This week saw welcome attention in Westminster focused on mental health care, but as ever there were caveats and, as usual, they mainly concerned nurse staffing levels.
The chancellor revealed in his autumn budget statement on Monday that the government planned to introduce a raft of measures designed to support mental health care, including a new crisis service.
Philip Hammond described it as a “sneak preview” of what the new NHS 10-year plan would include ahead of its release later this year. “There are many pressing demands on additional NHS funding but few more pressing than the needs of those who suffer mental illness,” he told the Commons.
“I can announce that the NHS 10-year plan will include a new mental health crisis service with comprehensive mental health support available in every major A&E, a children and young people’s crisis team in every part of the country, more mental health ambulances, more safe havens in the community and a 24-hour mental health crisis hotline,” he said.
“People in the sector are telling me that they are concerned about the pressure it faces”
The announcement fits well with the growing recognition that mental health requires a much higher profile and that, thankfully, stigma associated with mental illness seems to be declining.
But I am becoming increasingly concerned about the state of mental health nursing. This is because people in the sector are telling me that they are concerned about the pressures it faces.
We have warnings that the shortages of learning disability and school nurses have already reached the point where services are being hampered as a result. We must not sleepwalk into the same situation with mental health.
The latest workforce figures, published this month by NHS Digital, reveal that the number full-time nurses working in the mental health sector in England was 35,374 in July this year. The spreadsheets reveal a steady decline since January 2011, when the number of full-time equivalents was last above 40,000; that represents a decrease of nearly 5,000 – or just under 13% - in less than eight years.
This week, nursing commentators lined up to welcome the chancellor’s comments on mental health, but they also highlighted that the plans would be reliant on appropriate staffing.
For example, Dame Donna Kinnair, acting chief executive of the Royal College of Nursing, questioned how the new crisis service would be created when the mental health nurse workforce was shrinking. She said: “It’s difficult to see how this vision will be realised without a sufficient, well-trained nursing workforce.”
“Any rhetoric on mental health must be backed by the necessary resources, namely nurses”
Likewise, Sara Gorton, head of health at Unison, said more needed to be done to support the mental health workforce. “Promising more funding is one thing – actually delivering is another,” she said.
Meanwhile, Sean Duggan, chief executive of the Mental Health Network, which is part of the NHS Confederation, noted that the “scale of the challenge the sector faces cannot be underestimated”.
Even the regulator set out concerns. Geraldine Walters, director of education and standards at the Nursing and Midwifery Council, called for funding to be allocated through the 10-year plan to cover continued professional development for the nurses staffing the new mental health services.
The message is clear – any rhetoric on mental health must be backed by the necessary resources, namely nurses. Not to do so is making false promises. The much-vaunted 10-year plan must take into account these workforce needs as well if it is to be worth the paper it’s written on.