Career paths ‘vital’ for sustainability of the mental health workforce

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

“The biggest challenge to meet this growing demand is the workforce shortage”

Sean Duggan

It has called for additional investment in mental health care to meet growing population demand and promote fair care for patients.

The findings of the briefing paper are drawn from a roundtable discussion on the mental health workforce, held in November 2023 and co-hosted by the Center for Mental Health, Mind and the NHS Confederation Mental Health Network.

Participants in 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 health problems.

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

The plan, published last year, warned that the current mental health nursing shortage was “particularly worrying”.

It is estimated that there could be a shortage of 15,800 mental health nurses between 2036 and 2037, due to fewer nurses training in this field and limited opportunities to fill the shortage through international recruitment.

As such, it has set out ambitious plans to expand the mental health nurse workforce, including increasing places in mental health nurse education by 93% by 2031-2032 to more than 11,000 places.

The briefing document acknowledged these commitments, but stated that implementing the workforce plan would be “a huge undertaking” for health care systems.

It has therefore outlined the key areas where it believes attention is needed to reform and expand the mental health workforce to meet rising demand.

Course

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

This could include more multidisciplinary training, but also ensure that mental health is part of the training of all health and care professionals.

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

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

However, as these services struggle to meet demand, it can sometimes be ‘difficult to guide and support people in training’.

As such, the paper has called for an expansion of placements, particularly in the voluntary and community sectors, which would give trainees a “broader world view” and increase capacity within the system as a whole.

Retention and career development

Mental health turnover remains “a major challenge” and is most visible among nursing staff, the paper said.

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

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

Importantly, the report noted that career development is not always about ‘moving up management hierarchies’, but can also be about working in new ways, in new areas or learning new skills.

It said: “Mental health nurses are the largest part of the workforce and the most diverse – so creating opportunities and career pathways for nurses is vital to making the service sustainable in the long term.”

Welfare

The well-being of the mental health workforce “remains undervalued and poorly served,” the briefing said.

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

It comes as nurse leaders last month called on the government to restore funding for mental health centres.

Cuts meant that 18 of the 40 centres, which provided psychological support to NHS staff, had closed in the past year.

The briefing paper said: “It is essential that welfare support covers the entire workforce and that funding is protected for as long as it is needed; not only as an immediate response to the damage caused during the pandemic, but also in recognition that the need remains acute and dire for many.”

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

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

The report explained that any workforce expansion and reform would require “collective efforts” 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 operating at full capacity for some time, with leaders and their teams pulling out all the stops to cope with these pressures.

Sean Duggan

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

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

He added: “Groundwork is already being done as our members embrace innovative approaches to workforce challenges such as peer support and employee housing.

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

The Ministry of Health and Human Services was contacted for comment.