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PCOs failing GPs on depression

GPs are having referrals boun- ced back by primary care organisations because depression services are unable to cope, Pulse's special investigation reveals.

The overwhelming majority of GPs feel their PCOs are failing to support them in their management of depression.

In the survey of 1,300 GPs, 73 per cent said their PCOs had refused to take referrals because they deemed them inappropriate; and 83 per cent complained their PCO did not offer support and training on depression.

The vast majority of PCOs are failing to provide depression services within primary care to ease the burden on GPs. Just 6 per cent of GPs said their PCO funded GPSIs in mental health and only 15 per cent said they had an enhanced service.

The parallel investigation of 170 PCOs uncovered an equally bleak picture. As many as 89 per cent admitted some referrals were sent back as inappropriate.

According to PCOs, 28 per cent had GPSIs and 33 per cent had enhanced services ­ a higher proportion than reported by GPs but still only the minority.

The PCO investigation also revealed acute problems in training. On average PCOs had 11 counsellors and mental health nurses fully trained in cognitive behavioural therapy ­ just 58 per cent of the total.

But the revised QOF could herald some improvements, with four out of five PCOs saying they already had plans to implement the changes. PCOs also had an average of five graduate or primary care mental health workers.

Dr Mike Henchy, a GP in Peterborough, said: 'I feel frustrated for the patients. We make a referral to the community mental health team and if they have some arbitrary criteria they will refer them back to us.'

Dr Martin Wolfson, a GP in Surbiton, Surrey, said there was a 'huge gap' in provision for patients who needed more support than counselling but did not have severe mental illness.

'I think PCTs have to take on this responsibility but at the moment they have other priorities,' he said.

Dr David Lloyd, a GP in Harrow, Middlesex, said: 'The NHS Plan says we should have graduate mental health workers, and we have one in the whole of Harrow. The issue of funding has been brushed under the carpet. Trusts are keeping silent about what their role is.'

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