We can no longer tolerate the negative impact that this lack of adequate staffing is having on the physical and mental well-being of those who use community mental health services in the locality.To our Service Users and families, we want your involvement with our service to be of the highest standard possible. We are striking to draw attention to our staff shortages. We hope you are not inconvenienced on or around our strike days. Although we will have a reduced service on strike days, we will make sure that some of our team are available to respond to urgent needs or crisis.
To any service users who attend Chorlton house for appointments or therapy sessions on strike days, please know that our friendly picket is aimed at securing more resources for mental health services locally. We encourage you to attend your appointments as usual and apologise in advance if there is a little extra background noise during your meetings (e.g. occasional car horn beeps in support of our efforts).
We are a small service and so our impact will be limited without the support of the public.Please assist us to publicise & encourage this new government to address the current crisis and invest in Manchester Early Intervention and secondary care community mental health services.
For updates, please check out our dedicated Twitter account:
@MancStrikeNHS
#ManchesterStrikeMH
or contact us on:
In Summary:
In 2020, NHS England identified that £1.03 million of ‘ringfenced’ funding for Manchester Early Intervention in Psychosis Services (EIS) was given to Greater Manchester (GM) Commissioners, but we did not receive the significant investment we need either then or since.
As well as alleviating distress, reducing hospital admissions and high suicide rates in these risky first years of psychosis, EIS saves £7,972 per person in the first four years, and £6,780 per person in the next four to 10 years of a person’s involvement with services (e.g. Rethink.org, 2024). A recent EIS audit conducted over two years, identified that for every additional Care Coordinator employed, 197 hospital bed days are saved. Every pound spent on Early Intervention in Psychosis Services saves society £18. Despite this, we have not received any significant investment in many years.
Multiple CQC inspections and independent reports have identified that Manchester community mental health services for people with more severe and enduring mental health difficulties (CMHTs) are failing desperately.
With 60% higher need than average for mental health services in Manchester and only £145 ‘per person’ in funding (compared to the £210 ‘per person’ nationally), GM commissioners and senior Greater Manchester Mental Health NHS Trust (GMMH) management have an extremely difficult job to do.
Unfortunately for us, GM commissioners and politicians prioritised mild to moderate mental health and ‘getting people back to work’ since 2019. This decision disadvantaged and discriminated against patients with more serve and enduring mental health needs.
As our CMHTs are failing for service users, families and staff, patient distress, health difficulties and mortality rates have increased significantly. GMMH, Pennine Care and the GM Integrated Care Partnership have received by far the most Regulation 28 Coroner ‘prevention of future death reports’ in the UK.
The region is trapped in a pattern of paying millions for expensive ‘out of area’ hospital beds and temporary agency staff, instead of proactively investing the preventative funding needed within the community services themselves (for example within EIS, where for ever extra Care Coordinator employed, we contribute towards a reduction in use of 197 less hospital bed days per year).
Now a much needed ‘community transformation’ has started to take place within CMHTs across the country. Manchester CMHTs amount to over 1% of the country’s CMHT population. We received 0% of the £2.3 billion a year funding and 0% of the £975 million per year ‘Service Development Funding’ supposed to help CMHTs adequately prepare for and staff this big transformation.
GMMH Trust and GM commissioners have been told we are getting no more money for the region. Worse, we are told that Manchester is £180 million ‘in debt’ thanks to the lack of central government resources allocated to the region. So, we desperately need investment within the region and what NHS England and Central Government are ‘offering’ is more austerity and cuts to local services.
Despite the absence of investment and with our CMHTs in crisis, this big unfunded reorganisation is starting right now. We are ignoring the lessons from the 12-community transformation ‘early adopter’ sites and instigating big changes with little staffing. Without a large investment of new money for the region, we are guaranteeing many more years of failing CMHT services locally.
We need the government to take responsibility for the mess we are in. Please help us and our most disadvantaged and vulnerable citizens of Manchester. Demand significant regional investment and improved services for people with more severe mental health problems now. Support us to get our message to those in government who can rectify this situation.
Dr John Mulligan says there has been a “serious decline” in support for people needing mental health care which is “unacceptable”
Source: BBC News, 10th October 2024
Dr John Mulligan, who works for one of Manchester’s Early Intervention in Psychosis teams, said union members were set to strike next week over concerns for patient safety due to understaffing.
It comes as a freedom of information (FOI) request by the BBC revealed the North West’s NHS hospital trusts spent £45m more on private mental health care beds in the last three years.
Dr Nish Mathew, of the Royal College of Psychiatrists (RCPsych), said with cuts to NHS beds for mental health care, sourcing private beds was the “next best option”.
The government said it would “fix the broken system” by recruiting 8,500 more mental health workers and reforming the Mental Health Act.
Dr Mulligan said: “There’s this big community transformation that’s happening at the moment and that community transformation I’m putting in inverted commas because we don’t have any funding for it in Manchester.”
He said for the first time union members in the Manchester Early Intervention in Psychosis teams were set to strike over understaffing on 16 October.
“We are absolutely on our knees in terms of the services at the moment and the death rates have increased significantly.
“We’ve noticed a serious decline in the quality of service that our patients and their families are getting,” he said, adding it was “unacceptable”.
On the cost of private mental health care beds, he said: “They are paying out all of this money and there’s no money left.”
‘Forgotten ones’
He claimed patients were dying due to lack of staff and said: “We’re having service users in Manchester dying and we have to think to ourselves, ‘what are we doing for our most vulnerable members of our local community?’.”
Dr Mulligan said people in an acute crisis requiring hospital admission faced a “massive queue”.
“There’s a serious lack of staff on the frontline, ready to be able to support people,” he said.
The ratio of therapists to patients in the Manchester area community mental health teams is one therapist to just under 600 patients, he said.
Dr Mulligan said it had taken its toll on staff, adding: “We have a lot of people who unfortunately have died over the last few years so we do take it personal and it is pretty painful.”
He said: “Sadly it feels like our service users in community mental health teams and early intervention [are] the forgotten ones.”
He said “ultimately it’s got to be central government” that fixes the crisis and it would need “a huge investment to break the vicious cycle”.
Dr Nish Mathew said with a surge in demand and NHS cuts, private beds were the “next best option”
Dr Mathew, chairman of the North West division of the RCPsych, said the number of mental health care beds in the UK was about 50,00 in 2001 but it was less than 25,000 now.
He said the idea was to treat patients in the community instead.
However, he said it had not been properly funded and care in the community was “not at the place where we want it to be”, resulting in the NHS paying up to £1,000 a night for private mental health care beds.
“Across the region, the numbers show there is still a need for those beds because you have to keep someone safe,” Dr Mathew said.
“If keeping them in their communities is not an option then you have to source the next best option. We have to source a private bed.”
Data from the FOI shows Cheshire and Wirral Partnership NHS Foundation Trust had the biggest spike in spending on private mental health care beds.
It spent £12.5m more on private mental health care beds in 2023-24 – a rise of almost 54,000% – compared with 2020-21 when it paid just over £20,000.
However, Mersey Care NHS Foundation Trust is bucking the trend by slashing its spend on private mental health care beds in 2023-24 to £20,330 while it laid out £2.5m in 2020-21.
A spokesperson for NHS Cheshire and Merseyside said “in line with the rest of the country”, it had seen an increase in demand on mental health services “which has called for additional capacity” and private beds were used “where it is clinically appropriate”.
They said the trust was working with partners “to utilise all capacity available – including the use of the independent sector – to improve the flow of patients across Cheshire and Merseyside”.
Greater Manchester Mental Health Care NHS Foundation Trust spending has jumped from £5.6m in 2020-21 to £14.5m in 2023-24.
In August, the BBC reported Greater Manchester had seen the largest increase in sending mental health patients out of area.
The trust has been contacted by the BBC for comment.
‘Safe care’
Lancashire & South Cumbria NHS Foundation Trust spent £50.4m on private beds – almost double the £27.7m in paid out in 2020-21, while Pennine Care NHS Foundation Trust spent £6.4m in 2023-24 on private mental health beds as opposed to £2.6m in 2020-21.
Lancashire and South Cumbria NHS Foundation Trust’s chief operating officer, Emma McGuigan, said: “Where we do not have a bed to offer, we find alternatives to ensure individuals can receive proper and safe care.
“Bed occupancy remains consistently high in our area and we are working with our partners to look at new provision so we can offer more places for our patients within the areas we cover.”
A Department of Health and Social Care spokeswoman said: “People with mental health issues are not getting the support or care they deserve, which is why we will fix the broken system to ensure we give mental health the same attention and focus as physical health.
“We will start by recruiting 8,500 more mental health workers to cut waits for treatment, and will also reform the Mental Health Act, to ensure people with the most severe mental health conditions get better, more personalised care.”
