Tag: austerity

Turning back the clock?

Here’s a post to draw attention to the RCN‘s newly published Report on Mental Health Services in the UK. This looks to be the latest document from Frontline First, a campaign revealing the effects of funding cuts on NHS care and nursing.

Working with the charity Rethink Mental Illness, and drawing on publicly available data, the RCN shows how (since 2010) the number of staffed mental health hospital beds across all four countries of the UK has reduced. The number of nurses working in NHS mental health services has also fallen, those remaining being revealed as an ageing group. Year on year, an increasing proportion is shown to be over the age of 50.

Here’s a chart showing reductions in the mental health nursing workforce, which I’ve extracted from page 16 of the report:

And, right at the front of the document, I see a clear case for investment contained in these recommendations which I reproduce word-for-word:

1) Governments must ensure there is equal
access to mental health services and that
the right treatment is available for people
when they need it.

2) Governments and NHS providers must
ensure that the commitment to parity of
esteem is directly reflected in the funding,
commissioning of services, workforce
planning, and patient outcomes.

3) Local commissioners and health boards
must make available enough local beds
to meet demand.

4) The principle of least restriction must
be embedded across all mental health
services. Detention under mental health
legislation should always be based on
clinical opinion and never be a result
of local failures to provide appropriate
care. Due to the significant increase in
detentions under the Mental Health Act
there should be a national objective set
to reduce detention rates in England.

5) There must be a consistent shift across
the UK from inpatient acute care to
community-based services which
recognises that prevention and early
intervention results in better outcomes,
reduces the pressure on acute services,
and reduces the overall cost to the NHS
in the long term.

6) Urgent action must be taken to address
the workforce shortages. Resources must
be committed to training and recruiting
enough mental health nurses who are able
to deliver specialist care in the changing
health and social care landscape.

7) NHS providers must invest in the current
mental health nursing workforce.
Band 6, 7 and 8 mental health nurses
should be developed to become advance
practitioners to deliver effective
recovery-led care in mental health
services.

8) There must be a sustainable and
long-term workforce planning strategy
which acknowledges the current
challenges facing the mental health
nursing workforce.

More on mental health services at a time of austerity

For the second time in two months the BBC and Community Care have collaborated to establish the extent of funding cuts to mental health services in England. Freedom of Information requests were sent to 51 NHS trusts, of whom 43 responded. Summaries of this investigation, and headline findings, can be found on the BBC website here and on the Community Care website here. Community Care says:

Data returned by over two-thirds of the mental health trusts, obtained in two separate Freedom of Information requests, showed that:

  • Overall trust budgets for 2013/14 had shrunk by 2.3% in real terms from 2011/12. Ten out of 13 trusts that provided forecast budgets for 2014/15 are projecting further cuts next year.
  • Budgets for ‘crisis resolution teams’ fell 1.7% in real terms compared to 2011/12 while the average monthly referrals to these teams rose 16%. The teams provide intensive home treatment in a bid to prevent acutely unwell people being hospitalised.
  • Budgets for community mental health teams flatlined in real terms but referrals rose 13.3%. These services provide ongoing support in a bid to prevent people’s mental health deteriorating to crisis point.

Community Care also lists 10 ways this underfunding is damaging care.

This is also the month that a special, free-to-download, ‘impact of austerity’ edition of Mental Health Nursing journal has appeared. In an email forwarded to all members of Mental Health Nurse Academics UK by Steve Hemingway (who is both an MHNA member and a member of the MHN editorial board), Dave Munday at Unite the Union (which publishes the journal) says:

This month the Mental Health Nursing journal is focused on austerity and mental health. I hope you’ll agree with me that this is a vitally important topic that not only every mental health nurse should know about, but every citizen. We hope that the journal will help to trigger some thoughts and debates that you can have locally in your workplaces but also outside of work. To this end we’re making the journal free to access even if you’re not a MHNA member or MHN subscriber.

Mental health services at a time of austerity

Last week I drafted a short, commentary-type, paper for a special edition of Mental Health Nursing which will be focusing on practice and services during a time of austerity. Some years ago I was on the editorial board of MHN. I’m pleased to learn that having disappeared from the library shelves in favour of becoming an online journal (available only to members of Unite the Union) it has made a return in traditional paper form. I’ve been sent a stack of copies, which I’ll be distributing to students.

Anyway: no sooner had I completed my draft and sent it onwards than yesterday’s big health and social care story broke. Under the banner England’s mental health services ‘in crisis’ the BBC ran a report drawing on a joint investigation conducted with Community Care magazine. The headlines were sobering, suggesting over 1,500 mental health hospital beds being lost since April 2011. These bald figures were illustrated with personal stories, revealing people needing crisis admission being transferred to wherever beds could be found around the country, and wards running at over 100% occupancy.

This is very bad news, and suggests a shrinkage back to the way things last were in the early to mid 1990s. In writing my paper for MHN I fished out my copy of this article by David McDaid and Martin Knapp, in which the point is made that at times of economic hardship demand for mental health care increases. And yet, as we are finding, services are actually retracting as austerity bites.

Jobs for new nurses

One of the things I’ve been doing recently is meeting up with final year students about to complete their degrees and register with the Nursing and Midwifery Council. These are hard-working, committed, people who have chosen to prepare for careers in mental health nursing. They’re now looking for jobs, and from what I’m hearing opportunities locally and nationally are few and far between.

Here, then, is the sharp end of NHS underfunding. There’s no question that new mental health nurses are required. In fact, we should expect demand to increase at a time of hardship. The problem is that vacancies are being frozen and services are generally retracting. As economic collapse fuels distress and increases need austerity bleeds public services of the capacity to respond.

So, good luck to everyone preparing to qualify. I hope you get the jobs you want and deserve, because you’re needed.