Tayside is at the epicentre of a “national scandal” in adult psychiatry care, with senior managers breaking ranks to brand wider services across Scotland “unsafe”.
The region was likened to a “canary in the coal mine” as new analysis found it has the worst record for recruiting general adult psychiatry consultants anywhere in the country.
The Courier can reveal a professional body representing leading psychiatrists is warning patients in Scotland are being put at risk by services at breaking point.
Situation is ‘critical’
Dr Amanda Cotton, chair of the Senior Medical Managers in Psychiatry group, said: “The situation regarding consultant psychiatrist vacancies across Scotland is critical.
“A review of vacant consultant posts undertaken by our group of Senior Medical Managers in Psychiatry last year demonstrated true vacancy rates in Scotland from 13% to over 50% around the country.
“Often it is the most impoverished areas of the country, and the areas that experience the worst rates of drug-related deaths, that have the least number of psychiatrists.
“This is a national scandal.”
Dr Cotton is also Associate Medical Director for Mental Health and Learning Disability Services at NHS Borders.
She warned bosses are trying to manage a “terrible shortage” of consultant psychiatrists by employing temporary locum doctors, “some of whom might not have undergone the necessary training”.
She added: “This is unsafe and would not be accepted in other areas of healthcare.”
‘Services must be scaled back’
Dr Cotton said the current situation in psychiatry would be like allowing doctors to operate without surgical training.
The expert said staff are “overwhelmed”.
And she called for a reduction in the number of services being offered until the next generation of consultants is trained.
She said: “We have raised our concerns directly to the Scottish Government and asked that they begin an urgent conversation with the Scottish public about what care specialist mental health services can and cannot provide over the next few years.
“Staff in mental health services need to feel they are doing a job that is safe, realistic and achievable.”
Crisis in Tayside laid bare
New analysis from the Senior Medical Managers in Psychiatry group, seen by The Courier, lays bare the extent of the crisis in Tayside and across Scotland.
The region should be employing 24.5 full time equivalent consultants in general adult psychiatry but has only five in post.
Health chiefs have tried to plug the gaps with temporary locum hires but still has a need for 4.5 full time equivalent staff.
It means 18% of Tayside’s psychiatry requirements are currently unfilled, the worst rate anywhere in Scotland.
The vacancy rate across the country as a whole is 9%.
In Fife, the vacancy rate is 8%.
‘Shocking’
Dundee-based MSP Michael Marra described the figures as “truly shocking” and said they “lay bare the massive task in rebuilding mental health services”.
He said: “The situation in Tayside – considerably worse than the rest of Scotland – has been described to me as the canary in the coal mine of an over-stretched mental health service nationally.
“Despite all of the warnings, the major reports and promises of action from SNP ministers there is scant progress on any of the big issues.”
NHS Tayside said the health board is working closely with staff to develop new workforce models, including advanced prescribing roles for non-medical practitioners.
A health board spokesperson added: “There is a UK-wide shortage of consultant psychiatrists which is creating a very challenging recruitment environment.”
SNP minister Kevin Stewart said the mental health workforce has “expanded significantly” under the current government.
Mr Stewart noted that “record numbers of staff” are providing more varied support to a larger number of people than ever before.
He added: “As part of our ongoing commitment and investment, we are working with partners to develop both a new Mental Health and Wellbeing Strategy and Workforce Plan in 2023.”
Conversation