Examination of Witnesses (Questions 520-524)
DR SALLY
PIDD, MR
ROB DARRACOTT
AND MR
BILL O'NEILL
15 JUNE 2006
Q520 Dr Naysmith: That is very helpful.
How do the STR workers—and for the audience and for the
note taker I had better say what that stands for, "support,
time and recovery" workers—fit into this?
Dr Pidd: I think they are fitting
in extremely well. The idea of support, time and recovery workers
came very much from service users and carers identifying that
what they needed more of were people who could given them hands-on
time helping them in activities of daily living, negotiating their
way through the benefits system, perhaps facilitating their use
of occupational activities and therapeutic activities. We have
always had within the healthcare system a huge number—they
used to be called unqualified staff—of non-professionally
qualified staff, who have had a variety names, and care assistants
and support workers have been part of the mental health service
for as long as I can remember. I think the introduction of the
STR workers has added a professional dimension to what they do;
they are not just the people who run around doing the odd jobs
to support people. But for many users of mental health services
they are their first port of call and their main support, their
main advocate. So I think STR workers—although I think the
numbers that were suggested in the NHS plan were fairly artificial—in
fact is one of the groups that has been quite enthusiastically
embraced because there was a ready pool of people already working
in other roles, for example, as OT assistants.
Q521 Dr Naysmith: So would you say
that they have improved productivity in the service?
Dr Pidd: I think it is difficult
to define what productivity is in these terms. I think if we are
talking about the quality of patients' lives then undoubtedly
STR workers have enhanced the quality of patients' lives, their
ability to access facilities that everybody else does. Certainly
in terms of social inclusion agenda, for example, I think STR
workers may not recognise that is what they are doing, but think
effectively that is what they are doing—that they are acting
as a bridge between the world, which many people with severe and
enduring mental health problems find quite a frightening place
to negotiate, and they are facilitating their re-entry.
Q522 Dr Naysmith: It is certainly
something that you would want to encourage?
Dr Pidd: Yes, I certainly think
so because the role of medication, for example, in the treatment
of mental health services is only a relatively small part for
people—it is a vital part—but making sure that they
can access housing benefits and recreational activities certainly
promotes the recovery model and that is absolutely vital.
Q523 Dr Naysmith: Finally to round
all this up, we started off talking about the shortage of psychiatrists
and you mentioned all those other people who make up the team,
but there must be variation in availability from one part of the
country to another in how these teams are made up.
Dr Pidd: Yes.
Q524 Dr Naysmith: Do you think that
people adopting new roles is sustainable into the future in order
to compensate for the shortage of psychiatrists? We will probably
need more psychiatrists in the future rather than fewer, given
what is going on.
Dr Pidd: I think we probably need
at least the number that we have at the moment, if we were fully
recruited to them, partly because of the changing demands. For
example, when the new Mental Health Bill finally surfaces that
will undoubtedly place more demands not just on psychiatrists
but on other mental health professionals as well. But I think
in terms of the sustainability of new teams, from a workforce-planning
point of view one of the difficulties has been that a lot of the
top down instructions about the composition of teams and how many
functional teams you need for areas was predicated on urban areas.
So I come from, relatively speaking, a rural area and it does
not match very well. So I think there is a need to ensure that
there could be local variation to meet the local services, but
also making sure that areas which are struggling, either for financial
reasons or for recruitment reasons, are having difficulty; that
there is some mechanism in terms of the oversight of the Strategic
Health Authorities or the reformed PCTs, the larger PCTs, to ensure
that services are still commissioned with an equality of access
to all these different professionals rather than areas that already
have those services continuing to have them and other areas struggling.
Chairman: Could I thank you all very
much indeed? Could I just say to Mr Darracott that one of the
roles we do play around this table is being the devil's advocate
on occasions—we do not expect witnesses to take everything
personally? Thank you very much indeed for coming along and helping
this morning.
| 
