Analysis

Call for more mental health nurses in general practice to ease primary care burden

GP Partnership Review highlights mental health as a major issue for NHS and looks at challenges facing general practices

GP Partnership Review highlights mental health as a major issue for NHS and looks at challenges facing general practices


Picture: iStock

Community mental health nurses should spend time as part of general practice teams to help ease the burden on primary care, a new independent review recommends.

Doing so could bridge a gap in mental health service provision between general practice and mental health services, the review says.

The GP Partnership Review has been looking at how general practices work and services are equipped to respond to the different challenges they face.

Burden on emergency departments

Published in January, the review points out that mental health is a major issue for the NHS and that the associated workload has increased significantly.

76%

of people in England with a common mental health condition do not receive treatment

(Source: Mind)

It states: ‘There has been much focus on crisis intervention and the burden on emergency departments.

‘However there remains a significant gap in the provision of adult and older people's mental health services in the community, and this has a major impact on general practice.’

Then it suggests: ‘The further development of the community psychiatric nurse role could bridge the gap between general practice and mental health services.


Crystal Oldman

‘Consideration should be given for a number of posts to be established with time spent as part of the practice team, as well as the community mental health team.’

Queen’s Nursing Institute (QNI) chief executive Crystal Oldman welcomes the proposals: ‘People presenting with mental health symptoms in primary care need access to specialist professionals who can assess them and decide quickly on what services or care will be best for them, and prevent escalation of their conditions.

‘The QNI is delighted to see that this has been recognised.’

Greater Manchester Health and Social Care Partnership primary and community care lead nurse Louise Brady also likes the idea.


Louise Brady

However, she argues it is vital that mental health nurses are physically present in general practice settings.

‘Otherwise there is a danger we create another tier or hoop to jump through. A referral to a psychiatric liaison nurse wouldn’t give continuity; they need to be based together,’ she says.

‘We see patients with diverse mental health needs all the time, but we have to do a lot of referring on, which breaks down the continuity of care.

‘If there were community psychiatric nurses linked to a general practice, or to a hub in the community, that would take the pressure off the system.'

Ten-year view

1 in 3

GP appointments includes a mental health element

(Source: Mind)

RCN professional lead for mental health Catherine Gamble points out that numbers of nurses working in community and mental health are still down by around 4,000 in each field, compared with ten years ago.


Catherine Gamble

‘Mental health nurses already work closely with GPs delivering care for patients.

‘But, for the proposals in this review to work, there needs to be significant and sustained investment in the nursing workforce and in their professional development.’

The government will now respond to the review’s recommendations.

Case study: Camden and Islington NHS Foundation Trust

There are already a few projects in England in which mental health nurses work in general practice.

Camden and Islington NHS Foundation Trust, London, provides mental health and substance misuse services, and treats 97% of people in the community.

The trust's community matron Anthony Jemmott has been involved in a project integrating mental health nurses into general practices.

Mr Jemmott says: ‘We have established practice-based mental health teams working in general practice supporting GPs.’

Within these teams, band 6 mental health nurses spend time in GP surgeries carrying out mental health assessments and necessary interventions, which prevents referrals going back to the main team.

‘It is creating a system with greater accessibility and more fluidity,’ he says.

 

Access the GP Partnership Review here

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