At least 4,600 extra crisis care nurses are to be created as part of a major workforce plan announced by the government today to improve mental health services.
The increase will include extra nurses, therapists, psychiatrists, peer support workers and other mental health professionals, and will total 21,000 additional mental health posts.
“We know we need to do much more to attract, retain and support the mental health workforce of the future”
The government said there would be a particular focus on services with projected shortfalls due increasing demand. This will mean the creation of an additional 4,600 nurses working in crisis care settings – as well as 200 extra therapists, it said.
A total of 2,000 additional nurses, consultants and therapist posts in child and adolescent mental health services will also be secured.
In addition, an extra 2,900 therapists and other allied health professionals will help support expanded access to adult talking therapies.
Meanwhile, “significant increases” in posts will also occur to boost perinatal mental health support, liaison and diversion teams and early intervention teams working with people at risk of psychosis.
The workforce plan – titled Stepping Forward to 2020-21: Mental Health Workforce Plan for England – has been developed jointly by Health Education England, regulator NHS Improvement, NHS England, the Royal College of Psychiatrists and other mental health experts.
“If these nurses were going to be ready in time, they would be starting training next month”
The government, which described the plan as “ambitious”, set out six ways that the workforce increase would be achieved.
For example, it highlighted improvements in how employers retained their existing mental health staff, including targeted support for 20 trusts with the highest rates of clinical staff exits.
There would also be a national retention programme, run by NHS Employers, and initiatives to improve career pathways and bolster access to training and development opportunities.
In addition, the plan pledged action to improve the mental health and “resilience” of its workforce.
Health Education England will deliver a programme to improve awareness of mental health among NHS staff.
It will also explore how to support trusts in recruiting and training staff from abroad to meet short term recruitment needs, said the government.
Like the general practice nursing action plan, launched by NHS England last week, the mental health initiative will include major “return to practice” campaign.
Led by Health Education England, it will aim to encourage some of the 30,000 trained mental health nurses not substantively employed by the NHS to return to the profession.
NHS Employers will also work with providers to develop more flexible and supportive working environments and help more of them to draw on the skills of recent retirees, said the government.
In addition, it promised a new action plan to attract more clinicians to work in mental health services and psychiatry, and the development and expansion of new professional roles to help “create more flexible teams and boost capacity”.
This would enable clinical staff to spend more face-to-face time with patients, by providing more support staff to take on the non-clinical tasks, said the government.
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Health secretary Jeremy Hunt said: “We want people with mental health conditions to receive better treatment, and part of that means having the right NHS staff.
“We know we need to do much more to attract, retain and support the mental health workforce of the future – today is the first step to address this historic imbalance in workforce planning,” he said.
“As we embark on one of the biggest expansions of mental health services in Europe, it is crucial we have the right people in post – that’s why we’re supporting those already in the profession to stay and giving incentives to those considering a career in mental health,” said Mr Hunt.
“These measures are ambitious, but essential for delivering the high performing and well-resourced mental health services we all want to see,” he added.
Mr Hunt has previously identified mental health as a priority area for Department of Health policy, but recent weeks have seen yet more concerns raised about the challenges faced by the sector.
“Over the last eight years the workforce has been decimated”
Less than two weeks ago, a regulator warned that mental health services were under “significant and increasing” pressure, with a continuing decline in the number of mental health nurses.
The Care Quality Commission highlighted a crash in mental health nurse numbers over the past seven years as “underpinning” a range of concerns facing the sector.
Meanwhile, earlier this month, Nursing Times exclusively revealed that mental health nurses had called on the prime minister to acknowledge the “drastic decline” in their numbers in recent years and to “urgently” reverse cuts to the profession.
Union Unite, which includes the Mental Health Nurses Association, wrote to Theresa May noting that since 2010, the number of whole-time equivalent mental health nurses in England had reduced by around 5,000 – or by 12%.
A hard-hitting report from the Royal College of Midwives also recently called for “appropriate and sustainable care” to be an “expectation and a right” for all women who experienced maternal mental health problems.
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Responding to today’s announcement, Janet Davies, chief executive and general secretary of the Royal College of Nursing, welcomed the government’s “laudable ambition” but claimed its policies did not appear to add up.
“If these nurses were going to be ready in time, they would be starting training next month,” she said. “But we have seen that the withdrawal of the bursary has led to a sharp fall in university applications and we are yet to see funding for additional places.
“There is already a dangerous lack of workforce planning and accountability and this report is unable to provide detail on how the ambitions will be met,” said Ms Davies.
“It is clear the government will need to work hard just to get back to the number of specialist staff working in mental health services in 2010,” she said. “Under this government, there are 5,000 fewer mental health nurses and that goes some way to explaining why patients are being failed.”
She added: “We welcome the development of new supporting roles but their responsibilities must be clearly defined to avoid down-banding or substitution. There must also be recognition of the excellent support roles already in place.”
Dave Munday, lead professional officer for mental health at Unite, said: “When Jeremy Hunt speaks of a ‘historic imbalance’, he seems to be totally unaware of the significant part he’s played in creating this imbalance.
”Since the Conservatives came to power in 2010, the number of mental health nurses has decreased by 5,067. If that number had kept pace with population growth, rather than being cut by 12.5%, we would now have 7,094 more (42,657 rather than the current 35,563),” he said.
Mr Munday said the plan did ” not go anywhere near far enough” to rectify the fall in staff numbers, arguing instead that the government should end the 1% pay rise cap and reverse its recent scrapping of bursaries for nursing course.
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He also highlighted the current fall in health visitor numbers as evidence that the government’s ”track record on achieving workforce improvements has not been good”.
“A recent Department of Health expansion plan, the Health Visitor Implementation Plan, missed its target, and since its formal finish, the number of health visitors has been cut by 14%,” said Mr Munday.
“In light of today’s promise that ‘perinatal mental health support’ will be improved, this cut is even more devastating,” he said.
He added: “In developing this plan, there has been little engagement with mental health nurses despite them offering constructive solutions to the problems highlighted. This offer remains in place.”
Danny Mortimer, chief executive of NHS Employers, said: “The government and NHS England have rightly prioritised mental health services.
“This focus on the workforce that provides this care is hugely welcome – especially given the pressures and challenges staff are facing,” he said.
“Service providers will absolutely play their part in delivering this ambitious plan,” he said. “They will also look forward to national support, particularly for improved access to funding for continuing professional development for the mental health workforce, and facilitating increased use of international staff where required.”
Alan Simpson: ‘Peer support in mental health needs a welcome, not wariness’
Alan Simpson, professor of collaborative mental health nursing at City, University of London, said the plan revealed the “major challenges” facing mental health services, adding that the sector’s workforce had been “decimated” over the last eight years.
“Mental health nurses posts – the bedrock of care and treatment – has fallen more than any area of nursing since 2009 and more than the rest of the psychiatric workforce,” he said. “There is a lack of psychiatrists with few medics choosing psychiatry.
“The attrition rate for mental health staff is almost 14% – much higher than in other parts of the health service,” he said. “The removal of nursing bursaries, the pay cap and Brexit add to the problems.”
Professor Simpson added: “There are some fantastic mental health staff and services out there but this has been due to heroic efforts by managers, clinicians and other staff against a relentless undermining of services through austerity and the failure to ensure allocated budgets reach mental health.”