Who Should Doctors Go to for Their Mental Health?

There’s been something of a funding fiasco at NHS Practitioner Health. 

An announcement to cut funding for new patients in secondary care received such a backlash that the NHS was forced to reverse its decision. 

NHS Practitioner Health provides a free, confidential service for doctors and dentists with a mental health or addiction issue. The U-turn underlines the importance of mental healthcare for NHS staff and the value placed on the service.

The need for mental healthcare for medics has not diminished post-pandemic. In fact, a recent poll (April 17) for NHS Charities Togethe r showed that more than three in four NHS staff have struggled with a mental health condition in the last year. 

The Initial Announcement

The announcement made on the NHS Practitioner Health website on April 12 said that NHS England was “undertaking a review of the staff support for mental health across all staff groups to consider long term sustainable goals. On this basis we have agreed to stop new registrations for secondary care patients”

The notice was met with dismay and disbelief. The BMA called it “deeply concerning”. Its workforce lead, Dr Latifa Patel, said on its website: “This is a short-sighted financial decision with potentially harmful consequences for both doctors and patients.”

Co-chair of The Doctors’ Association UK (DAUK), Dr Helen Fernandes, told Medscape News UK: “I was astounded. It seemed a very arbitrary, unsafe, and cruel decision.”

Many health organisations, unions, charities, and individual doctors took to social media in an uproar. An open letter written to the Health Secretary and NHS CEO by Dr Rachel Clarke and Dr Natalie Silvey on behalf of all NHS staff complaining about the cut received more than 15,000 signatures.

Susannah Basile, head of external affairs at the charity Doctors in Distress, told Medscape News UK: “My initial reaction was shock followed by concern. We know that healthcare staff are burnt out. We know one doctor takes their own life every 3 weeks; one nurse every week. And to pull a secondary care mental health service which is arguably the only viable one for people to attend in confidence seemed really shocking.” 

U-Turn

Many doctors took to social media to praise the service they had been given from NHS Practitioner Health. 

“So many people came out and said: ‘Practitioner Health has given me treatment’ or ‘Practitioner Health has saved my life’,” said Basile. “I don’t know if the NHS underestimated the impact it had and maybe made them realise the implications of the decision.” 

Three days later the decision was reversed. The Health Secretary Victoria Atkins posted on X saying: “We have heard the concerns of NHS staff in recent days. You deserve the right support. After meeting with the NHS I am pleased that this important service will be maintained for both existing and new patients.”

NHSPH confirmed the news on its website. Dr Navina Evans, NHS England’s chief workforce officer said: “Following discussions with Practitioner Health on their current service for secondary care doctors, dentists and senior NHS staff, we have jointly agreed to extend the service by 12 months for both new and existing patients, while we carry out a wider review to ensure that all NHS staff groups have the mental health support they need.”

On the change of heart, Fernandes said: “I think that weight of response from across the medical profession was an important factor.”

Praise for NHSPH

The debacle over defunding has demonstrated how much support there is for NHSPH and how necessary it is.

“Practicing in the NHS currently is hard. It’s under-resourced, overstretched, there’s little job security, people are treated poorly by employers and government, and Practitioner Health is a lifeline of support for those doctors who aren’t coping with these stressful situations,” explained Fernandes.

When the initial funding cut was announced, there were suggestions that people could get alternative support from their GP, occupational health department, or employee assistance programmes.

But Basile explained: “There’s a huge stigma among healthcare workers [about] accessing support for their own mental health. It’s unrealistic to suggest that doctors should go to their own employer and admit they are struggling, or to go to their GP. What if they are a GP and that is their colleague? The benefits of Practitioner Health or Doctors in Distress is that they are totally confidential and anonymous. That was what was so moving about the number of doctors coming out on X saying they had been supported.”

The Future

Was this a rogue defunding decision that was quickly rectified or part of a larger cost-cutting exercise?

The service for secondary care patients has only been given a 12-month extension. Funding for primary care staff, like GPs, has also only been extended until the end of March 2025. The NHS said it is carrying out “a wider review of mental health support for all NHS staff.”

So could this be simply a year-long stay of execution for NHSPH? 

“We sincerely hope not, and that it remains a permanent service. It seems a relatively small amount of money to spend to keep thousands of doctors over the years in their workplace,” said Fernandes.

“You just have to look at the NHS staff survey to show that people need it. NHSPH needs to be made permanent. I think the NHS should speak to clinicians, people working in the NHS and charities like us, to get a broad view of what’s needed,” added Basile.

In a statement on X, the BMA said: “We now need assurance that the review will lead to equal or better provision of mental health support in the future.” 

Another organisation that wants guarantees about mental health support for NHS staff is the British Psychological Society. Its President-elect, Dr Roman Raczka, told Medscape News UK: ” The evidence is clear that long-term investment at scale in staff mental health support is needed and funding needs to be ringfenced and protected. We haven’t yet had any further detail from NHS England as to the full scope of the review and timescales, however we will be paying close attention and hope there will be the opportunity for the British Psychological Society to be able to input into the review.”

The NHS has been trying to give assurances. CEO Amanda Pritchard posted on X: “We will review the mental health offer for all staff so that we have the right services that reach the whole workforce that are sustainable for the future.” 

Susannah Basile hopes that really is the case. “NHS England needs to put the mental health of its healthcare workforce front and centre and not see it as an added extra. It needs to be an essential part. Many people are leaving the profession due to poor mental health. If you look after your staff, you will have a happier and healthier workforce.”

Siobhan Harris has been a health and medical journalist for WebMD/Medscape since 2009. She has a law degree from the University of Sheffield and a postgraduate diploma in journalism. She has also worked as a national/international news journalist at ITN, BBC, and BFBS Forces News.