Well, its been a year full of twists and turns, and I’ve spent half of it on maternity leave. However, I still feel like the other trust winning the competitive tender was the death knoll for a brilliant CAMH service. I am now employed by a load of managers and medics who seem to care more about the figures than the people who use and work for the service.

In a devious bit of manouvering I was told I could keep my Consultant banding and post if I agreed to manage the LAC service. What they didn’t say was that I would never get to do any of the work I was appointed to do, as the Specialist Attachment Intervention Team has yet to be funded by commissioners and therefore doesn’t exist. Also, that they’d make it very hard for me to recruit a locum to cover my maternity leave, that the other psychologist in the team would also go on maternity, and that they would delay and then absorb 2 of the remaining 4 posts, leaving me with less team to offer a service to the whole county than we had to offer the service to half the county before the tender.

So, I’m being pressured to pick up bits of work in order so that the service doesn’t cave in. I already read all my emails, write the strategic documents, deal with recruitment, and supervise the other team members from home, but now they want me to offer a fortnightly consultation morning, and a monthly complex case clinic.

I feel so let down. The job I loved has become something so different I can hardly recognise it. Add to that the fact that some key colleages are no longer with us (my main link to social services, and inspiration around adoption has died, the social worker I linked most with has left to join a private provider, the 8B in the office next door me moved out of area and won’t be replaced, etc etc). Makes me wonder whether the NHS is all I thought it was as an employer 😥

Post script: I’m less negative about the situation today. I met with the CAMHS manager, and we have resurrected one of the band 7 posts, which will be out to advert in two or three weeks – hooray! In the end I used one day a week of the funding from my own post to make the difference, as I intend to work part-time for at least the next few years. Also, we are likely to absorb a few staff from a social services run team for placement support that is being reconfigured. They are also reassuring me that the bid for the attachment team is still live, and something high on the agenda for commissioners. Most importantly, there are shifts happening amongst the senior and management staff, which might put the people I hold in higher regard in places of more power, and lose some of the people I feel are less attuned to this being about people (staff, service users). Maybe by the time I return it will be a service I want to be part of after all!

18 months after that:

Well, 18 months on from my last post on this thread, 3 years on from losing the tender, and I still don’t like my new employing organisation. My team has shrunk from 8 WTE to 2.5 permanent and 1.5 temporary staff, despite having massively increased referrals (partly due to massive cuts in the parts of social services we used to link up with). We no longer have a named link medic and have to negotiate case by case with the 8 sector consultants in tier 3 camhs. We are in a new building which is lovely but half the size we need so most people have to sit in a ‘call centre’ of a shared office where people don’t even have their own desk or computer. My allocated (shared) office space has no internet or telephone access 14 months after we moved in to that room. You reach it by swiping out of the CAMHS offices into the fire exits, then swiping into the adjacent building, then going along a neglected corridor to the very end. If you don’t book a room in advance for every appointment it is not possible to find anywhere to see people. I feel like I am between a rock and a hard place – as a senior clinician I feel a responsibility to protect my team from burnout and to offer the clients a good service but I don’t feel like I can do either. I’m being asked to do many things yet not given the authority to get on with them. I feel like I am being asked to climb a cliff and no-one will take the handcuffs off. It doesn’t suit me to be grumpy and pessimistic when I am normally so enthusiastic and creative. And it is beginning to affect my health and the frame of mind I bring home to my family.

So, I’m going to take a career break from the NHS. It will be a year in which to explore other options. I’m quite excited about it. And if other people are curious I might just continue to blog about it here and report back how my foray into the brave new world goes…