Heartbroken to be kicked out of NHS

[NoLongerNHS]

NC for this as I have been on MN for a long time. I have worked in Mental Health for decades, the last 15 years in the NHS. Lived overseas growing up so have experience of living (and working) in the American healthcare system.

I was so proud to join the NHS and believe passionately in the principles behind it. I know it needs reform, and many things about it are not good. The review on Nottingham shows how utterly broken most parts of the system are. But I have seen what happens when money and profits drive healthcare, and it is much worst than we have, especially for mental health.

The contract offered for the work I do is up next year. There will be no NHS bidders. So after 15 years, I will no longer work in the NHS. I was called into a meeting with less than an hours notice to be told this. I may not have a job at all, but I may be transferred to a private company if any will take over the contract.
I am heartbroken. Furious. Sad. Blindsided. And worried - for myself and for my clients.

When private providers take over they cherry pick cases, tighten exclusion criteria, and close down much more readily than NHS. Workers rights are not as protected, salaries are depressed, and all kinds of tricks are used to avoid making redundancies while getting rid of more expensive (more experienced) staff. I have a friend who works in physical health care and this happens there - they regularly need to pick up the cases the private provider in the area refuse or mess up.

We are in the middle of a MH crisis. The events in Nottingham show how badly wrong things can go when services are not working well. How the fuck can this be happening? Why are people not more upset about this?

YABU - suck it up, its a better way to work
YANBU - its privatization and thats not good

Are you a member of UNISON? I would go and talk to them. It’s awful this is happening and must be a shock for you.

Yes, union is involved. Dont think it will make any difference. But it is nice to have them onside.

Privatisation if health services is appalling.

From a personal pov, look for another job. Nothing will be better for you under a private company. For all it's faults, the NHS offers it's staff some significant benefits, plus being forced to practice in a way not in line with your personal values will wear you down.

I’m sorry that you’re going through this but I wouldn’t assume that the NHS is better for staff or patients.

On an ideological level I’m passionate about the NHS and it’s a model which quite rightly is envied by many across the world.

However, in real terms (as shown in Notts), mental health services are so badly designed - often for the benefit of the organisation not the patients - that they’re untherapeutic and dangerous. Third sector organisations (which are often the ones putting in bids when services go out to tender rather than private companies) tend to be more patient focussed and end up picking up the people that the NHS exclude because they don’t need / respond to the 6 week / short term intervention model.

I hope that whatever happens it works out for you, union is a good shout, they’ll probably want to TUPE you over to a new organisation.

I agree that NHS services are not always run well. But I think I would disagree that its a design problem - at least not in the first instance. The issue is that services have been cut to the bone, so have changed over the years to accommodate much reduced funding. Not that they were initially designed that way, or that the people who run them want to do it that way or think it is good (often a disconnect from what senior leaders say in public and what the managers and staff of the service actually think about it. And a lot of the most pressured services will never have private providers wanting to take them over because there is no money in it. So unless you have an easy problem to solve, you may find yourself out of luck.

But it is true I dont know it will be terrible to work privately. It goes against my values for sure. But it may have benefits. I have watched friends in other parts of the country go through this, and most were really unhappy with what was expected of them, in terms of standards and clinical focus.

PS - the only service in our area which does not cap at 6 sessions is the NHS service.

I wish I lived where you are, I work in a non NHS service and try and access support for my patients on a daily basis only to have them bounced around.

It’s a minimum of a two year waiting list for anything other than short term work, people don’t even bother referring to secondary care anymore because there is no capacity and it completely is badly designed. Someone on Twitter used the phrase ‘weaponising the recovery model’ which 100% is what’s happened round here.

Its only charities round here which provide any therapy or support longer term without a waiting list of years.

Anyway, I didn’t want to detract from your thread, just to offer a perspective that these things aren’t always negative. Best of luck with it.

@FunIsland I agree, it may not be bad. Although the experiences I have heard have not been hopeful. You are right about secondary care though - I dont work there, but it is non functional. And the recovery model sucks.

Write to your MP. Write to your local councillors. Write to Wes .
start a petition on that petition site I can’t remember the name of

mentwl health services are already crap. Care in community is really “drug and dump”

instead of venting here - vent with purpose to political movers

and, check your TUPE rights vs redundancy rights . Unison involved so they should be all over it.

On it with all of that. But still needed to vent. And to tell people. Good ideas though, and thank you for taking time to reply.

Not surprised.

I've had 30 hours of assessment and still not offered any help.

Currently I'm with a local mental health service and seeing some care coordinators who just speak to me...

My issues are intrusive thoughts.

Good luck…I hope you come out of it ok. (I’d sign a petition 🤷🏼‍♀️🤣)

Good MH staff are like gold dust. It might be worth looking around now and seeing if there are any other jobs in your trust or neighbouring ones.