Career pathways ‘vital’ for mental health workforce sustainability

A new briefing paper, Building a mental health workforce for the future, has set out changes that need to be made to mental health services in England, based on the ambitions of the NHS Long Term Workforce Plan.

“The biggest challenge to meeting this growing demand is workforce shortages”

Sean Duggan

It has called for additional investment in mental health services, in order to meet the increasing demand of the population and promote equitable care for patients.

The findings of the briefing paper have been drawn from a roundtable event on the mental health workforce, held in November 2023 and co-hosted by the Centre for Mental Health, Mind and the NHS Confederation’s mental health network.

Participants at the roundtable included the Royal College of Nursing, Unite, NHS England, the Department of Health and Social Care and people with lived experiences of mental ill health.

The roundtable had explored how expansion and transformation of the mental health workforce can be achieved, in the context of the recent NHS Long Term Workforce Plan.

The plan, published last year, warned that the current shortfall in mental health nursing was of “particular concern”.

It estimated that there could be a shortage of 15,800 mental health nurses by 2036-37, due to fewer nurses taking up training in this area and limited opportunities to fill the shortfall through international recruitment.

As such, it set out ambitious plans to expand the mental health nursing workforce, including increasing mental health nursing education places by 93% by 2031-32 to more than 11,000 places.

The briefing paper acknowledged these commitments, but argued that implementing the workforce plan would be “a huge undertaking” for healthcare systems.

Therefore, it has outlined key areas where it believes attention is needed to reform and expand the mental health workforce in order to meet the rising demand.

Training

The briefing paper noted that any ambitions to expand training places in the workforce plan would also provide an opportunity to “change the ways people are trained”.

This could include more multidisciplinary training, as well as ensuring that mental health forms a part of training for all health and care professionals.

Meanwhile, it also highlighted how expanding training places would require a subsequent expansion of mental health clinical placements and teaching staff who will supervise them.

The paper argued that mental health clinical placements “tend to be limited to a narrow range of settings”, namely inpatient services in the NHS.

However, as these services struggle to keep up with demand, it can sometimes be “difficult to supervise and support” those in training.

As such, the paper has called for there to be an expansion of placements, particularly into the voluntary and community sector, which is said would give trainees “a wider worldview” as well as increasing capacity within the system as a whole.

Retention and career development

Attrition in mental health services remains “a major challenge” and is most visible among nursing staff, said the paper.

It argued that understanding why mental health nurses leave the profession and what would help them to stay “is vital to improve retention”.

The briefing highlighted the need for greater career progression and development, to support retention of mental health nurses.

Importantly, it noted that career progression was not always about “rising through management hierarchies” but could also be about working in new ways, in new areas or learning new skills.

It said: “Mental health nurses are the largest component of the workforce and the most diverse – so creating opportunities and career pathways for nursing staff is vital for services to be sustainable long term.”

Wellbeing

The wellbeing of the mental health workforce “continues to be undervalued and poorly served”, the briefing explained.

It noted that some of the support that had been offered during the pandemic had been withdrawn and scaled back.

It comes as, last month, nursing leaders called on government to restore funding for mental health hubs.

Funding cuts meant that 18 of the 40 hubs, which had been offering psychological support to NHS staff, had closed down in the last year.

The briefing paper said: “It’s vital that wellbeing support covers the whole workforce and that it has protected funding for as long as it is needed; not just as an immediate response to the harm caused during the pandemic but in recognition that the need continues to be acute and serious for many.”

Overall, the briefing paper called for a commitment from the government for additional investment into mental health services.

It argued that this investment should not just be made to NHS-funded mental health services, but in local government-funded support, including public health and social care.

The report explained that any workforce expansion and reform would require “collective effort” from professional bodies, higher education institutions and other training providers and employers.

The chief executive of the NHS Confederation’s mental health network, Sean Duggan, said: “Services have been running at capacity for some time, with leaders and their teams pulling out all the stops to meet these pressures.

Sean Duggan

“But, as this joint briefing with the Centre for Mental Health shows, the biggest challenge to meeting this growing demand is workforce shortages.”

Mr Duggan, who has a background in mental health nursing, argued that getting new staff to expand service capacity was important, while at the same the health service “must do everything it can to retain the staff it already has”.

He added: “There is groundwork already being done as our members are embracing innovative approaches to workforce challenges such as peer support and housing workers.

“However, we cannot make any headway without the commitment from the government that the NHS Long Term Workforce Plan will be fully funded and delivered.”

The Department of Health and Social Care was contacted for comment.