Talking therapies services in Derbyshire will move to private providers in 2025, as the current NHS provider, Derbyshire Healthcare NHS Foundation Trust, has decided not to bid for the new contract.
As a result around 80 staff will have to leave the NHS whether they want to or not, and into the employ of a private provider.
Derbyshire Healthcare NHS Foundation Trust’s decided not to bid for the new contract as it considers the budget of £65 million over five years, or £13 million a year, set by the Derby and Derbyshire Integrated Care Board (ICB) as not sufficient to cover the service.
The contract is set to begin 1st July 2025 and last 3 years with the option to extend the contract for a further 2 years.
Having run the talking therapies services for almost 16 years, the NHS trust has built up a team of trained staff who will now be forced to move out of the NHS. There is the possibility that they will be moved to a private company that has opted out of Agenda for Change meaning pay and working conditions will be under threat.
Staff, in association with Unison, are campaigning against the decision and have set up a petition that can be signed here.
At no point have the staff involved or the people of Derbyshire been consulted about this change to provision to a privatised service, notes Paul Hardy from Derbyshire Unison in a letter to the media outlining Unison and staff concerns.
“The people of Derbyshire have not been informed about this, no-one’s asked them if they want [mental health services] privatised”.
There are many concerns about what a service run by a private company on a much lower budget would look like, with fears that cost cutting to keep to budget and make a profit will mean patients do not get offered the same standard or length of treatment as at present. With patients being encouraged to accept the cheaper guided self-help approach at an earlier stage in treatment, which could have negative consequences in the long run for patients.
Another concern is the willingness of a private provider to work with more complex clients as these require more sessions with the consequent increase in costs. There is currently a massive gap between the talking therapies service and Community Mental Health services which already leaves many people without the help that they need, or waiting for years for it. The lack of investment in talking therapies will inevitably lead to an increase in the pressure on the Trust’s other mental health services.
Ultimately as Paul Hardy notes, once a service has been privatised the service and all its expert staff trained by the NHS will be lost from the NHS.
“Once these services have moved away from being directly run by NHS Trusts, there is little or no prospect that they will be regained in the future.”
As well as being bad for patients, there are concerns for staff as there is no guarantee that employment terms and conditions will remain the same, i.e., under Agenda for Change, once they have had to move out of the NHS. Indeed, the other large provider of talking therapies in Derbyshire, the private company Trent PTS, has recently exited from Agenda for Change conditions of employment opening the way to pay its staff less.
However, despite cost cutting, Trent PTS is also not continuing with its service to the NHS after March 2025, due to the lack of budget, leading to more uncertainty and upheaval for patients.
Trent PTS recently noted the cost pressures associated with providing the service given that “funding levels have not increased since 2021.”
Despite the cost pressures, the talking therapies services in Derbyshire had been performing well according to ICB board papers from a meeting in July 2024 with NHS Talking Therapies services in the area “Continuing to exceed national standards re 6 week wait (86%, standard=75%) and 18 week wait (99% standard=95%)” plus “Recovery rates all achieving or exceeding national target”.
However, now the Talking Therapies service is a victim of pressure from NHS England on Derbyshire ICB to not exceed a deficit of £50 million by 2024/25 year end. As a result the ICB is currently trying to make savings of £169.7 m under its Cost Improvement Programme (CIP).
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