Shake-up of mental health care could see 50 jobs axed

First published in News The Oxford Times: Photograph of the Author by

UP to 50 mental health posts could be cut as Oxford Health restructures its adult services.

A staff consultation document, leaked to the Oxford Mail, reveals plans to streamline adult mental health services from November.

And the changes include axing about 50 whole-time equivalent posts including 30 posts for frontline nurses and social workers.

The Oxford Mail asked for a guarantee from the chief executive of the trust – Stuart Bell – that the changes would not affect patient care or the safety of the public but did not get a response.

The trust has about 6,200 staff and 1,600 in its adult mental health services – posts can be filled by more than one person so the total figure could be higher than 50.

Fears have been raised that bringing together all adult services will force specialist workers to become “jacks of all trades”.

An employee, who did not want to be named, said: “We already feel under pressure and morale is low.

“We are worried that more cuts to the service will increase this and we are concerned about whether or not we can deliver the service at all.”

Richard MacKenzie, 32, who has bipolar disorder, said: “If they cut staff numbers it is going to put people’s lives at risk. It will be catastrophic.”

Oxford East MP Andrew Smith said: “Especially after the difficulties that were previously revealed at the trust, the public will be concerned at this apparently big cut affecting frontline staff.

“Since the Francis Report into the awful deaths at Stafford Hospital showed how important it is to keep up or increase frontline staffing, it makes it all the more important that the mental health trust explains if it can comply with this.”

The Francis Report, into the deaths of hundreds of people at Stafford Hospital, said a chronic lack of staff was largely responsible for the substandard care.

Ian McKendrick, of Oxfordshire Unison health branch, said: “I do not see how it is going to be able to offer the same quality of service with a reduced level of staffing. It seems to fly in the face of the Francis Report. But all of this is happening in the context of the national cuts to the NHS. It is slash, slash, slash and managers are forced into a position of making frankly terrible choices.”

The proposals will see specialist services, including community mental health, assertive outreach teams and community acute services, brought under one roof with staff having to work across different areas. The new adult mental health team will deal with treatment and assessment 24 hours a day, seven days a week.

Currently, community mental health teams operate from Monday to Friday, 9am to 5pm. After 5pm, patients use a GP out-of-hours service or the crisis team.

Oxford Health’s job cuts include 30.4 out of 181 whole-time equivalent posts from band 5 and 6 staff, which are registered social workers and nurses.

The foundation trust says it was not proposing redundancies but will not replace staff as they leave.

The restructuring was signed off by Oxford Health’s executive in June. The staff consultation began on September 2 and will end on October 4 with the new structure fully in place by April 1, 2014.

Oxford Health was criticised after life prisoner Ian McLean walked out of Littlemore Mental Health Centre and travelled to Poland, where he took his own life last month, and for its handling of Kauthar Silvera, who murdered her mother days after being discharged from the same place.

The trust was forced to make changes to its crisis team after the suicides of Gareth Christian and Graham Kirtland in 2011 and earlier this year both the Warneford Hospital and Littlemore Mental Health Centre failed inspections by the Care Quality Commission.

Oxford Health spokesman Duncan Alistair said: “The proposed changes are designed to improve patient safety in line with the Francis Report. The new model will mean service users will gain better access to staff with specialist skills, be able to maintain existing therapeutic relationships for more hours in the day and make greater use of the assessment/crisis function.”

Asked whether the changes were as a response to inquests into the suicides, a spokesman said: “We have taken into account the lessons from investigations into all relevant incidents as well as national guidance on good practice.”

He said the changes would not save money.

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