"Adult mental health- inpatient and out patient care Nottingham. NHS commissioning. GP services Nottingham."

About: NHS Nottingham West CCG Priory Group Limited

(as the patient),

I was recently discharged from a 6 week stay in an acute mental health ward at The Priory Hospital Nottingham. All the staff were highly trained and offered excellent care. This included access to 1: 1 therapy on a weekly basis, as well as group therapy twice weekly. Before being discharged I was promised what appeared to be a satisfactory package of care, but unfortunately this has yet to materialise. Although a therapy referral has been made, this was only done post discharge and there is now an 8 week wait for an initial assessment and then a further wait before the therapy can start. I have been told that I am not stable enough to begin the psychodynamic therapy for which I was originally assessed, many months ago, so access to this remains on hold. In the mean time I have fortnightly appointments with a 'care co-ordinator' who has yet to offer me any therapeutic input. In addition I have had to wait 3 weeks for a medication review with my out patient psychiatrist. Initially this was a 5 week wait which I have managed to bring forward due to difficulties with my medication. In the mean time I have had to stop taking one of my medications due to side effects, something I was advised against doing before a review with my psychiatrist. However five weeks is a long time to suffer what have been both uncomfortable and distressing side effects.

I strongly believe that the difficulties that led to my inpatient care were in a large part down to the extremely poor care I received from my GP. He is a single practice GP and during each and every appointment in the months leading up to my admission he failed to read any of the communication from my outpatient psychiatrist. The appointments were always rushed and he spent the time typing up my notes as he went along and thus not listening to or making any eye contact with me. He also answered his iphone during appointments, as well as allowing other members of staff to walk in unannounced to sign off prescriptions or answer questions. Often I would be mid sentence when he would suddenly stand and declare the appointment over and offer a patronising comment such as 'Don't worry it will be ok', as he opened the door to show me out. This inabilty to listen to me properly and observe the difficulties I was having, led him to over prescribe benzodiazapine medication on many occasions.

Over several months I soon became dependant on these medicines and as my anxiety increased I was also hospitalised due to over dosing. Even after being discharged and advised quite clearly not to take any benzodiazapine this GP again began prescribing me the same sleeping medication albeit this time on a weekly basis. My partner became very worried about this and we decided that it was essential to look for another GP practice. This time I was determined to find a GP with mental health training and experience. Unfortunately due to our address being on the 'wrong' side of the A52 this search proved to be a huge challenge. Eventually, we did find a practice willing to take me on and I was delighted to see information and advice about mental health on their website. Also many of the Doctors clearly had experience and special interest in mental health which was detailed in their biographies.

I had appointments with two GPs here and have not been disappointed. Both doctors offered extremely good care and I felt that at last I could relax and know that I was in safe hands. I was therefore extremely distressed to be told by my care co-ordinator that this General Practice didn't commission services with my secondary health care team and I would therefore have to move to the city team. After what I have been through throughout the past few years this news has come as a devastating blow. I have an excellent relationship with my current psychiatrist and strongly believe that, along with my new GP I am at last on the road to recovery. If I am forced to change psychiatrist or move to yet another GP, I am in absolutely no doubt that this will have an adverse effect on the state of my mental health and thus the well being of my family as a whole (my eldest daughter continues to struggle with anorexia nervosa). I therefore wish to plead to the NHS managers and commissioners who have the ability to change this situation to allow me to remain under the care of my current psychiatrist and GP. Surely in the long run this makes sense not only my well being but also financially for the NHS trust. I certainly don't want to be hospitalised again at great cost to my family stability and of course huge financial cost to the NHS.

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Response from Patient Opinion

Posted on behalf of NHS Nottingham West CCG:

"Thank you for taking the time to post your feedback on Patient Opinion.

Could I request that you make contact with the Clinical Commissioning Group (CCG) Patient Experience Team on 0800 028 3693 (option 2) so that we can discuss this matter further and identify a way forward”

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