Mental health workforce now bigger but ‘less experienced’

According to the King’s Fund’s 360-Degree Review of Mental Health Services, shared exclusively with HSJ, although the mental health workforce expanded by 23 per cent between 2010 and 2023, growth varied widely by staff group.

Researchers found that while the number of therapists and support staff grew by 45 per cent, the number of mental health nurses – the largest staffing group overall – grew by just 3 per cent.

Data on psychiatrist training placements also showed certain specialities, such as old-age psychiatry and learning disabilities, have “consistently been unable to fill all available placements, limiting future capacity”.

And, while the number of child and adolescent psychiatrists had increased by 22 per cent, this was “insufficient to address growing vacancy rates.”

The King’s Fund also found the increased staff numbers had been fuelled by a higher proportion of newly qualified staff. For example, in 2010, 15 per cent of psychiatrists were “junior” (foundation doctor year 1, foundation doctor year 2 or in core training) but by 2022 this had increased to 27 per cent. 

The report added: “Changes in the level of staff experience and skill mix of services have led to concerns about being able to provide safe and effective care.”

Royal College of Nursing head of nursing practice and professional lead for mental health Stephen Jones said staff shortages in mental health nursing account for around a third of all NHS nursing vacancies in England, with more than 13,000 posts left unfilled. 

He added: “The NHS Long-Term Workforce Plan needs the number of training places for mental health nursing in England to increase by 93 per cent by 2031-32, yet the number of applicants to study nursing has fallen by 26 per cent in just two years. This should sound alarm bells in government and across health and care.”

Deterioration of quality

The King’s Fund also noted the proportion of mental health services rated ”good” or “outstanding” by the Care Quality Commission deteriorated between 2022 and 2023, with “substantial and unwarranted variation in the quality of care between providers and services”.

Researchers analysed CQC inspection reports and concluded: “The ability to make meaningful changes was further compromised by a lack of mechanisms for sharing information or learning from incidents, lack of action planning to implement improvement, or simply lack of action.”

It also pointed out that, according to the NHS staff survey, satisfaction among NHS mental health care staff with the care their organisation provides has fallen to its lowest level in five years.