Tayside psychiatry vacancies worst in Scotland as expert warns national services ‘unsafe’

Tayside psychiatry vacancies worst in Scotland as expert warns national services ‘unsafe’

Tayside is at the epicentre of a “national scandal” in adult psychiatry care, with senior managers breaking ranks to brand wider services across Scotland “unsafe”.

The region was likened to a “canary in the coal mine” as new analysis found it has the worst record for recruiting general adult psychiatry consultants anywhere in the country.

The Courier can reveal a professional body representing leading psychiatrists is warning patients in Scotland are being put at risk by services at breaking point.

Situation is ‘critical’

Dr Amanda Cotton, chair of the Senior Medical Managers in Psychiatry group, said: “The situation regarding consultant psychiatrist vacancies across Scotland is critical.

“A review of vacant consultant posts undertaken by our group of Senior Medical Managers in Psychiatry last year demonstrated true vacancy rates in Scotland from 13% to over 50% around the country.

“Often it is the most impoverished areas of the country, and the areas that experience the worst rates of drug-related deaths, that have the least number of psychiatrists.

“This is a national scandal.”

Dr Cotton is also Associate Medical Director for Mental Health and Learning Disability Services at NHS Borders.

She warned bosses are trying to manage a “terrible shortage” of consultant psychiatrists by employing temporary locum doctors, “some of whom might not have undergone the necessary training”.

She added: “This is unsafe and would not be accepted in other areas of healthcare.”

‘Services must be scaled back’

Dr Cotton said the current situation in psychiatry would be like allowing doctors to operate with surgical training.

The expert said staff are “overwhelmed”.

And she called for a reduction in the number of services being offered until the next generation of consultants is trained.

She said: “We have raised our concerns directly to the Scottish Government and asked that they begin an urgent conversation with the Scottish public about what care specialist mental health services can and cannot provide over the next few years.

“Staff in mental health services need to feel they are doing a job that is safe, realistic and achievable.”

Crisis in Tayside laid bare

New analysis from the Senior Medical Managers in Psychiatry group, seen by The Courier, lays bare the extent of the crisis in Tayside and across Scotland.

The region should be employing 24.5 full time equivalent consultants in general adult psychiatry but has only five in post.

NHS Tayside chief executive Grant Archibald with chairwoman Lorna Birse-Stewart.
NHS Tayside chief executive Grant Archibald with chairwoman Lorna Birse-Stewart.

Health chiefs have tried to plug the gaps with temporary locum hires but still has a need for 4.5 full time equivalent staff.

It means 18% of Tayside’s psychiatry requirements are currently unfilled, the worst rate anywhere in Scotland.

The vacancy rate across the country as a whole is 9%.

In Fife, the vacancy rate is 8%.

‘Shocking’

Dundee-based MSP Michael Marra described the figures as “truly shocking” and said they “lay bare the massive task in rebuilding mental health services”.

He said: “The situation in Tayside – considerably worse than the rest of Scotland – has been described to me as the canary in the coal mine of an over-stretched mental health service nationally.

“Despite all of the warnings, the major reports and promises of action from SNP ministers there is scant progress on any of the big issues.”

Michael Marra MSP
Michael Marra MSP. 

NHS Tayside said the health board is working closely with staff to develop new workforce models, including advanced prescribing roles for non-medical practitioners.

A health board spokesperson added: “There is a UK-wide shortage of consultant psychiatrists which is creating a very challenging recruitment environment.”

SNP minister Kevin Stewart said the mental health workforce has “expanded significantly” under the current government.

Mr Stewart noted that “record numbers of staff” are providing more varied support to a larger number of people than ever before.

He added: “As part of our ongoing commitment and investment, we are working with partners to develop both a new Mental Health and Wellbeing Strategy and Workforce Plan in 2023.”

Relocation of local services will be ‘a travesty for people struggling with mental health’

The Carseview Centre, beside Ninewells

Tayside health bosses are set to press ahead with the relocation of major mental health services, in the face of widespread opposition.

A consultation on moving all acute mental health services for the region to Dundee’s Carseview Centre — resulting in the closure of the recently renovated Mulberry Unit at Stracathro Hospital — ended in October.

The survey also asked for views on the relocation of learning disability services from Carseview and Strathmartine Hospital to wards at Murray Royal Hospital in Perth.

Service users, the public and community groups from Dundee, Perth and Angus all voiced their disapproval of the plans — but health bosses at the Perth and Kinross Integration Joint Board, which will make a final decision on the plans in January, have indicated they intend to carry out the “necessary” changes.

A draft feedback statement said: “It is clear from the consultation that the majority of people would prefer to receive their health care close to where they live.

“The challenge to mental health services is balancing this with the need to provide safe inpatient services which are high quality and provide best value for money.”

During the feedback, 57% opposed relocating Tayside’s acute mental health services to Carseview, in Tom McDonald Avenue.

In addition, 59% of respondents were against relocating all inpatient learning disability services to Perth.

The Susan Carnegie Centre, at Stracathro Hospital, which houses the Mulberry unit.

Several community and support groups expressed “major” concerns about rural patients’ ability to access services should the move go ahead.

However, health bosses believe centralising services is the “safest, most sustainable” way of looking after patients.

The preferred option is expected to be formally approved in January, with refurbishment of Carseview commencing in November 2018 and the full “transformation” programme completed by June 2020.

Phil Welsh, whose son Lee was found dead at his home in Dundee’s West End in July having experienced mental health problems for a decade, said the plan was “a travesty” for people with mental health problems in Tayside.

Phil said: “What you are going to have is people who are experiencing mental health problems, that need to be seen by a crisis team rapidly, having to get to Dundee on a bus, in a taxi or relying on someone to give them a lift. It is putting stress onto people who are already in a very stressful situation.”

Mairi Gougeon, MSP for Angus North and Mearns, said: “I’m absolutely staggered that I am learning about this proposal through the media and not directly from anyone at NHS Tayside.

“However, sadly, it is in keeping with the way this entire consultation process has been conducted. I still firmly believe that the consultation process was biased, over-complicated and heavily weighted towards the preferred option.”

North East region MSP Liam Kerr described the consultation process as “a sham”.

He said: “I have real concerns about contingency plans if something goes wrong at Carseview, once the dust settles.”

Robert Packham (right), chief officer for Perth & Kinross Health and Social Care Partnership, said: “This feedback forms a critical part of the evidence which will be presented to the NHS Tayside board and the Angus, Dundee and Perth & Kinross Integration Joint Board during December and January.

“If the preferred option is approved, NHS Tayside and the health and social care partnerships are committed to continuing conversations with staff, service users, carers, partner organisations and local communities to address the issues they have raised and look at ways of minimising the impact of the proposed changes.”

 

 

Link to Evening Telegraph here