The NHS Long Term Plan, published last month, reasserted the government’s commitment to improving mental health services both for adults and for children and young people.
With a portfolio of improvements, the plan built on chancellor Philip Hammond’s Budget pledges, extended commitments in the Five Year Forward View for mental health and committed to proposals outlined in the green paper on young people’s mental health.
Financially it confirmed that mental health funding – provided through a ring-fenced investment fund – would outstrip total NHS spending growth in each year for the next five years.
In short, mental health investment will be at least £2.3bn higher a year by 2023-24. The plan also mandated that investment in children and young people’s mental health provision would grow faster than both the overall NHS budget and total mental health spending.
”The response from the King’s Fund spoke for many when it championed the ambitions of the plan”
Practically, the plan highlighted crisis response, liaison support in A&E departments, new and integrated models of primary and community mental health care, and new commitments to prevention and early intervention.
The response from the King’s Fund spoke for many when it championed the ambitions of the plan.
“The continued commitment to mental health services, and consistency of direction, is positive.
“Focusing on comprehensive support recognises that mental health services work best when integrated with each other and the wider health and care system,” it said.
But the respected health charity also sounded notes of caution.
“Improving core community mental health services has been neglected in previous plans and represents a significant (although as yet undefined) commitment.
“The plan’s focus on acute mental health services in particular will depend on recruiting enough appropriately skilled staff,” it said.
There can be little doubt that mental health nurses will be fundamental to the implementation of this plan and to the success of its strategies.
NHS Improvement director Seamus Watson is clear about the opportunities and challenges the plan presents for the specialty.
“The growing emphasis on promotion of mental health, the prevention of ill-health and improving the lives of people living with mental health difficulties is long-awaited and welcomed,” he wrote in an opinion piece for Nursing Times.
“As nurses, we are used to talking about services for people who are already experiencing mental health problems, but rarely speak up about the promotion of mental health and the prevention of ill-health.
“The opportunity to take on this new challenge has arrived. As nurses we are well-placed to lead the change.”
NHS workforce analysis published by the Health Foundation earlier this month, and reported by Nursing Times, is therefore particularly concerning.
While a big plan sets out big ambitions, this latest data identifies worrying trends in the workforce needed to support those ambitions.
The number of mental health nurses has risen by less than 0.5% over the past year. While the number working in community mental health rose by 4%, the number working in other areas of mental health fell by 2.6% in the same period.
Without a solid mental health nursing base the long-term plan will remain exactly that – a plan.
Mental health care is a unique environment with unique challenges. It is a field where care and treatment are inextricably linked and where patient outcomes depend on the success of that fusion. Compassionate nursing care in this environment delivers the essential emotional framework within which any treatment or intervention can begin to take effect.
The NHS workforce implementation plan is due to be published later this year. It is vital that this plan outlines a clear strategy for mental health nursing and for the recruitment and retention of nurses within this specialty.
“Mental health care can never again be overlooked”
The fact that mental health was ever allowed to become a Cinderella service – and to remain so for so long – is unacceptable. While it may not always feel that way, the UK is still a prosperous country, and failure to address this crucial aspect of healthcare is a human embarrassment and a social and economic nonsense.
Mental health care can never again be overlooked. Nor can mental health nursing. The success of the NHS Long Term Plan in this field will depend to a large part on nurses and the future of those nurses who choose to work in this profession.
Ensuring enough nurses choose to enter, remain in or return to this area depends on the government acting on its commitments rather than allowing the plan to languish in its digital archives as evidence of more broken promises.