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Mental health trust leaders might breathe a sigh of relief after NHS England’s chief financial officer Julian Kelly revealed their services (along with maternity services) should be exempt from the national squeeze on workforce spending this year.

However, Mr Kelly also confirmed acute trusts would still be expected to hold their workforce costs “roughly flat” by cutting temporary staffing and reducing permanent posts.

Several providers have declared they need to cut jobs in recent weeks, driven by national and local budgets which are rising by less than 1 per cent after accounting for inflation.

Mr Kelly said the reason for the different approach to mental health was the need to expand services. This was echoed by NHS England’s national mental health director Claire Murdoch who said mental health services were “facing near record levels of demand”.

Interestingly, HSJ analysis of NHS Digital data showed the mental health workforce had grown more quickly than other sectors over the five years from December 2019 to December 2023 with some trusts reporting a rise of up to 40 per cent.

Some may be asking why, considering this large growth, is the sector unable to keep up with demand. Mental health leaders can surely expect some tough questions around productivity to follow.

Growing concern

HSJ’s analysis of more than 5,000 prevention of future deaths reports has found the number of coroners’ reports raising concerns about lack of capacity in emergency care – including long delays in ambulance responses, hospital handovers, and emergency department waits – was around four times higher last year than pre-covid.

There were 52 such reports issued in 2023, compared with 13 in 2018 – the highest number issued in a year pre-pandemic. The number published citing emergency care capacity also appears to have been steadily rising since 2020. 

The proportion of PFDs linked to emergency care capacity has also risen. In 2023, nearly 10 per cent of the reports cited this as a problem, compared with just 3.3 per cent in 2018. In 2024 so far, 8.6 per cent of reports have raised concerns about capacity in emergency care.

Describing the figures as “upsetting”, Royal College of Emergency Medicine president Adrian Boyle said: “When a death occurs, relatives and staff want to be assured that they have done everything that could have been reasonably expected. Knowing that there were deficiencies in care is hard for both relatives and clinicians.”

Also on

The Care Quality Commission has announced it is postponing its inspections of integrated care systems until after July’s general election. Meanwhile, NHSE has awarded Deloitte a £99,000 contract to carry out an eight-week “reset” of a critical national IT project. And this fortnight’s The Download takes a look at how a pilot for the Federated Data Platform is being used by a trust in the North East.