Fishermen's clinic saves lives: A model the NHS must follow

Mental Health Services in Leicestershire: An Unacceptable State of Affairs

By: James BlairIn my day, if something needed fixing, you jolly well fixed it. You didn't tinker about the edges whilst people suffered. The latest inspection report on Leicestershire Partnership NHS Trust's mental health services reveals waiting times that would have been unthinkable when this country's institutions functioned properly. Between April 2024 and March last year, waits for psychology support from community mental health teams averaged 351 days. In East Leicestershire, the average wait was 599 days, the report said. That's nearly two years for people in genuine distress to receive the help they desperately need.[bbc.co]​More than 700 people had been waiting at least 12 months to be seen by the adult community mental health service, and staff had not carried out 2,149 follow-up appointments in the same timeframe. These aren't mere statistics—they represent real people, taxpayers who've paid into the system their entire working lives, left languishing without proper care.Systemic FailureThe report said leaders had processes in place to identify risks, but these plans did not always address them in enough depth or with suitable timeframes to make improvements. In plain English, they knew what was wrong but couldn't be bothered to fix it properly. The trust was told to produce a plan showing what action it was taking in response to these concerns, and the CQC confirmed it had been submitted.[bbc.co]​Previous concerns over medical equipment and making people aware of their rights had been addressed, inspectors found. Small mercies, one supposes, though rather like congratulating the captain of the Titanic for polishing the brass whilst water poured through the hull.The Care Quality Commission inspection, conducted in May last year, uncovered three new breaches of regulations concerning waiting times, caseload management, and overall service governance. Following the inspection, a warning notice was issued emphasising the urgent need to reduce waiting times for outpatient appointments, which currently average 133 days.This isn't merely a Leicestershire problem—it reflects a nationwide crisis in mental health provision that's been decades in the making. According to recent analysis, those waiting longest for adult community mental health care (727 days) have waited twice as long as those waiting for elective care (315 days). Four in five people (80%) experience deterioration in their mental health whilst waiting for support.The average wait for first therapy appointments across the country stands at 28 weeks, with significant regional variations ranging from 12 to 40 weeks. For Children and Adolescent Mental Health Services, some trusts report waits exceeding two years. What sort of country allows its children to suffer for two years before receiving help?The mental health crisis costs the UK economy over £150 billion per year. That's real money being frittered away because we can't organise services properly. When I was working, businesses that performed this poorly went bankrupt. Yet here we are, year after year, tolerating mediocrity dressed up as "improvement".'Encouraged'The sites visited during the inspection included Merlyn Vaz Health and Social Care Centre, Loughborough Hospital, Maidstone Centre, Orchard Resource Centre, OSL House, Melton Hospital, Hawthorn Centre and Braunstone Health and Social Care Centre.Ceri Morris-Williams, deputy director of mental health in the Midlands for the CQC, said: "While it was encouraging to see the LPT had made improvements in some areas, our inspection team still had concerns about community mental health services in Leicestershire. Some people waited a long time to receive the outpatient appointments they needed, which could potentially have had negative effects on their mental health"."Potentially have had negative effects"—what careful, bureaucratic language. Let's speak plainly: when someone suffering from severe depression or anxiety waits nearly two years for treatment, their condition worsens. Some may take their own lives. Others may lose their jobs, their families, their homes. These aren't potential negative effects—they're predictable, preventable tragedies.Despite the concerns, inspectors said many service users found staff were kind, supportive, and treated them with dignity and respect. One can hardly fault the frontline staff who, I'm quite certain, are doing their level best with inadequate resources and impossible caseloads. The failure lies with management and, ultimately, with successive governments that have allowed this situation to develop.Angela Hillery, chief executive of LPT, added: "Whilst the overall rating has remained at requires improvement, I am encouraged that our ongoing improvements have been recognised with a good rating in three of the five domains that the CQC uses to make its assessment - safe, effective and caring - compared to two out of five when they last inspected adult community mental health services"."Encouraged" seems a peculiar choice of word when 700 people have been waiting over a year for treatment. In my world, you don't congratulate yourself for marginal improvements when the house is still burning down. You acknowledge the crisis, take responsibility, and implement wholesale reforms.What's Gone Wrong?The NHS, for all its virtues, has become a bureaucratic behemoth that's lost sight of its fundamental purpose: treating patients promptly and effectively. The LPT has stated that measures have been implemented to reduce waiting times, including hiring five new consultants. Five consultants to address a backlog of hundreds? It's rather like sending a boy to do a man's job.The CQC rates services across five domains: safe, effective, caring, responsive, and well-led. Leicestershire Partnership NHS Trust now achieves "good" ratings in safe, effective, and caring—but continues to "require improvement" overall. The problem lies in being responsive to people's needs and in leadership. When people wait 599 days for psychology support, the service is manifestly not responsive. When management has "processes in place to identify risks" but fails to address them with "suitable timeframes", leadership is lacking.This country once led the world in healthcare provision. The founding principle of the NHS—that treatment should be based on need, not ability to pay—was fundamentally sound. What's changed is the scale, the complexity, and frankly, the competence of those running these vast organisations.We need managers who understand that "requires improvement" is not an acceptable permanent state. We need politicians with the courage to make difficult decisions about funding and reform. Most importantly, we need to remember that behind every statistic is a person—a mother, a father, a son, a daughter—suffering whilst we debate process improvements and domain ratings.Until we return to the basic principle that waiting nearly two years for mental health treatment is simply unacceptable, no amount of "encouraging" progress will suffice. Our fellow citizens deserve better, and in a civilised country, they should receive it. Direct quotes from this article: Community Mental Health Services Leicestershire