PSYCHOTHERAPY SERVICES AT SOUTH LONDON & MAUDSLEY NHS FOUNDATION TRUST
This letter is sent jointly from the United Kingdom Council for Psychotherapy (UKCP) and the British Psychoanalytic Council (BPC). Please enter it into the consultation you are carrying out.
These organisations are the two leading national voluntary regulators in the field of psychotherapy and both organisations have members working in South London & Maudsley NHS Foundation Trust Psychotherapy Services. We are gravely concerned about the Trust’s proposals to restructure its psychotherapy services, and associated staff redundancies, which will lead to the effective closure of both the Maudsley Psychotherapy Service and the St Thomas Psychotherapy Service. The proposed changes would an irreparable loss to local mental health services, and would have serious consequences for the welfare of patients, both present and future.
We have four major concerns:
Firstly, the proposed “re-provision” and restructure of psychological therapies is a complete misnomer. The Trust’s recent internal consultation proposes to cut 81% adult psychotherapy posts and 57% of medical psychotherapy posts in Lambeth alone, placing 36 psychotherapist posts formally at risk. In particular, we note St Thomas psychotherapy service provides treatment to 300 patients every week through a well-established and clinically effective model of service delivery that is highly rated by service users. The service hosts over 70 honorary (i.e. unsalaried) psychotherapists, providing specialist psychotherapy training, clinical placements and professional development for experienced mental health professionals, up to and including consultant grade. Yet the proposed restructure will leave just 1.5 (whole time equivalent) posts in the service, undermining this well-established model of service provision which, it is suggested, will reduce psychotherapy treatment provision by around 80%.
Secondly, the Trust’s consultation process does not appear to have followed transparent and standard procedures of consultation and decision making. It is perplexing that the Trust’ consultation process has apparently been restricted to a small internal consultation carried out in an extraordinarily rushed period of just five weeks over the Christmas period – while many potential respondents were of course on leave. We are gravely concerned that service users whose present and future wellbeing this ‘restructure’ will mostly affect appear to have been excluded from the consultation process. (Indeed, we understand psychotherapists were explicitly asked not to inform their patients of the proposed restructure and this consultation). This lack of transparent consultation and decision-making falls significantly short of standards of public service.
Thirdly, such severe cuts to psychotherapy provision will have repercussions both to other clinical services within the Trust, and to the wider mental health field. As part of the unique Clinical Academic Group for mood, anxiety and personality, SLaM psychotherapy services has a wider involvement within King’s Health Partners Academic Health Science Centre, making a distinctive contribution to the AHSC’s purpose of delivering high quality health care, world-leading research, as well as teaching and education. The Trust’s psychotherapy services have a prestigious and international reputation for excellence in the field, and St Thomas’ is notably the international centre of Cognitive Analytic Therapy, an evidence-based therapy pioneered by Dr Anthony Ryle in the 1980s. Indeed, the psychotherapy services provide what we understand to be a highly-regarded contribution to the AHSC’s wider organisational purpose, especially in supporting therapeutic environments in challenging settings – through clinical supervision, reflective practice groups and team consultation. We are concerned that the proposed ‘restructure’ takes no account of such present and future contributions.
Fourthly, while the consultation proposes reductions across the whole Clinical Academic Group, we have serious concerns that the burden of cuts is intended to be borne by psychotherapy services. We note that just 6 clinical psychology posts have been placed at risk, yet cognitive-behavioural therapy (CBT) provision is dominant mode of psychological therapy (indeed, there appears to be a 6:1 ratio of clinical psychologists to psychotherapists across the Trust). Whilst CBT is clearly an important mode of therapy, we seriously question whether tipping the balance even further in this direction is actually based on patient choice and clinical need. The plans we have studied will undoubtedly lead to a lack of choice for patients, the maintenance of which is a key feature of one of Andrew Lansley’s ‘four steps’ consultation guidance. The provision of a choice of a range of psychological therapies is absolutely essential, and we can direct you to research demonstrating this to be the case.
To proceed with such ill-considered plans to effectively close these highly regarded psychotherapy services without proper and full consultation cannot conceivably be justified. We urge you to remedy this as a matter of urgency. NHS bodies have two separate legal duties to consult about the way that the NHS is operating and about proposed changes. The duties focus on consulting patients and the public, and consulting the local authority Overview and Scrutiny Committee.
Section 242(1B) of the National Health Service Act 2006 provides as follows:
“Each relevant English body must make arrangements, as respects health services for which it is responsible, which secure that users of those services, whether directly or through representatives, are involved (whether by being consulted or provided with information, or in other ways) in:
(a) the planning of the provision of those services,
(b) the development and consideration of proposals for changes in the way those services are provided, and
(c) decisions to be made by that body affecting the operation of those services.
Subsections (b) and (c) need only be observed if the proposals would have an impact on:
(a) the manner in which the services are delivered to users of those services; or
(b) the range of health services available to those users.”
Regulation 4 of the Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002 provides that where a local NHS body has under consideration any proposal for a “substantial development of the health service” in the area of a local authority, or for a “substantial variation in the provision” of such service, it shall consult the overview and scrutiny committee of that authority.
These requirements apply before closing, or substantially restructuring or varying a service.
We therefore urge you to call a public meeting or series of meetings as soon as possible, to address both these serious failures of attention to patient welfare, and due process. In addition, we fully endorse the Rt Hon Tessa Jowell’s advice to you in her letter dated 10th January, asking you to carry out a full Equalities Impact Assessment and Health and Wellbeing Impact Assessment.
The recent PEDIC report on the St Thomas’ service shows a very high level of patient satisfaction. Outcomes Study funded by Guys & St Thomas’ Charity (summarised in the St Thomas Psychotherapy Service 2011 Annual Report and available on the SLAM Trust website) reports a high level of recovery over all treatment modes, with improvement continuing long after therapy has ended.
Multiple focus groups taking place over the next few weeks!
Next one on Thursday this week! – Tomorrow!
South London and Maudsley (SLaM) Mental Health Trust’s vision is that people who use our services will be treated respectfully.
To be treated with privacy and dignity can mean many things to different people. Examples of these include, attitudes and behaviours of staff, communication, the environment, privacy to protect peoples modesty, confidentiality, to have your nutritional needs met and to be free from abuse.
People that use our mental health services are diverse. We need to make sure that we work in a way that represents the needs of service users, families and carers. Therefore, we would like a broad range of people to help us make things better together!
Focus groups will be facilitated by people who have experience of SLaM services themselves and will ask questions like:
What are your suggestions for improving the privacy and dignity of people that use our services?
- View this graphic flyer for more details about the dates and times of focus groups CLICK HERE: Privacy & Dignity Focus GroupsAlternatively see all dates below by borough: (This information is more clearly available in the flyer above)In Croydon
When?: Wednesday 21st March
What time?: 11.00 – 12.30
Where?: Bldg 21 O.T. Department,
Bethlem Royal Hospital
Monks Orchard Road
When?: Thursday 15th March
What time?: 2.00 – 3.30
Where?: Croydon Voluntary Action
82 London Road
When?: Wednesday 28th March
What time?: 2.00 – 3.30
Where?: SHARP Team
308 – 312 Brixton Road
When?: Thursday 8th March
What time?: 11.00 – 12.30
Where?: 4th Floor Meeting Room
Lewisham High St.
When?: Wednesday 14th March
What time?: 2.00 – 3.30
Where?: Room 1, Civic Suite
1 Catford Road
When?: Tuesday 20th March
What time?: 2.00 – 3.30
Community Links Centre
Douglas Bennett House
When?: Thursday 29th March
What time?: 11.00 – 12.30
Where?: St. Giles House
1 St. Giles Road
Please come along to one of the focus groups to give your views. Your views will be noted anonymously along with other peoples, and the themes will be passed on to staff members who are developing the privacy & dignity policy. You don’t have to have any experience of coming to groups like this – the groups are informal and everyone is welcome.
If you are unable to come to any of the groups, but would like to give your views, please contact: Alice Glover:
Tel: 020 3228 0959 Email: firstname.lastname@example.org
This hear us open meeting is jam packed and surely a must for your diary!
View the flyer for this event CLICK HERE:Hear Us Open Meeting 6th March 2012
When?: Tuesday 6th March 2012, from 1pm (starting off with tea and cake!)
Where?: CVA, West Croydon (82 London Road, CR0 2TB) – opposite Lidl
Map: CLICK FOR MAP
Who is invited?: The Hear Us Open Meeting is for anyone with an interest in mental health and wellbeing – service users, carers and staff.
This meeting has two important topics:
1) – Digital TV Switch Over
Did you know that the digital TV switch over is taking place in London in April this year.
– Come along and find out if you are eligible for free help from the digital switch over team.
– Get advise about, TV Services – Re Tuning – Aerials and Recording – Equipment
2) – Guest speakers from SLaM want to know how recent changes are affecting you.
– New team?
– New Care Coordinator?
– New Psychiatrist?
– Different Resources Centre?
You will have a chance to make your voice heard regarding all of the above!
Equality of access; treatment; outcomes for all
You are cordially invited to our Partnership Time Event to help us develop our equality objectives that will inform our work programme, on Monday 5th March at the Robens Suite, 29th floor Tower Wing, Guys Hospital, London Bridge
9.30 for 10.00am start and lunch from 1.15 – 14.00pm
Please book your place and confirm any special dietary needs (lunch is included), with Fatu Kargbo: telephone 0203 228 2146 or email email@example.com
Flyer to print and display here: March 2012 PTE flyer V3 1
King’s Health Partners Academic Health Sciences Centre (AHSC) was set up in 2009 as a joint organisation comprising three NHS trusts – Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley – and King’s College London.
Now all four partner organisations have unanimously endorsed a recommendation from the King’s Health Partners Board to prepare a strategic outline case to assess the benefits, costs and risks of establishing a single organisation.
“What we are considering isn’t just another NHS merger – not only are we approaching this from a position of strength financially, but we will be creating a totally new type of organisation that brings closely together mental and physical healthcare with research, education and training at its highest level,” says Professor Robert Lechler, executive director of King’s Health Partners.
“Working as one, alongside our university partner King’s College London, will mean we have the potential to fully transform the delivery of healthcare to our local patients and beyond, creating a system rated amongst the best in the world.
“This is a hugely significant moment for our AHSC. However, it is only the first step along the road to integration. As we develop the strategic outline case we will be engaging with staff and patients as well as healthcare providers and commissioners in south London to ensure that our new organisation is able to deliver the very best patient care possible and speed up the time it takes for research discoveries to become routine clinical practice.”
After 30+ Years in SLaM, Su Glazier is Retiring
Please join us in saying goodbye and wishing her a happy retirement
Monday 19th March
3.30pm – Maudsley Canteen for afternoon tea and a formal presentation
5.00pm – informal drinks at the Phoenix Pub (next to Denmark Hill Train Station – we’ve reserved a room upstairs)
As part of Su’s leaving present, we want to create a book of messages for Su and your memories of working with her. If you would like to send something for the book please email Linda or Susan.
We will also be holding a collection for her – the following people will be collecting any contributions:
Ray Johannsen- Chapman
Please forward this email on to any staff, service users or carers who Su has worked with over the years.