An NHS Trust’s cost-saving drive has “decimated” community mental health teams and left overstretched crisis teams unable to provide a safe alternative to hospital for people in acute mental distress, a campaign set up by frontline staff has claimed.
The campaign to save mental health services in Norfolk and Suffolk alleges that inpatient and community services are in “acute crisis” after the local NHS mental health trust decided to accelerate a £20 million cost-savings drive. Some professionals are finding it “almost impossible to function in a safe and legal manner” due to the pressures, campaigners warn.
However, Norfolk and Suffolk NHS Foundation Trust said the claims were inaccurate. The trust’s official Twitter account posted a link to a letter detailing the campaign’s concerns earlier today.
The campaign has been initiated by frontline staff who said they felt a duty to speak out. It has been backed by disability campaigners and several unions, including Unite. Care minister Norman Lamb, whose north Norfolk constituency is covered by Norfolk and Suffolk NHS Foundation Trust, has agreed to meet staff to discuss concerns over cuts later this month, according to the trust’s Unison branch.
In an open letter published online, the campaign makes a series of claims about how cuts are damaging care. These include allegations that:
- Approved mental health professionals, the group of staff qualified to carry out Mental Health Act assessments, are finding it “almost impossible to function in a safe and legal manner” due to problems finding beds for patients assessed as needing urgent care.
- At least one of the trust’s crisis resolution teams – the type of service NHS England claims is boosting home treatment and reducing the need for hospital care for patients across the country – is “no longer able to provide a safe alternative to hospital” due to it operating at 25% below capacity.
- The situation is putting staff and patients at risk, with the team now expected to carry out urgent assessments alone, rather than in pairs.
- The trust has also disbanded key preventative services and cuts have “decimated” community teams. There are almost 200 unallocated referrals in Norwich community mental health teams alone.
- Care co-ordinators are being told their caseloads will treble in size from an average of 25/30 cases to an average of 75/90 cases.
- Staff morale is “at an all-time low”, with many posts being made redundant or downgraded.
“As professionals, we are initiating the campaign because we are no longer prepared to remain silent any longer; we do not want to find ourselves in a Mid-Staffs situation – whereby standards of care sink to an unacceptable level – without our having spoken out,” the letter said. The campaigners are holding a public meeting on 25 November to discuss the issues further.
However, the trust said the claims were factually inaccurate. It said:
- Care co-ordinators’ caseloads remained, typically, at 25-35, and were not trebling in size. Some co-ordinators had higher caseloads than because they were reviewing people settled in residential care or those starting on dementia checks, who would require routine checks at regular intervals. It said the trust monitored caseloads and always took action if it saw increases in a particular team.
- The crisis resolution home treatment team was not operating below capacity. It said acute mental health services were under considerable pressure across the county, particularly from hospital A&E departments. The trust was deploying mental health liaison services at A&E to relive pressure on crisis teams so they can work with people in the community to prevent hospital admissions. Crisis resolution and home treatment teams are due to increase in size in the New Year.
- Of 2000 open cases, 98, not 200, were yet to be allocated to a named care co-ordinator as of 22 October, and were due to be allocated by 15 November;
- The trust said 61 of its 4,000 staff had been made redundant since October 2012, 41 on a compulsory basis. It admitted that other staff’s posts had been downgraded but their pay had been protected and the trust would try to find them a higher-banded post at the earliest opportunity. It said it worked hard to avoid redundancy through using natural turnover and by creating new posts from new business.
- In response to claims it had disbanded its assertive outreach and homelessness teams, the trust said it had created a new service to deliver these functions and that service users would not see a reduction in service.
- It said it was currently operating under a four-year savings cycle from 2012-16 and expected to be slightly behind schedule by 2014, meaning that reductions were not being accelerated.
The claims come weeks after Norman Lamb hit out at “unacceptable” shortfalls in mental health crisis care nationally after a Community Care investigation revealed widespread problems in the system. Lamb’s office has been contacted for comment on the campaign’s claims.
In recent weeks, local press have reported on a number of other concerns about mental health care in Norfolk and Suffolk.
The Norwich Evening News reported that the trust spent £13m in three years sending patients to out-of-area placements due to a shortage of NHS beds, an issue raised at national level by Community Care earlier this year. The Eastern Daily Press has also reported on problems with the mental health support being delivered by social services in Norfolk.
Andy McNicoll is Community Care’s community editor