“Non-urgent” direct mental health referrals in north Ceredigion have been paused as the number of staff vacancies has put patients at risk.

Ceredigion’s health board Hywel Dda introduced special measures “due to clinical risk” starting 3 March that have stopped referrals from GPs to mental health teams.

The changes lasting an initial six months will instead defer “non-urgent” GP patients to the phone service NHS 111, option 2.

An increase in mental health admissions in Ceredigion has been “directly linked to a reduction of care and treatment options in the community” due to these vacancies, according to a Hywel Dda report.

The report states that due to the high number of absent staff and abnormal level of sick leave from current staff, the decision was taken to prioritise critical community support over routine mental health assessments “at such a critical time of medical and nursing staffing deficits”.

This temporary change to referrals was put in place “to create capacity to deliver secondary care and respond to urgent crisis presentations” - including giving patients injections of anti-psychotic medication and patients under Mental Health Act orders.

This comes after north Ceredigion’s Consultant Psychiatrist left his position in November alongside “significant” medical and nursing vacancies, none of which have been successfully permanently filled - equating to close to six full-time staff in north, and close to three in south Ceredigion.

The report lists risks including an “increased number of serious and untoward incidents for an individual waiting for a routine assessment”.

Since the Consultant Psychiatrist left, the quality measure statistics for north Ceredigion’s patients have plummeted.

Currently only 56 per cent of north Ceredigion’s 147 patients have a care and treatment plan in place, compared to the 90 per cent required Welsh Government target.

Medical outpatients are waiting eight to nine months for an appointment, whilst others face a 42-day wait for routine mental health assessments, compared to the 28-day target.

The change means those referred for a mental health assessment will be assessed by a 111 practitioner instead of in-person by the community team.

Though GPs will still be able to refer urgent cases directly to the community mental health team, the default will be for the GP to instruct patients to call 111 for a phone assessment with a well-being practitioner and registered nurse.

The patient will receive a call from 111 themselves if they don’t call the service within 72 hours.

The changes aim to relieve the workload of the community team whilst reducing the 42-day wait time patients currently face for assessments.

According to the report, despite waiting up to 42 days for an assessment, less than 5 per cent of patients require ongoing care.

Mental health treatment in north Ceredigion has been reliant on the community mental health teams since the Bronglais in-patient ward closed in 2012.

Meanwhile, the lack of a Consultant Psychiatrist to lead the north Ceredigion teams is affecting “morale, staff retention and the potential to recruit” with “no consultant cover” and “unsuccessful recruitment” of temporary locum staff.