‘We are facing a funding crisis’, says Norwich mental health nurse
Emma Corlett has worked as a mental health nurse in Norwich for 14 years, and is media spokesman for the Unison NSFT branch:
'Imagine that your relative has a severed limb and is bleeding but you are told that nearest accident and emergency bed is in Stevenage, Woking, London, Sussex, Manchester or Glasgow. Imagine there are no NHS ambulances available to take you to hospital, and you have to wait hours for a private ambulance. There would quite rightly be outrage, people would take to the streets and demand action. Yet this is the reality facing mental health staff trying to support people in mental health crisis on a weekly, if not daily, basis. Should our citizens with a mental health emergency not equally expect help when they need it? As recent press coverage has shown, mental health emergencies can be matters of life or death too.
I was asked this week whether our mental health services are in crisis. We are certainly facing a crisis of funding, and for that the blame lies firmly at the door of the Department of Health, Norman Lamb, our other MPs, and the clinical commissioning groups who decide how much money to allocate to mental health services.
The blunt instrument of a 20pc cut to all NHS trusts was always going to have a disproportionate impact on mental health services. Over 85pc of the running costs of our trust are staff costs. We are in the business of talking to people, and that can only be done by (highly trained) humans. This cut is on top of insufficient previous funding - west Norfolk and Suffolk commissioners have historically funded mental health services at below the national average. All this, at a time when demand for our services is rising and people need us most.
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Unemployment, increased living costs, the impact of welfare reform all takes its toll on the mental health of the people of Norfolk and Suffolk. Stigma associated with mental illness must play a part, because I can't believe that any other part of the NHS would be expected to respond to a predictable rise in need by ploughing on with cuts to the service. But the government say that cuts have to be made! Do they? The billions of pounds wasted on the top down reorganisation of the NHS to bring in the health and social care act could have sustained front line services for years.
Colleagues are telling me on a regular basis of their frustration and sadness at the lack of resources available to provide the standard of care that they want to, having to constantly juggle competing priorities. Rising caseloads, difficulty getting help in a crisis, maternity leave not being covered, watching colleagues being made redundant or move jobs, wondering how on earth you are going to cover their work..... Morale is at rock bottom in many areas.
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Do you risk losing someone's trust and cancel their appointment to prioritise seeing someone heading towards a crisis, when you already cancelled their previous one for the same reason? Do you telephone someone because you are short of time, even though you know you can really only assess how they are by seeing them face to face? At night, as the only assessor on duty, you drive out to a rural area and spend two hours with someone in acute distress. You have a 45 minute drive back to base, during which time 2 more urgent referrals (to be seen within 4 hours) have come in. You have to write up the visit you have just done, perhaps speak with a family member on the telephone or arrange a mental health act assessment. The phone continues to ring with more referrals. Who do you prioritise? Every choice is an impossible one.
Urgent referrals are coming in at such a rate that to keep up with demand each assessor would have to see 26 people per day - in a seven and a half hour shift! People are already not taking breaks and working late. The pressure of high demand takes its toll on the mental health of staff. We're human too! However you reorganise services, expecting 19pc fewer staff to see the same number of service users just isn't realistic without something suffering. To promise otherwise is disingenuous, and we need to be honest.
Staff have arranged the public meeting on November 25 because many of the people who rely on our service are unable to speak out. We feel that to remain silent about the reality on the front line would bring us in conflict with our professional codes of conduct. To work in an honest way, in the best interest of people in our care, requires us to stand up and say enough is enough.'