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One in five GPs report patient harm as mental health services struggle to cope

Exclusive A fifth of GPs have seen patients come to harm as they were unable to access appropriate support from their community mental health teams, with some patients committing suicide, being sectioned or admitted as a result.

The survey of 500 GPs reveals a worrying crisis in community mental health, with more than eight out of ten GPs saying they were not confident their local community mental health service could cope with its caseload.

Some 18% of GPs said they had experienced patients who were harmed because of delays or a lack of support from their community mental health or crisis teams.

The vast majority of GPs said that they were having to manage patients with mental health issues outside their competence at least some of the time.

GP leaders said the ‘shocking’ findings of the survey illustrated an ‘urgent review’ of the funding of mental health services was needed to prevent patients falling through the cracks.

The findings come despite the Government promising that mental health will have parity of esteem for physical health.

The main findings included:

  • More than eight out of ten GPs saying their local community mental health service could not cope with its caseload;
  • Around 43% reporting services in their area had become worse or much worse in the past 12 months;
  • More than a third (34%) report patients having to wait two or more days for teams to respond to urgent requests for assessments. And 85% say they have to wait a month or more for a routine request;
  • 82% of respondents saying they have to manage patients with mental health issues outside their competence at least some of the time;
  • And 84% of respondents saying they were forced to prescribe at least sometimes because the local Improving Accessing to Psychological Therapies (IAPT) service is not able to help a patient, with 50% saying they were forced to do this ‘often’ or ‘all the time’.

Dr Elliott Singer, Londonwide LMCs medical director and a GP principal in Chingford, east London, said that he is having to refer patients to A&E for assessment and that his local trust was discharging patients without enough community support in place.

He says: ‘It is a very high-risk strategy the trust is adopting. My concern is it’s a waiting game until a tragedy happens, if patients are not being monitored properly.’

Professor André Tylee, head of primary care mental health at the Institute of Psychiatry, Kings College London, said the findings were ‘shocking and worrying’ figures.

He added: ‘There needs to be an urgent improvement in the whole system whereby more resources go into both frontline mental health services that liaise with primary care and into primary care to support mental health training and related service development.’

Dr Maureen Baker, chair of the RCGP, said the survey showed an ‘urgent’ reassessment of funding allocations was needed to ‘rebalance’ the system.

Dr Baker said: ‘There is an urgent need to reassess the way funding is allocated so that services in the community have adequate resources to deliver more proactive, planned care to patients with mental illness.

‘We are working with our colleagues at the Royal College of Psychiatrists to call for a rebalancing of NHS resources so that people with mental health problems get the care that they need and deserve.’

But NHS England said they were making progress. Dr Martin McShane, NHS England’s director for people with long-term conditions, said: ‘We must make sure patients get the right care as close to home as possible. While these decisions are made locally, we are supporting CCGs to deliver high-quality care and parity of esteem for mental health services – both of which are a priority for NHS England.’

The latest findings come as part of a series of Pulse investigations into mental health services. A recent Pulse investigation found GPs were unable to get adequate support for young people with mental health problems owing to ongoing cuts in child and adolescent mental health services, and another found mental health experts were questioning the results of local psychological therapies services.

 

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Readers' comments (6)

  • There was much media coverage recently regarding a practice in the Lake District (approx. 1200 patients) that was closing - surely in some circumstances there is the need for existing partners to think about their business viability and seek alternative arrangements to maintain the clinical presence rather than have a 'No Cuts' banner

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  • Only 1 in 5?

    Perhaps the other 4 in 5 stopped referring because they knew there was no point.

    Despite our Psychiatry colleagues working hard they have lost control of the system. Nurses gatekeep admission in many areas (and I have personally seen cases where the Consultant Psychiatrist has wanted to admit but the CAT/Crisis team has refused and managed in the community inappropriately).

    Combine this with the fact that sometimes CMHT initial assessments don't even have doctor input at the beginning (conducted by a social worker or mental health nurse) and you have to ask - are these vulnerable patients getting the service they deserve?

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  • Vinci Ho

    To have more psychiatry colleagues working in the actual community , to at least keep those mental health care beds, to manage young patients( including conditions like Asperger's and grown up ADHD) ; there must not be any more 'efficiency saving'.
    And so called integrated care is also a fallacy if no funding is going along with it.
    No more excuse and defending for bureaucrats and politicians.......

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  • This is not news but the reality of anyone working in front line General practice. And it is not just mental health patient, the list of specialities is very very long. 3 months for dermatology, 6 months for neurology, ......

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  • no no no...wasting money on idiotic schemery is obviously more important ....and inflated salaries and unproven populist schemes..than saving lives..according to the evil disgusting nhse and doh.
    nye bevan is oscillating on his grave like an F5 tornado..please emerge and smash the sick evil self serving crew now reighning without democratic consent or accountability at the top of the nhs and the malignant growth of deluded managers following parkinson's law of pointless parasitic irrelevance.

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  • This comment has been moderated.

  • As expected.






    Unemployment due to recession would increase the demand for the psychiatric services.

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