Mental Health Service Provision in Suffolk – A Very Different Conversation

I am sure you like me are frustrated about the continuing issues around mental health service provision in Suffolk. These are well summarised by Healthwatch Suffolk’s report (November 2018) – A Very Different Conversation (More information can be found here)

We are aware that the current provider is being placed in special measures for the third time. We in primary care and community services are aware of the difficulty that our patients have in access to appropriate care.

I welcomed the statement in the initial Five Year Forward View to remove the division between physical and mental health. Mental health services for a long time being overlooked and primary care has predominantly carried that burden. Equality for mental health means that providers must step up and provide the same level of service that we expect from medical and surgical colleagues in terms of waiting times and particularly urgent requests. Crisis referrals can be difficult and something of a battle with mental health colleagues that we certainly do not see with other specialties. The inability to speak to a consultant clinical colleague at any time is not acceptable.

The complexity of services with the current provider with patients being handed between multiple services adds delay, confusion and patients are lost in the system.

Mental health is no different from other health conditions. It needs early diagnosis, rapid assessment and, appropriate advice and treatment. This makes a significant different to recovery rate and long-term morbidity. A broken mind should be managed in no different way to a broken leg.

How can we improve things?

General practice manages the bulk of mental health problems; therefore the service should be embedded in primary care. Our patients have confidence in seeing practitioners in the surgery and that close link  increases attendance rates .

Timely response to treatment

Earlier treatment reduces crises and this would allow more specialist services to deal with the patients that only they are able to deal with. This should take the pressure off some of those services and increased resource will need to flow into primary care to early intervention services.

Use of GP clinical record

A recurrent theme of patients is having to tell their story over and over . The efficiency of the service having direct access into a patient record, the GP clinical record and writing directly into it will be a significant benefit in terms of time, avoiding duplication, and avoiding patients having to repeat their story. The services need to be based in general practice so that the service can offer the same flexibility and reaction to pressure, as we do with other conditions in general practice.

In Felixstowe and Ipswich, five practices have joined together to employ three mental health nurses. Although their main remit is to provide services that would be provided by primary care, they have had a significant impact on limiting onward referrals. Feedback from patients has been extremely positive and I feel this should be the model for primary care mental health services moving forward.