After seven years at Pulse, it is rare to be shocked by the results of one of our surveys. But this one is different.
The survey of nearly 500 GPs found one in five had seen patients come to harm due to delays or a lack of response from community mental health teams.
This is an appalling statistic that belies a thousand sad stories where individuals have fallen through the cracks of a system designed to care for the most vulnerable.
GPs describe patients committing suicide, being sectioned or ending up in hospital due to delays or failures in care.
They say that as triage becomes much more aggressive and delays for routine and urgent cases lengthen, they are being left to cope with managing vulnerable patients far outside their competence.
Mental health services have always been a ‘Cinderella’ service, but GPs say that the service has now deteriorated after year-upon-year cuts in budgets. Community mental health teams are doing their best, despite being – as one LMC leader put it the other day – ‘completely decimated’.
This all comes at a time when the NHS is meant to be ensuring physical and mental health have ‘parity’. But even while ministers have been trumpeting this change in policy, NHS England and Monitor have been advising CCGs to cut non-acute provider contracts – including community mental health services – by 1.8% this year, compared with 1.5% for acute sector contracts.
And this underlines the problem. It would be completely unacceptable to wait two or more days to have someone with a COPD exacerbation or a TIA assessed, so why is this allowed for patients after a mental health crisis?
The NHS needs to do much better. The health service is meant to be there for patients at their most vulnerable and there is clear evidence from this survey that it is failing patients with mental health issues.
With all the talk of intervening earlier and preventing costly hospital admissions in physical health, there has been little talk of doing this with mental health. This has to make sense when the NHS is looking to ensure more care takes place in the community. But CCGs may want to make a change, but they are undermined by cuts in social care and lack of funding.
As the RCGP says, the funding of mental health needs an urgent review and this needs to look closely at what support GPs are being given and put a plan put in place to plug the many gaps that our survey highlights. Practices are doing a heroic job, but they need much better support.
Nigel Praities is editor of Pulse
