‘No care left in the system’: patients on use of locum psychiatrists in Scotland

Scotland’s health boards have paid up to £837 an hour for locum psychiatrists to help cope with a deepening staff shortage crisis in mental health services.

The Royal College of Psychiatrists and NHS executives said mental health services in Scotland were now at breaking point because of severe staff shortages, which was damaging patient care and causing experienced consultants to quit.

Vox Scotland surveyed patients after hearing of repeated cases of poor experiences with locums, the agency psychiatrists on whom Scotland’s mental health services increasingly depend.

The complaints about locum psychiatrists have a clear pattern. Patients say they routinely experience inconsistent care or get contradictory advice. Some describe an indifference that borders on box-ticking.

“I had 14 locums [and] they all had different views and opinions on my care,” said one respondent to a survey of 469 patients by the advocacy group Vox Scotland. “The last locum did not bother to call me back. That was four months ago. I’ve had no contact from my mental health team since then.”

For some, the anger is palpable. “There is no care left in people or the system and it’s criminal what they have been allowed to do, especially over these last few years taking everything online,” one respondent said. “Online appointments are not accessible to many neurodivergent people like me. Suicidal? Nothing says care like a five-minute Zoom and a prescription 20 miles away with nobody to collect it.”

Nearly a third said all or most of their care came from locums, of whom half were dissatisfied or very dissatisfied with the overall quality of care. A fifth of those polled said they did not know whether they were seen by locums or NHS psychiatrists.

“Every new locum has new ideas, medication changes, but are never here long enough to see the medication work or not. Then the cycle begins with the new one,” another said.

“Each time you see someone different you have to pour your heart and soul out,” said another. “There is no rapport or relationship with locum psychiatrists for vulnerable people – it is impossible to do from receiving notes from the last person.”

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Source: The Guardian, 7 October 2024