A recent review of mental health services in the Barnet, Enfield and Haringey NHS trust suggests that significant community funding cuts may be on the horizon.
Local NHS commissioners ordered the review, which was carried out by consultancy group Mental Health Strategies - who found that NHS mental health services across the region were 'unsustainable' at current levels. The solution comes down to further investment by the commissioners (you can guess how well that's going to fly) or to cost-cutting measures. Needless to say, my money's on the cost-cutting measures.
A £5.8 million overspend on acute admissions during 2013-14, in response to 'increased acute activity' has clearly spooked the Trust, which sees no change in the trend towards greater numbers of patients for 2014-15. A spokesperson from the trust said:
"The mental health trust is currently under pressure from increased numbers of patients, without the corresponding increases in its funding. It has already made major cost reductions over the last five years, but is unable to keep doing this while still providing safe, high quality care for patients."So, the number of patients is increasing, and cuts are already in operation - they have been in operation for the last five years. Still, the report says, the situation is unsustainable. It proposes caseloads must be cut by at least 10% and staffing must be reduced to plug a £15 million funding deficit for services.
What does this mean, exactly? Well, you don't have to be a rocket scientist to figure out that with more patients needing mental health treatment and fewer services to meet that need, there will be more mental health patients finding their own way in the community. That's the bottom line here. The sums simply don't add up and guess who's going to pay the price?
The trust spokesperson continued:
"The trust still bears most of the financial risk around increases in the numbers of patients the trust is caring for, which is causing the trust major financial problems this year, as it did last year. This is not sustainable…"Mark those words 'financial risk' - they are part of the lexicon of the new NHS. To threaten such risk looks set to become the justification for radical withdrawal of services, no matter how many mental health patients end up wandering the streets.
The rising burden of mental health patients is serious cause for concern. And it's not just a problem for them, it's a problem for all of us. Society cannot continue turning a blind eye to the underlying causes of mental dysfunction - or rather, it can, and sooner or later, the consequences will make themselves felt in ways we can scarcely imagine. Throwing money at the problem was never going to be a sustainable solution in any case, as the number of people just keeps getting bigger. Maybe the withdrawal of services will give us the wake-up call we need.
What are your thoughts? What are the causes and what's the solution? As ever, your comments welcomed.
Written by Jacqui Hogan
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