide specialist mental health care on the NHS, while the East of England and Yorkshire and Humber benefit from less than half that number - just 5 for every 100,000 people.

Those in Wales have comparatively very poor access to specialist mental health care with an average of just 6 consultant psychiatrists for every 100,000 members of the population, compared to Scotland where 10 consultant psychiatrists are available for the same number of people.

Northern Ireland fares equally to England, with 8 consultant psychiatrists available per 100,000 people.

The number of NHS consultant psychiatrists per 100,000 people across England is:

1. North Central and East London – 13
2. North West London – 12
3. South London – 11
4. North East – 11
5. North West – 8
6. West Midlands – 7
7. East Midlands – 7
8. Thames Valley – 7
9. Kent, Surrey and Sussex – 7
10. Wessex – 6
11. South West – 6
12. Yorkshire and Humber – 5
13. East of England – 5

The number of NHS consultant psychiatrists per 100,000 people across the UK is:

• England - 8
• Scotland - 10
• Wales - 6
• Northern Ireland – 8

While the government has recently pledged an expansion of the mental health workforce to the tune of 570 extra consultant psychiatrists by the year 2020/21, the number of medical students specialising in psychiatry has all but flatlined. In England, over the 5 years since March 2012, psychiatry consultants increased by just 1.7%, while the number of consultants across the rest of the NHS increased by 20.2%.

The RCPsych says this enormous variation shows the need for more psychiatrists to deliver Government plans for better access to services. The Royal College of Psychiatrists is today launching its Choose Psychiatry campaign to encourage medical students to be part of vital workforce needed to support people with severe mental health conditions.

Despite the challenges, mental health services consistently rate highly in nationwide polls on indicators such as staff satisfaction with the quality of work and care they are able to deliver no matter where psychiatrists are based across the country.

The 2016 NHS Staff Survey showed that the top three trusts where medical staff in training felt personally satisfied with the quality of work and care they could deliver were from the mental health sector. Among trainees, 9 of the top 10 trusts rated best for professional recognition and staff feeling highly valued were also from the mental health sector.

Professor Wendy Burn, President of the Royal College of Psychiatrists said: “People with a severe mental illness should expect to see a specialist consultant, just as you would for a severe physical illness. The huge variation in consultant psychiatrists across the country means reality is increasingly falling short of our expectations.

“No matter where you work in the UK, being a psychiatrist is a privilege. As highly skilled medics, psychiatrists must be able to spot the nuance in symptoms, ask the right questions, and understand what the problem is. Without psychiatrists to lead specialist mental health teams we cannot deliver the high-quality care that our patients deserve. I always wanted to be a doctor and now I can honestly say there is nothing else I would rather be.”

Dean of the RCPsych Dr Kate Lovett said: “As a consultant psychiatrist I lead a community mental health team in Devon. Mental illness affects people even in the most apparently idyllic of places to live and work. Nothing beats seeing someone who you have been alongside through an incredibly difficult time start to get better.

"Anyone who is interested in a varied, stimulating career where you have time to get to truly know your patients as people should consider psychiatry.” 

For more information, visit www.rcpsych.ac.uk/choosepsychiatry| #ChoosePsychiatry

ENDS

Notes to editors

• The figures for NHS consultant psychiatrists across each region in England have been calculated using the workforce data published by NHS Digital, which reports on medical staff working within NHS trusts and CCGs in England, extracted from NHS HR and payroll records. Full-time equivalent consultant psychiatry numbers for each Health Education England region were most recently published for March 2017.

• There is a near three-fold variation in consultant psychiatrist numbers between the Local Health Boards in Wales. The most recent workforce data, for September 2016, illustrated that there were merely 4 consultant psychiatrists for every 100,000 people in Powys Teaching LHB compared to 11 in Cwm Taf LHB. Average numbers across the country were 6.4 for every 100,000 people.

• Psychiatrists are based in ‘secondary care’ – hospital or community-based teams that are specialists in mental health. People are referred to secondary care when their condition is too complex to be dealt with in primary care. Referrals can either be planned following a diagnosis or as a result of an emergency following an incident such as self-harm.

• A consultant psychiatrist has trained for 13 years specialising in mental health:

• a 5-year degree in medicine, recognised by the General Medical Council.

• • a 5-year degree in medicine, recognised by the General Medical Council.

  • a 2-year foundation programme which forms the bridge between medical school and specialist/general practice training.

  • a 6-year specialist training programme separated into two parts: 3 years in core training which covers a range of psychiatric sub-specialties (eg child and adolescent, older people, forensic or perinatal) and 3 years higher training which focuses on one (or two) psychiatric sub-specialties.

  About the Royal College of Psychiatrists

  1. We are the professional medical body responsible for supporting over 18,000 psychiatrists in the UK and internationally.
  2. We set standards and promote excellence in psychiatry and mental healthcare.
  3. We lead, represent and support psychiatrists nationally and internationally to governments and other agencies.
  4. We aim to improve the outcomes of people with mental illness, and the mental health of individuals, their families and communities. We do this by working with patients, carers and other organisations interested in delivering high quality mental health services.