New Ways of Working for Psychiatrists: the achievements and the challenges
| Published date | 20 July 2009 |
| DOI | https://doi.org/10.1108/17556228200900014 |
| Pages | 18-22 |
| Date | 20 July 2009 |
| Author | Sally Pidd |
| Subject Matter | Health & social care |
18 The Journal of Mental Health Training, Education and Practice Volume 4 Issue 2 June 2009 © Pavilion Journals (Brighton) Ltd
New Ways of Working for
Psychiatrists: the achievements
and the challenges
Abstract
The New Ways of Working national programme
was started by psychiatrists (through the Royal
College of Psychiatrists) when it became apparent
that the roles they were being asked to carry
out were unrealistic in their demands. This had
contributed to a drop in recruitment and early
retirement for psychiatrists in post. The New Ways
of Working programme led to a reconfiguration
of mental health services in many areas and an
increase in the numbers of psychiatrists as well as
improved levels of job satisfaction.
This paper describes some of the challenges
that still need to be met if New Ways of Working is
to be fully implemented.
Key words
psychiatrists; multidisciplinary; workforce planning;
responsibility; accountability
Introduction
New Ways of Working (NWW) reall y started with
psychiatrists, a fact that with the passage of time some
seem to have forgotten. Louis Appleby, National Director of
Mental Health (England) summed up our difficulties in New
Roles for Psychiatrists (British Medical Association, 2004),
which summarised the findings of two conferences held
on the topic in 2003, attended by over 300 psychiatrists in
the profession.
‘We cannot go on with the model of the consultant
psychiatrists we have had in recent years. General
psychiatrists, in particular, see the demands on them
increasing, their responsibility spread too thinly across
too many parts of their local service. As I see it, the
solution lies in redefining the role of psychiatrists to
reflect their specialist skills. It should mean we no
longer do a bit of everything but become specialists in
our part of the service.’
Most psychiatrists would have agreed with him then.
The profession was facing major recruitment difficulties,
with consultant vacancies running at around 20% or
more in parts of the country, which led to a huge
expenditure on locums, and low morale generally among
hard-pressed substantive consultants (National Institute
for Mental Health in England & Sainsbury Centre for
Mental Health, 2005). New teams brought into being
with the implementation of the National Service Framework
for Mental Health (Department of Health, 1999) and
the NHS Plan (Department of Health, 2000) required
consultant input, and these new roles pulled even more
of us away from community mental health team (CMHT)
and inpatient work, the core services underpinning the
delivery of mental health care. What was to be done?
The remainder of this paper will give my personal
perspectives on the answers to that question. I will
also highlight towards the end the not inconsiderable
challenges that lie ahead for our profession as we hold
our place as part of a capable, multiprofessional mental
health workforce.
Reflections on six years of NWW
I have been involved as workforce lead for the Royal
College of Psychiatrists (referred to subsequently as the
College) since 1999. Mike Shooter, President of the College,
understood very clearly that the problems we had were
not going to be solved by us alone, and as a result of his
approaches to the National Institute for Mental Health in
England National Workforce Programme (NIMHE NWP),
the National Steering Group (NSG) on NWW was set up,
which he and his successor co-chaired. His commitment
and enthusiasm helped drive forward the work from
the outset, and when I joined the group to represent
the College, what impressed me was the willingness of
other professions to put time and energy into helping
us with our difficulties. I am not sure if we have always
Sally Pidd
Consultant Psychiatrist and Workforce Lead, Royal College of Psychiatrists
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