Health chiefs say a controversial shake-up of psychiatric services across Tayside is being hampered by “significant workforce challenges” – exactly as opponents predicted more than a year ago.
NHS Tayside pressed ahead with its planned review in January, despite concerns that many staff would be unwilling or unable to make the move to new cities.
Under the scheme, leading disability inpatient services will be provided at Murray Royal Hospital, Perth, while services are being transferred out of the Mulberry unit at Stracathro Hospital near Brechin and general adult psychiatry acute admissions centralised in Dundee
However, members of the Perth and Kinross Integration Joint Board have now been told that the majority of staff – around 55% – are unable to move for a variety of reasons.
At a meeting on Tuesday, Gordon Paterson, chief officer of the Perth and Kinross Health and Social Care Partnership, said: “The progress of implementing the redesign programme has been slow and that is partly because of some of the significant workforce challenges, in relation to the proposed transfer of patients and wards from one site to another.
“We need to ensure that we have adequate staffing in place. We need to engage with nursing staff and clinical staff to ensure that that they can transfer from Perth to Dundee, or Dundee to Perth. If they can’t we have to make sure we can suitably redeploy them and there are some alternative options.”
He said: “We recognise that this is an upheaval for staff and we recognise that some staff can’t travel.”
Mr Paterson said it was crucial to get to the next phase of the plan, which involves shifting a ward from Carseview to Murray Royal.
“We are anticipating we will be in a position to progress this early in the new year, notwithstanding the fact we are sensitive to the impact and implications for staffing,” he said.
Independent councillor Xander McDade described the situation as “quite disturbing”.
He said: “At the meeting in January 2018, the main rationale for the redesign – which we were given repeatedly – was that the only way we could safely staff the service was to go ahead with this model.
“That was the clinching argument.”
NHS Tayside’s Alan Drummond said: “This was raised as a red risk prior to that meeting.
“It wasn’t a case that staff didn’t want to carry on their care for patients, they were just unable to make the move.
“We raised this as part of the consultation and we were told that the risk would be managed. This is not the unknown we are dealing with, this was raised three years ago.”
Mr Paterson said he was also aware that an independent inquiry into mental health services, led by Dr David Strang, was due to be published in February and could make further recommendations.
Dr Strang said earlier this year that the redesign should be halted to allow for a wider review of health services.
Tayside health chiefs say their focus is on treating mental health patients at home – despite calls for improved hospital provision in Dundee.
The family of David Ramsay, who killed himself in October 2016 after he was reportedly rejected for treatment at psychiatric unit Carseview, have led calls for a facility similar to the now-closed Liff Hospital to be opened for those fighting mental health issues.
They have also campaigned to have a public inquiry launched in to the suicides of several people who have come in to contact with the centre.
The topic was brought up in the Scottish Parliament on Thursday, when Scottish Labour leader Richard Leonard called for the inquiry.
He asked the First Minister: “Why has your government remained silent on this crisis and on this demand for a public inquiry?”
Nicola Sturgeon, sending her condolences to Mr Ramsay’s family, said it was “not fair or right” to say the government had been silent.
She said her administration would “pay very close attention” to NHS Tayside’s response to recommendations made by the Mental Welfare Commission, following an unannounced inspection in March.
Now, Robert Packham – chief officer for Perth & Kinross Health And Social Care Partnership, which runs adult mental health services across the area – appears to have ruled out the creation of a new facility.
He said only six out of every 100 mental health patients needed hospital treatment, adding: “We have been redesigning mental health services to adapt to the changing needs of our population and new services have been introduced to manage people in crisis and support people to remain at home.
“Healthcare is changing rapidly, with a greater focus on recovery and improved mental wellbeing.
“Specialist hospital services will always be needed for those who are most unwell and, when people are in hospital, they should receive the highest possible quality of care in buildings which are fit for the delivery of modern healthcare.
“It is important to remember that most people with a mental health problem are treated at home or in the community. When it is no longer possible to do this safely, a patient will be admitted to hospital.”
“Deep concern” has been expressed over a 10% drop in acute mental health beds across Tayside over the past five years.
The number of beds for men and women dropped from 99 in 2013 to 90 last year.
Health chiefs said the reduction was due to a reconfiguration in Perth and the interim relocation of the Mulberry Unit in Angus to the Carseview Centre and insisted most patients were now treated in the community.
However, Angus MP Kirstene Hair is seeking a reassurance from NHS Tayside that the numbers will not fall any further.
She said a total of 44 beds were likely to be relocated from Murray Royal Hospital and the Mulberry Unit at Stracathro in Angus as part of a shake-up of mental health care, while a similar number will be set up in Dundee at Ninewells Hospital.
But she added: “This research finds that the number of beds for a growing problem is reducing anyway – which is of deep concern.
“There needs to be a reassurance from NHS Tayside this number will not shrink any more.”
Conservative MP Ms Hair said she was also concerned that there are no eating disorder beds locally, meaning people are still having to go to Aberdeen for specialist treatment.
“It’s my concern and that of many of my Angus constituents that local health services are disappearing in the background,” she added.
“It is only huge change, such as ward closures, which makes people sit up and take notice.”
Closure of the Mulberry ward at Stracathro Hospital has been identified as the preferred option in a programme to address what officials have described as an unsustainable model for mental health care across the region.
Perth and Kinross integration joint board will have the final say on the package next week.
The move is likely to mean the axe for the Angus unit while general adult psychiatry acute care will be provided from four wards at Dundee’s Carseview Centre, along with learning disability inpatient services from three wards at Murray Royal Hospital in Perth.
Chief officer for Perth and Kinross health and social care partnership Robert Packham said only around 6% of people who access mental health services each year need hospital care.”
He acknowledged there had been a small reduction in the number of acute general adult psychiatry beds in the last five years, adding: “This is due to the reconfiguration of Moredun Ward at Murray Royal into separate male and female environments, and the interim relocation of the Mulberry Unit to the Carseview Centre.
“We have also been redesigning services to adapt to the changing needs of our populations and new services have been introduced to manage people in crisis and support people to remain at home,” said Mr Packham.
“Our communities would expect treatment to be available to them and their families when it is required and we remain committed to ensuring our patients can access the best treatment in the most appropriate place.”
The following video was lifted from STV’s North Tonight. the quality of the video is not brilliant, however, it would be good to receive some opinion regarding the training of police officers to make the decision whether an individual with mental health issues should be referred to Carseview by means of a telephone conversation. Also it should be noted that often a person may not express the anxiety they are currently experiencing over the phone. Often the physical actions of an individual can reveal much more than what a telephone consultation can.
In addition to the article/video above, I received this observation regarding the subject from a friend of a friend on Facebook. Please share any opinion or experience you have regarding this particular subject in our contact section. Which you can find here
“Almost half of Scots receiving mental health treatment on the NHS have endured an “unacceptable quality” of care, new research indicates. Lengthy waits of months for suicidal Scots and patients being advised to “pay privately” for treatment are among the cases recorded in a survey by the Scottish Association for Mental Health (SAMH).”
A damning survey carried out by a mental health charity in Perth has painted a picture of a service in crisis.
PLUS Perth found an overwhelming majority (88%) of more than 300 service users say mental health provision should not be transferred from Murray Royal Hospital in Perth to Carseview in Dundee, and also feel they are being ignored.
The charity also claims the plan proposed by the Perth and Kinross Health and Social Care Partnership, with NHS Tayside, has thrown local mental health teams into crisis.
The partnership’s preferred option is to close the Moredun ward at Murray Royal Hospital and move the service to Carseview. The ward treats acute adult psychiatric inpatients.
PLUS Perth recently carried out a survey of 319 of its users and the results were critical of the proposal. It found 88.18% of people do not agree with the plan to move mental health services to Dundee and that 39.1% have “no confidence” and 38.78% have “little confidence” in the proposal.
A total of 98.41% of respondents stated they want mental health services to be based locally, with 97.58% saying they feel it is important to have local support for “crisis and emotional” distress.
78.03% of the respondents stated they did not believe giving their opinion via the consultation process would influence the outcome.
Susan Scott, PLUS Perth development manager, claims there is no strategy associated with the centralisation plan and hit out at the proposal, claiming it is “picking on the most vulnerable” people in society.
“The people affected don’t have a voice and are made to look invisible by this plan – this is the spectre of the future.
“There is a decline in the number of people working in local community health teams – they are losing staff. As a result, we are seeing a lot more people coming into us for help and advice.
“People suffering from mental health problems need help locally, not put in hospital where you then have the internal stigma attached to that.”
“The PLUS Perth survey shows the majority of people don’t want the service moved to Dundee – they want it kept local, and they are not impressed by the consultation process.”
Among the reasons for not agreeing to the centralisation of services, one resident said: “It’s not practical for people who live more rurally in Perth.”
Another PLUS Perth user added: “For those experiencing acute mental health problems being further isolated and further away from their home and family will have a significant impact.”
Another resident claimed the move will result in an “increased risk” to individuals with acute mental health needs.”
A spokesperson for the Perth and Kinross Health and Social Care Partnership said: “As with every service we do experience fluctuation in our staffing levels.
“However, the staffing establishments for the community mental health teams have remained stable for the past three years.
“There is strong local commitment to the development of our integrated services to support adult mental health and wellbeing and our new local mental health and wellbeing strategy for Perth and Kinross is currently being developed in full partnership and has had wide stakeholder engagement.”