Mental health and learning disability
In the region of 1.5 million people are referred to NHS mental health therapy services every year, with around 200,000 people being substantively employed by the NHS to care for the people who need these mental health services. However, building and maintaining a qualified workforce of committed staff can be particularly challenging in mental health and learning disability services. The nature of the work is incredibly demanding and requires dedicated, compassionate individuals and relies on a multitude of different health professions. There is also significant competition from those providing private mental health services, with more flexible working patterns and better pay.
Part of the £1.8bn investment detailed in the 2016 Mental Health Five Year Forward View was to recruit and retain a sufficient mental health workforce in order to deliver and support delivery of more accessible services. Since 2017, the number of professional mental health staff has grown by over 7,300 (8.2%) which is around the level needed to meet the target of 11,000 additional mental health professionals by 2020/21. On top of this, the Mental Health Implementation Plan published in 2019 outlined ambitions to increase the number of mental health professionals by some 27,000 by 2023/24.
About the target: Health Education England’s 2017 mental health workforce strategy sets the ambition that an additional 11,000 mental health staff from “traditional” pools of professionally regulated staff (such as nurses, occupational therapists and doctors) to be employed by 2020/21. The exact professions that this target is aimed at is not clear, but we have used the new definition of mental health workforce which narrows the focus on staff actually providing (or supporting provision of) mental health services, rather than the old definition which looked at all staff working in mental health trusts.
Mental health nurse numbers have been in decline in the last few years, despite the increase in demand for mental health services. Applied psychology and psychological therapy staff are allied health professionals working in mental health services. They comprise a variety of different roles, such as therapists, scientists, technicians and managers. As at March 2020, the number of mental health nurses appears to have decreased by 11.6% since September 2009, though there are signs of this slowly increasing by 1,300 over the past year. In contrast, allied health professionals working in mental health have increased by 75% since September 2009.
About the target: Health Education England’s 2017 mental health workforce strategy outlined ambitions for an additional 8,100 mental health nursing and midwifery staff, and 4,200 more allied health professionals working in mental health. More recently, the 2019 Mental Health Implementation Plan stated an ambition of 4,220 mental health nurses in addition to the initial HEE target of 8,100.
In 2015, the Migration Advisory Committee listed core psychiatry as an occupation experiencing a high rate of staff shortages. More recently, there has been an effort to address this gap, and although there has been a 3.8% increase since 2015 (equivalent to 160 full-time consultants), at present the numbers do not seem to be enough to meet the target set by Health Education England.
About the target: The target of 570 additional consultant psychiatrists by 2020/21 was part of Health Education England’s mental health workforce strategy. The source of the figures in the strategy detailing the current number of posts in psychiatry has not been referenced, so caution should be taken when comparing the target to the data we have used for numbers of consultant psychiatrists.
The number of learning disability nurses has been in significant decline over the last 10 years. As of February 2020, there had been a 2,300 decline (-41.3%) of these nurses since 2009. In July 2019, Health Education England announced a commitment of £2m to boost the learning disabilities nursing workforce, which is intended to have some impact on numbers in forthcoming years.