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.

We think that the PCT’s service specification is flawed in a number of respects:

1. It falls short of meeting Andrew Lansley’s (DoH, 2010) four key tests for service change by:

• Failing to demonstrate strengthened public and patient engagement in its development. The public, clinicians within the service and the service user group were not consulted. Claims that Derbyshire Voice supported the proposal have been revealed as unfounded.

• Failing to exhibit clarity on the clinical evidence cited. A reliance on NICE ignores the considerable evidence base for psychodynamic approaches that does exist, and the local experiential evidence of professionals and service users.

• Failing to be consistent with current and prospective patient choice by cutting a well established and effective model and explicitly offering only cognitive behavioural approaches.

2. This significant cut in provision is obscured in a vague, imprecise proposal, which claims to raise service quality while falling short committing the PCT to any real improvements: 

• Short-term psychodynamic and mindfulness group approaches ‘may’ be provided; Commissioners reveal to OSC that the proposal’s claim of providing equity of service across the county is dependent on finding cash in the future.

• Proposal fails to compare current and future spending or staffing levels to demonstrate real improvement in quality, providing only impenetrable activity levels.

3.The negative impact of the proposal on service users is not made clear:

• Those whose severe and complex difficulties frequently impact on their personalities, the people most in need of the help provided by psychodynamic therapy, are explicitly excluded from the proposal. 

• Choice will be limited to one type of therapy, regardless of service user preference or whether that approach has helped in the past.

4.The negative impact of the proposal on Derbyshire Healthcare Trust is not made clear:

• When the proposal was revealed 13 specialist psychotherapists were simultaneously placed ‘at risk’ and given 90 day redundancy notices - a significant cut to DHT service provision.

• Clinical expertise and a highly valued training and supervision resource, built up over decades, will be lost.

Please make your voice heard 

and 

help save this vital 

Derbyshire NHS Mental Health Service.