ABSTRACT
At the present time, the National Health Service is facing serious problems. In job planning in the past, it was not always easy to work part time. In addition there were specific challenges for those working in psychiatric services. With the development of new talking therapies other disciplines such as psychology, social work, nursing, counsellors, etc. have quite rightly got involved many of whom are excellent therapists. The Lansley reforms introduced by the coalition government led to a fierce debate about their implications for services. The challenges faced by clinicians and doctors in particular not choosing to go into management did create tensions. Covid pandemic showed the advantages of having a truly national health service, but it also showed some key deficiencies. Pandemic exaggerated and illustrated already existing problems about workforce, resources, and social care. Integration of health and social care is a key step for the future. For many services national standards are necessary but the delivery has to be local. There remain many problems in the system which need urgent corrective measures.
