NHS staff in Scotland who have borne the brunt of the pandemic are facing prescription charges and journeys to England for crisis mental health treatment.

Health Secretary Humza Yousaf last week announced an £8million package of measures to improve wellbeing, including dedicated services for health and social care staff.

NHS staff will have access to a crisis helpline, counselling and rest spaces in hospitals, leading to the eventual creation of a National Wellbeing Programme for NHS staff. The UK government announced similar measures in October last year.

The funding, which is an increase of £3million on the previous year, has been described as an important step by doctors' leaders. However, questions have been raised after it emerged assessment and treatment will be provided by clinicians and therapists based in England. 

The policy document states that initial appointments will take place online. and if medication is required, such as anti-depressants, staff will face a £9.15 prescription charge.

For those who require more specialised treatment such as addictions therapy, "this may involve travelling to England to one of the government's approved providers". 

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The government said it is an interim arrangement and services will begin to be established in Scotland over the next few months. 

However, Scottish Labour said questions were piling up about the scheme that could see staff "out of pocket" and travelling miles for appointments.

The British Medical Association (BMA) said it would have have preferred to see an extension of existing Scottish services and said it would be raising the prescription charge issues.

Labour's Health spokesperson Jackie Baillie said: “After everything NHS and social care staff have had to face during the pandemic, access to specialist support is a good idea. 

“However, the SNP should have put the work into setting up a service that actually works for Scottish staff instead of piggybacking off the English one.

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“These half-baked proposals could see staff being out of pocket for prescriptions and travelling miles for appointments.

“We need clarity urgently on how this will work in practice and when services will be available in Scotland.”

The guidelines state that if tests or investigations are necessary, a local provider will be needed for support but does not provide any further details. Staff are advised that they may be able to request prescriptions from their own GP.

It is not clear if NHS staff would be prioritised for crisis support.

It comes after a major study looking at the psychological effects of the pandemic on NHS staff found mental health problems quadrupled during the first wave.

Being female, single, young, working on the frontline, and a manager, were all associated with severe psychiatric symptoms. Nurses also had worse mental health symptoms than doctors, the study by Roehampton University found.

Dr Patricia Moultrie, Deputy Chair of the BMA’s Scottish Council said: “It is difficult to overstate the impact the pandemic has had on the profession – and the need for such specialist treatment for doctors was there even before that. 

“So moving quickly to get the WSS in place was the right thing to do. The priority was to have the service available immediately to those that need it while the Scotland delivered service is developed.

“On prescriptions, it is important that the service is able to prescribe directly to Scottish users of the service, this is an important part of a confidential service and we will be working with the service to consider the prescription charge issue further.

“We also need to be assured that pathways are in place to access necessary testing and investigations for safe initiating and monitoring of treatment. 

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“The Scottish Government, as commissioners of the service, need to ensure that these are robust and in place within Scotland.”

She suggested that some NHS staff may prefer the anonymity of accessing treatment south of the border.

She said: “Facility for inpatient management of addictions is important and whilst providing this within Scotland may be a good option for some, travelling to England may provide higher levels of confidentiality and may be preferred by some users of the service – so again the most pressing aspect is to have the facility available.

“These are important developments, but are best done building on a service which is already available – rather than delaying the start to get them in place. Indeed we will be monitoring development of the service consistently to ensure it is meeting the needs of doctors.”

A Scottish Government spokesperson said: “The wellbeing of health and social care staff is a key priority, and we are committed to supporting them now and into the future. 

“That is why we are offering an unprecedented package of wellbeing support totalling £8 million, which will continue the 24/7 National Wellbeing Helpline, the National Wellbeing Hub and Coaching for Wellbeing as well as developing further practical support measures and additional resources for Boards. 

“The Workforce Specialist Service is being delivered digitally on an interim basis by NHS Practitioner Health while the service is designed to integrate in the Scotland healthcare system. 

“It is a primary care-led mental health service for regulated health and social care professionals who can experience barriers to accessing confidential care.

“We are keeping this interim provision under review to ensure that it is as accessible as possible to those health and social care professionals who need it.”