Christine Vize et al (Psychiatric Bulletin, February 2008, 32, 44–45) advise us against any loss of momentum in this revolution of our working practice. Previous debates on community care and home treatment were clear and based on significant background information, whereas New Ways of Working is unclear what it is about (other than the abandonment of traditional out-patient clinics) and is not supported by evidence.
It would be easier to join this bandwagon if it was clear where it was coming from and heading to. The movement originated from recruitment and retention problems in psychiatry but has moved on to attempt to optimise functioning of multidisciplinary teams. The real stress in adult psychiatry never came from dysfunctional multidisciplinary teams but rather emerged from unrealistic expectations about our ability to curb violent patients. Nothing in New Ways of Working will address this.
The term has become divisive with its denigration of previous patterns of service and its unwillingness to let the evolutionary processes that have worked well over the past 20 years continue to take their course. I do not agree that the body of the profession has been ‘one of the biggest single drivers’ of New Ways of Working which is about changing professional roles on a wide scale. The College will not be able to control New Ways of Working either. It is time for a more cautious approach to the change incompatible with such a phrase as ‘new ways of working’.
Declaration of interest
M.G. has been a General Adult Consultant Psychiatrist for 14 years.
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