2018-11-28 Mental Health

On Tuesday I asked the Government what estimate they had made of the level of staff vacancies in the NHS. The answer I got was about doctors and nurses employed in hospital wards, it was not about vacancies. That was a shame, because over and over again the reason our mental health services appear to be failing is that they do not have enough staff, and I want to know whether health ministers appreciate that.

So I asked, “With Suffolk’s only psychiatric intensive care unit having been closed down from April to October this year because of lack of staff, and with a two-to-three-month waiting list for counselling, does the Minister not understand that his reassurances do not bear much relationship to people’s experience?”

The reply was that “the local trust has had a number of problems and ….. there is a plan to put in place the staffing so that the whole ward can reopen in the near future.”  This doesn’t deal with the lack of assessment and counselling for people who don’t need intensive care.  But above all it shows a complete lack of urgency.  “There is a plan” just doesn’t wash any longer. 

In July last year I was already getting messages from distraught residents who were unable to get the care they needed for their family members.  One mother, for instance, told me of her 4 hour wait with her teenage daughter in A&E while the medical doctors did everything they could to find her the help she needed, but nobody from Norfolk & Suffolk Foundation Trust (NSFT) – the mental health trust – was there to speak to her and assess her needs. 

I finally managed to meet with the then Chairman and Chief Executive of NSFT on October 13th last year, the same day that the East Anglian and Ipswich Star reported that NSFT had been rated inadequate and placed in Special Measures for the second time.  Various reasons were given, but they mostly stemmed from three causes – not enough staff, insufficient beds and poor management. I challenged the leadership at the time to show me that these problems were being dealt with. I made it clear then that if the trust was going to survive it had to show it was improving, not just talk about it.

This year’s Care Quality Commission inspection report shows that there has been very little progress.  Last year lack of staff was the main factor behind NSFT’s poor performance, and that is still the case.  Back in 2014 inspectors severely criticised NSFT for its inability to provide safe support – now, 4 years later, it is no longer good enough to say “we have a cunning plan”.  Even Simon Stevens, Chief Executive of NHS England, admitted that the Government’s “NHS long-term plan” doesn’t answer the problem of insufficient training places for NHS staff.

The standard of caring from the staff at NSFT is good, and that is confirmed in the report this week. But without enough professional carers and doctors the trust are simply unable to assess all those who need their help in a reasonable time, or to provide them with the treatment that they need.

The inspectors say “The trust leadership team has not taken action at the pace required to bring about sustained improvement and to resolve failings in safety. The people who depend on this trust for care and support deserve better.”

I am meeting the trust’s Chief Executive today (Friday), to give him the chance to show me evidence that they are making progress.  But if he cannot convince me – and he was unable to convince the inspectors from the Care Quality Commission in September – then I will add my voice to those calling for the trust to be broken up, for Suffolk to have a separate service from Norfolk, for the management to be replaced by special administrators, and for a complete overhaul of mental health services in Suffolk.

The Children’s Commissioner, the National Audit Office, the Health Select Committee, the Royal College of Psychiatrists – all have slammed the Government over the lack of resources for mental health.  The situation in Suffolk is probably the worst in the UK, but it is not good anywhere. I am not going to try to defend local bad practice, but ultimately the responsibility for the situation of mental health services in Suffolk rests with the Government and I will continue to call on them to do what it takes to put things right.