28 July - Mental health network webinar

This week, we were joined by Lord Victor Adebowale, Chair of the NHS Confederation, who shared his reflections on the current political turmoil and social care workforce issues.

“We are in the midst of a political storm.”

Victor feels the government is in crisis. He spoke of a sense of deja vu from the late seventies and early eighties regarding economic choices that are being faced, the rhetoric around public services and the perceived risk of wage inflation alongside the reality of actual inflation. Any money given to the NHS is largely eaten away by inflation. The severity of the ongoing workforce crisis has not been acknowledged. The NHS is facing unprecedented demands on all fronts, especially mental health. Victor spoke of concerns regarding the rhetoric of prioritisation focusing on what is politically convenient, rather than the systemic necessities.

“Flow is a system wide issue. There is a need to keep pressure on the system to acknowledge mental health is a critical part of the system and part of population health in any place.”

Victor spoke of the Confed’s campaigning around the social care workforce issue affecting NHS services and the voluntary sector.

“The demands that have been placed on the system as a whole are due to failures to recruit, retain and manage social care staff across the piece.”

Victor spoke of a recent survey of 250 members with startling results regarding access to healthcare, mental health and community. The response from government regarding the social care issue has been disappointingly shallow so far.

“We need to remain politically neutral and have realistic conversations with those in government about resourcing the NHS.”

Something NHSE are perhaps not able to do on their own.

“It is essential to maintain a good relationship with NHSE and ensuring they are aware of their unique contribution. Good relationships with local government are also key, to ensure a credible dialogue between local government and health.”

The mental health demand backlog is concerning, as well as the impact of the upcoming recession, considering the link between cost of living, poverty and mental health. There is a need to work collectively to alleviate pressures on staff, including close working with partners in the voluntary and community sectors.”

“The NHS will be a big issue coming up to the next election. In the short term, we must be weary of increased attention on perceptions of waste in the NHS, an attempt to blame the victim over the system in mental health and a need to protect colleagues who are in minority groups as they likely come under increasing attack. In the medium term, we might expect suggestions that social care have been solved and that the NHS has enough money, along with greater scrutiny of leaders.”

“We must also acknowledge an increasing use of private services.”

“There is a danger in reducing mental health to a number of conditions, such as anorexia, instead of a whole system. There is a need to retain the relevance of mental health to the whole system.”

Someone spoke of continuing to fight for mental health even as they step down, and adopting a spirit of national unity to help solve the current issues.

“All parties involved agree there is a workforce crisis but disagree on how to solve it. They agree there is a demographic challenge and that Covid is a significant challenge.”

“Covid is still very much around, although as a society, we are acting as though it is not.”

The group went on discussing harmful narratives regarding NHS targets in the media and the need to push back.

“We need data to be disaggregated around protected characteristics and postcode. The most deprived areas are most affected. Prevention is a cross party, cross government issue and the Treasury is a key part of this.”

“Is a better narrative is required? What should this narrative be?”

The group then asked for Victor’s view on how concerns should be voiced without appearing to be engaging in politics, for example regarding inflation.

“The narrative needs to be much more focused from within, in that mental health is part of the system, evidenced by statistics.”

A participant spoke of her experience as a local councillor in the eighties and the pressures of huge poverty and community response and reaction.

“We ought to start conversations around the responsibility of chairs to be supportive to local communities around mitigation, prevention and practical support.”

Victor referenced some positive practice around community engagement and encouraged the group to keep sharing.

The group was then presented with the inaugural conference and launch of Asian Professionals National Alliance (APNA) NHS, which takes place on 9 and 10 September. More information here.

Finally, some questioned if the focus of a future session could be on prevention, including ‘what works’ and incorporating colleagues’ experiences in the fire and police services. The Mental Health Foundation is well known for prevention – inviting Mark Rowland was suggested, to share and discuss principles of good practice.