Socialist Alternative

Criminal Cuts to Mental Health Services

I personally would be worried if myself or one of my friends or family became a patient there.

Those were the words of a worker employed by the Sheffield Health and Social Care NHS Foundation Trust reported to the Sheffield Star at the beginning of May after the Care Quality Commission (CQC) recommended the Trust be put in special measures.

The Trust is responsible for many of Sheffield’s mental health services, including both in-patient wards and community services. A CQC inspection in January and February this year of 5 of the Trust’s 10 activities found 3 inadequate (the lowest possible ranking) and 2 in need of improvement. Overall, the Trust’s performance was found to be inadequate – a substantial deterioration from the assessment only 2 years ago. The inspection found 47 breaches of legal requirements across 8 regulations.

Significantly, the only area where the Trust was rated ‘good’ was in Caring. This is solely due to the performance of the Trust’s staff despite having to work with inadequate resources under poor management. All the areas under direct control of management including safety were classed as inadequate or needing improvement.

Management response
In Involve, their magazine for members, the Trust states that ‘We are very disappointed with the rating…’ as if it came as a shock out of their control! They would clearly have been not as disappointed as those patients who have had to suffer unsafe and unclean conditions in wards, including examples of threats to sexual safety.

The assessment came as no surprise to the employee who spoke to the local newspaper. Nor would it have been a surprise to UNISON members who were balloted last year on strike action over cuts and the lack of resources. 83% voted to take strike action – a difficult decision by dedicated staff committed to caring for vulnerable people. On UNISON’s blog, regional organiser Charlie Carruth stated in December 2019:

Patients and the city’s communities are being let down by an underfunded service, while frontline staff are in danger of burning out as they try to deliver more with substantially less.Individuals are being put at risk because of short-sighted penny pinching that values balance sheets ahead of people…Senior managers at the Trust and the City Council ned to invest properly in mental health services before it’s too late.

The deterioration in the Trust’s assessment and the growth in staff discontent is directly related to the implementation of a restructure 2 years ago designed to save money.

Unbelievably, though, new chief executive Jan Ditheridge claimed in the same Star article ‘We have not made financial cuts…’ This goes against the evidence. In addition to the ‘restructuring’ of community services, the Trust is in the process of flogging off its current head office buildings and two years ago the CCG planned to cut a further £7.1m from the mental health budget. Unlike elsewhere in the NHS, the Trust cannot plead poverty – in the last 2 years it has made a ‘profit’ of £15 million!

A former User Governor of the Trust, explaining why they only served one term, stated ‘It was clear that we were being used merely to rubber-stamp cuts in the name of improvement and efficiency’.

The Covid-19 Threat
If the mental health services in Sheffield can’t cope with normal levels of demand, they are worryingly likely to be overwhelmed in the coming months as the fallout from the Covid-19 pandemic strikes. The Royal College of Psychiatrists has warned of a ‘tsunami of referrals as a result of the pandemic. This will come from a variety of avenues:

  • Delayed routine appointments
  • Post-Traumatic Stress Disorder (PTSD) amongst frontline staff and patients who have been in intensive care
  • Effects of lockdown – isolation and loneliness affecting the mental health not only of existing sufferers but of those who haven’t suffered mental health problems previously
  • Impact of increased unemployment, financial insecurity and homelessness as a result of the economic recession.

Sheffield Save Our NHS (SSONHS), in which Socialist Alternative members are active, had already decided to make mental health one of its two priorities for 2020 before the lockdown.

The Covid pandemic and the state of mental health services in Sheffield makes action even more urgent. SSONHS will be putting a series of questions to Sheffield Council’s Scrutiny Committee in August.

We can have no faith in the Trust itself. In Involve, it states that you can check on our progress at www.shsc.nhs.uk towards dealing with the issues raised by the CQC report. By mid-July nothing had been posted on the website apart from the Trust’s initial response. There has not even been an apology for its poor performance. Publicly available reports have been made to the Board of Directors. Unsurprisingly though these normally public meetings have been closed to the public with no attempt to make them accessible online!

Socialist Alternative members have therefore started a petition calling on the Council to hold an enquiry on which trade unions, users and community groups should be represented to investigate the Trust and campaign for more resources for mental health.

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