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Boost to nursing workforce pledged in NHS mental health action plan

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Efforts to transform mental health services will require a significant boost to the size of the mental health nursing workforce, plans set out by NHS England have revealed.

The plans lay out expansions across a range of services including mental health liaison in hospitals, early intervention and crisis teams in the community, liaison and diversion work with offenders, and perinatal mental health.

NHS England has drawn up the proposals - plus the funding and workforce developments needed to achieve them – in response to a report earlier this year by an independent taskforce commissioned by the government to review mental health services.

”A significant expansion in workforce capacity for inpatient mother and baby units and in perinatal mental health community teams [will be needed]”

Implementing the Five Year Forward View for Mental Health report

The taskforce’s report – the Five Year Forward View for Mental Health – said mental health care in the NHS was “inadequate” and called for a series of changes to be made.

Goals set out in the implementation plan document published yesterday include ensuring all acute hospitals have mental health liaison teams in place by 2020-21, with at least half providing a round-the-clock service with teams able to care for both young people and adults.

To deliver this objective “the existing workforce capacity will need to increase”, said the plan. It suggested around £15million of funding for local sustainability and transformation plans will be allocated in 2017-18 to support the development of liaison services, increasing to £120million in 2020-21.

Guidance referred to in the report states that for a hospital with around 500 beds, a liaison team providing 24-hour cover will need at least six band 7 and seven band 6 nurses.

Another key goal is to eliminate all out-of-area placements for those with serious mental health problems within the next five years, which will require an expansion in crisis resolution and home treatment teams (CRHTTS).

”Additional investment will be deployed to ensure primary care staff feel confident in actively supporting people with severe mental illness”

Implementing the Five Year Forward View for Mental Health report

However, the plan acknowledges current pressures on acute mental health services and issues including inadequate staffing.

“The majority of CRHTTs are not currently sufficiently resourced to operate 24/7, with caseloads above levels that allow teams to fulfil their core functions of a community-based crisis response and intensive home treatment as an alternative to admission,” says the document.

As a first step all areas will be expected to review current provision this year and develop plans to meet core standards.

The plan also promises a total of £94 million from 2017 to 2021 to improve secure services. Funding will be used to test the development of more community-based support to prevent admissions and provide step-down services when people leave secure wards.

Meanwhile there may need to be a 45% expansion in the workforce providing liaison and diversion services to offenders, said the report, called Implementing the Five Year Forward View for Mental Health.

Teams are made up of practitioners from various backgrounds with a high proportion from mental health nursing. In total £92 million up to 2020/21 will be provided to boost capacity.

NHS England said it was working with national workforce planning body Health Education England to develop a number of innovative recruitment and training models.

Over the next five years £365 million will be invested in improving perinatal mental health services.

All women should have access to specialist services under the plan but currently most areas – 85% –have a service that does not meet official guidelines, or none at all.

”[This plan] will improve access and outcomes, reduce inequality and deliver efficiencies across the local health and care economy”

Claire Murdoch

“Delivering this objective will also require a significant expansion in workforce capacity both for inpatient mother and baby units and in perinatal mental health community teams,” said the document.

The funding will include a new perinatal community development fund to be set up this year. Local areas will be invited to bid for cash to develop specialist teams in the poorest-served areas.

Recent research identified serious gaps in nurse training when it came to some of the key mental health therapies that form part of new government standards for treating psychosis.

The implementation plans says HEE will deliver a programme “to ensure there are sufficiently numbers of appropriately trained staff to deliver the key interventions” including cognitive behavioural therapy and family therapy.

The plan also promises mental health training and support for staff working in primary care after a recent survey found 42% of practice nurses have no mental health training at all.

“Additional investment will be deployed to ensure that primary care staff feel confident in actively supporting people with severe mental illness to access relevant physical health screenings and interventions,” it said.

Claire Murdoch, NHS England’s new director for mental health, said the plan “will improve access and outcomes, reduce inequality and deliver efficiencies across the local health and care economy”.

Mind

Paul Farmer

Paul Farmer

“As well as setting out our expectations of the NHS, we have outlined how national partners will work together to provide the right enabling structures and frameworks, to support and help drive improvements in mental health over the coming years,” she said.

“Other organisations who have a role to play such as social care, employers, schools are also paramount to the success of this work. The need for action cannot be ignored. It is now up to all of us to make this a reality.”

Paul Farmer, chief executive of Mind and chair of the mental health taskforce, welcomed the report and said he would “keeping a close eye on progress”.

“The implementation plan is a step in the right direction, but we cannot afford to become complacent,” he said. “The job is just beginning and we must all play our part.”

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