Thursday, 10 November 2011

The Derby City Council Adults Health and Housing Commission has now produced a report, read the whole report here. 

Here are the Reports main Conclusion and Recommendations

 Derby City Council 

31 October 2011

Report of the Adults Health and Housing Commission
Review of proposals to reconfigure Psychodynamic Psychotherapy


47. The Commission received evidence from a range of organisations and
individuals on the PCTs proposals to reconfigure psychodynamic psychotherapy
services. The key message from service users, staff and unions is that there
has been a high degree of confusion over the consultation process which could
have been avoided had the PCT been clear from the start about its intentions
and what it wanted to achieve. The initial documents presented to the
Commission and subsequent the confirmation through email stated that the PCT
had already taken a decision to phase out psychodynamic psychotherapy
services. It also expected the provider Trusts to reassess individuals on whether
they should be receiving psychodynamic psychotherapy services. A direct
consequence of this approach was that the provider trust began issuing
redundancy notices to its staff. This was prior to the start of the consultation
from 1 August.

48. Evidence considered by the Commission provides a strong case supporting
continuation of psychodynamic psychotherapy services. However, the Scrutiny
Commission does not feel it should dictate the level of psychological therapy
services over other types of provision such as CBT to be commissioned by the

49. The Commission does not feel it is in apposition to favour the level of provision
of psychological therapy services over other types of provision such as CBT.
There is evidence that both are effective for certain conditions and both need to
be retained to provide patient choice.

50. The Commission was also very concerned that service changes had already
begun to be implemented by the provider trust before proper consultation had
been started let alone be completed. This should not have happened. This
approach has caused anxiety and stress for service users as well as staff and
could have been avoided.
51. The Commission is not qualified to make recommendations about the level of
Psychodynamic Psychotherapy Services to be in the city. However, it is
important for patients that require this service to be able to access it. The
Commission heard that the reason there was no demand in the North of the
County was because it was not commissioned in the north and therefore there
would be no referrals.
52. The Commission was concerned that this is the second time reconfiguration of a
psychological therapy services has been carried out without following proper
procedures. This is unacceptable. It has caused anxiety and stress for service
users as well as staff which could have been avoided. The Commission
recommends that the PCT follows proper procedures and consults its
stakeholders during any substantial reconfiguration of its services.
53. After having considered the evidence on the proposals for reconfiguration of
psychodynamic psychotherapy services in Derby and Derbyshire the
Commission recommends:
1. The Trust retains psychodynamic psychotherapy services as part of a
balanced treatment service.

2. That access to psychodynamic psychotherapy services is made fair and
equitable across Derby and Derbyshire.

3. That the Trust should seek to equalise rather than reduce the level and
quality of service provision in Derby and Derbyshire.

Sunday, 23 October 2011

'Those with most serious problems would be left without the best help'

PSYCHIATRIST Dr David Smith has more than 30 years of experience and believes the NHS Commissioners proposals to decommission Psychodynamic Psychotherapy Services in Derbyshire could leave patients without the most effective form of therapy. He said psychodynamic psychotherapy was of "major benefit" to patients.

Read the whole article from the Derby Evening Telegraph here.

Dr Smith has written a response to the plans to decommission Derbyshires highly specialist, front line NHS Mental Health Psychodynamic Psychotherapy Services. You can read "The Case for Long-Term Psychodynamic Psychotherapy: A response to the Derbyshire County Primary Care Trust" here

ANALYSIS AND CRITIQUE OF THE CONSULTATION DOCUMENT  ‘Psychological Therapies Specification’ Draft Version 0.9

 Read the whole document here

This paper offers an analysis and critique of proposals contained in the Consultation Document 'Psychological Therapies Specification Version 0.9 (Draft)' produced by Derbyshire PCT Commissioners in July 2011.

It is presented by UNITE on behalf of Clinicians who work as Specialist Psychodynamic Psychotherapists within the Derbyshire Healthcare NHS Foundation Trust.

We address concerns about the processes by which these proposals were arrived at and presented for consultation, and their content.

We address our concerns to all stakeholders: the Commissioners, Derbyshire Healthcare NHS Foundation Trust, G.P.s, service users and their representatives, and the Overview and Scrutiny Commissions for Derby City and County Councils who have authority for holding Commissioners accountable for their decisions.

We describe who we are, provide an initial executive summary of our response and then speak in more depth to these issues.

The Specialist Psychodynamic Psychotherapy Service.
For over thirty years, we have provided a tertiary service within Derbyshire Healthcare NHS Foundation Trust treating adults with severe and complex psychological disorders. These are vulnerable adults, often presenting with lifelong histories of mental ill-health and multiple use of local services. Staff have a core professional training in mental health, and a post-qualification specialist training in psychodynamic psychotherapy of four or more years. Some staff have Doctorate or PhD qualifications in addition to their clinical qualifications.

Treatment within the service takes the form of individual, group or couple therapy, with an average attendance time of 18 months to 2 years. The service aims not just to ameliorate symptoms, but to produce lasting change and a number of outcome measures are used to demonstrate this. The Psychodynamic Psychotherapy Service is provided from the Department base in Derby City, and from locality Recovery Team bases in the South of the County. 

Sunday, 4 September 2011

Letter from Professor Andrew Samuels Chair, UKCP. United Kingdom Council for Psychotherapy.

This is a copy of a letter from Professor Andrew Samuels Chair UKCP, United Kingdom Council for Psychotherapy.The Letter has been sent to the Commissioners, Derbyshire County PCT and Derby City PCT. The letter has also been sent to the Chief Executive of Derbyshire Healthcare NHS Trust and to the Chair and members of Derby City Council Adult Health Overview and Scrutiny Commission.



You will, of course, be aware of the concern - one might say consternation - caused by the very damaging and abrupt proposals to decommission the psychodynamic psychotherapy and Group Therapy Programme within the DHFT.  Decommissioning in this manner will lead to a lack of choice for patients, the maintenance of which is a key feature of one of Andrew Lansley's 'four steps' consultation guidance. In terms of psychological services, the provision of a choice of a range of therapies is absolutely essential.

Threat to cut NHS Psychodynamic Psychotherapy Services in Derbyshire

Threat to Front Line NHS Mental Health Services. 

PCT Commissioners for Derbyshire and County Derby City have proposed a service specification for NHS Psychotherapy Services that requires the de-commissioning of psychodynamic psychotherapy services within the Derbyshire Healthcare Foundation Trust. The Psychodynamic Psychotherapy Department and the Group Therapy Programme would be lost. 

The Overview and Scrutiny Committee has required the PCT to undertake a three month public consultation on the proposal and to halt the decommissioning process. 

A month into this consultation no public meeting has been announced and 13 specialist psychotherapists remain ‘at risk’. 

The Psychotherapists have been informed by Derbyshire Healthcare Foundation Trust (in letters received on 2nd September 2011) that their  90 days redundancy notice has been "deferred" pending the outcome of the consultation. 

The Staff, Service Users and other Clinicians relying upon the Psychotherapy Services have once again been left in a position of profound uncertainty.

Thursday, 18 August 2011

Threat to NHS Psychological Therapy Services in the Derbyshire Healthcare Foundation Trust

What is this about?

PCT Commissioners for Derbyshire have put forward proposals for Psychological Therapy Services which would lead to the de-commissioning of the NHS Frontline Psychodynamic Psychotherapy Service and the Psychodynamic Group Therapy Programme within the Derbyshire Healthcare Foundation Trust (DHFT). The consultation on these proposals will close on 30th October 2011.

There is great concern about the damaging impact these proposals would have on patient care if accepted.
There is great concern that the proposal document is flawed. It is not written in a way that is accessible and informative for service users, their families and the general public. It misrepresents the case for these proposals and misrepresents what would be the outcome of these proposals if they were accepted.

There is great concern the consultation is not being conducted in an open and inclusive way that allows people to know it is happening and informs them how they can make their contribution.