Mental health appointments for elderly cancelled over 'staffing pressures'

The Belfast Trust has apologised to patients after having to cancel some appointments with a service that provides mental health support for older patients.

An email, seen by BBC News NI, was sent to GPs in the trust area saying there would be no new or follow-up referrals to the Psychiatry of Old Age Service.

The trust said it was due to ongoing staffing pressures, including "significant sickness absence and vacant posts".

In an email to GPs, the trust said the measure had been implemented "to protect patient safety and ensure that remaining clinical capacity is deployed appropriately and safely".

The email advised GPs of developments within the Belfast Health and Social Care Trust (BHSCT) Psychiatry of Old Age Service - a community-based service that provides assessment and review of older adults following referral from GPs, which ordinarily operate with a target waiting time of nine weeks.

It said due to the ongoing staffing pressures it "had to temporarily stand down new and review appointments within the Psychiatry of Old Age Service".

It also said it was not in an position to offer the hospital liaison service for older adults.

It advised GPs to continue to submit referrals as usual and said the service would continue to triage all referrals, with the remaining workforce focusing on "prioritising urgent or high-risk referrals for assessment and intervention".

"While routine appointments cannot currently proceed, the team remains committed to ensuring that individuals presenting with urgent or escalating concerns are identified promptly and offered an appropriate response," it said.

The email added that the Community Mental Health Team for Older People was "actively providing support, advice, and follow up to individuals whose appointments have been cancelled".

It said it recognised "that these temporary measures will present challenges for patients, families" and said the trust was "working diligently to stabilise staffing levels, restore capacity, and safeguard patients during this period of disruption".

Dr Ursula Mason, who is the chair of the Royal College of GPs in Northern Ireland, said the trust's letter marked a "significant change" to services for older patients.

"Obviously as it stands that's really quite concerning for the patients that we look after, particularly those who are in significant need for access to mental health services and are now potentially facing a delay in service and not really knowing what that will look like," she told BBC Radio Ulster's Evening Extra programme.

"It will not only have a huge knock on effect for patients that we see, but also have an impact in terms of GPs' workload as well."

Dr Mason said there is a "huge number" of patients who comes through general practice who need support before needing to be referred out, and it's these patients who will be most affected.

She said this decision will lead to "difficult conversations or consultations" for both patients and doctors, and could leave some wondering why the services are impacted by a so-called "postcode lottery".

Siobhan Casey, the Commissioner for Older People for Northern Ireland, said she was "deeply concerned" about the announcement from the trust.

"Unfortunately this development is something that I'm hearing about right across Northern Ireland in terms of healthcare cuts and how services are being diminished for older people, they're being eroded for older people," she told Evening Extra.

"I'm hearing day and daily that people are feeling increasingly shut out of the health and social care system and the services are disappearing before their eyes."

Casey said the scaling back of services for older people, were making them feel "less worthy" and "vulnerable".

"There's so many things that's been said by the government at the minute in terms of prioritising older people, and there seems to be an intent there within government to do that but it's not the lived experience, it's not what I'm seeing people feeling on the ground," she added.

The commissioner questioned how this would effect patients who are waiting on a dementia diagnosis, as well as their family and carers.

"This in particular is concerning because we know there's long waits for dementia diagnoses and that dementia pathway isn't in place for people and that means there's a door into that service so it's particularly worrying," Casey said.

In a statement to BBC News NI, the Belfast Trust said the measures had been taken to "protect patient safety and ensure that remaining clinical capacity is deployed appropriately and safely".

"Belfast Trust sincerely apologises to everyone who is affected by this.

"We are keeping this situation under close review and we are continuing to seek additional staffing to support the service."