A report by MPs says that demand on mental health services is rising faster than the number of staff employed in those services
“More capital investment is vital for mental health services to increase capacity in the face of growing demand and to overhaul outdated buildings and facilities to give patients the therapeutic environments and high-quality care they need." Saffron Cordery, deputy chief executive, NHS Providers
A combination of staff shortages and work pressures are hindering the government’s plans to improve mental health services, according to a new report from the Public Accounts Committee (PAC).
The report states that 17,000 staff left the NHS mental health workforce in 2021/22, with 14% of those citing work-life balance as their reason for leaving. While the NHS mental health workforce was 22% bigger in 2021/22 than 2016/17, referrals to mental health services had increased by 44% during the same period.
The PAC, a committee of MPs tasked with examining the value for money provided by government projects, warned that higher workloads create more pressure for remaining workers and are a factor in high staff turnover. Last month, figures from NHS Digital showed that 24.6% of staff sickness absences in NHS England were caused by anxiety, stress, depression and other psychiatric illnesses.
The report also expressed concern at the lack of progress on the government’s goal, announced in 2011, of creating “parity of esteem” for mental and physical health services.
Dame Meg Hillier, who chairs PAC, said the findings “must serve as a warning,” adding: “NHS mental health staff deal with some of the most challenging care needs there are. Staff in this space deserve not just our heartfelt gratitude for the job they do, but concrete support and training to work as part of well-staffed workplaces. Our report warns of a vicious cycle, in which staff shortages and morale both worsen in self-reinforcing parallel.”
The PAC has given NHS England and the Department of Health and Social Care (DHSC) six months to achieve a number of recommendations laid out in its report. These include NHS England outlining interventions to make sure it can recruit doctors, nurses, therapists and other clinical and non-clinical staff in the mental health sector.
The report also says that NHS England and DHSC should make it clear how they intend to achieve equality between mental and physical health in practice, including access and waiting times.
Data on NHS mental health services “lags behind that for physical services,” the report says. Although improvements have made since 2015, they are “taking longer than planned”.
The PAC has called on DHSC and NHS England to provide details on how they will improve the quality of data and how they will ensure it is shared appropriately within six months.
The committee has also expressed concern that integrated care boards (ICBs) could “struggle” to prioritise mental health in the face of funding issues and backlogs, and said that DHSC and NHS England have not yet committed to rolling out waiting times standards to all mental health services.
“The short-term actions being taken by the government and NHS England to tackle ongoing pressure are welcome,” Hillier said. “But these numbers are still going in the wrong direction, as demand for care well outpaces the supply of staff to provide it.”
Responding to the report, Saffron Cordery, deputy chief executive of NHS Providers, said: “With more than 1.8 million people on the waiting list for overstretched and understaffed mental health services, trusts are deeply concerned about levels of unmet need, particularly for children and young people.
“More capital investment is vital for mental health services to increase capacity in the face of growing demand and to overhaul outdated buildings and facilities to give patients the therapeutic environments and high-quality care they need.
“We also need the right levels of long-term investment in and support for prevention and early intervention services to help tackle growing demand and inequalities.”
Andy Bell, chief executive of the Centre for Mental Health, said that the PAC’s call for action to prevent mental ill health and boost public mental health services was “especially important”. He added: “The abandonment of the proposed ten-year cross-government mental health plan means we lack leadership nationally to promote better mental health for all, or a long-term approach to addressing the causes of distress. Year after year of cuts to the public health grant have left local councils without the resources they need to protect the public’s mental health.”
The report highlights the scale of the problems facing the NHS in its struggle to meet demand for mental health services. Staff numbers have risen, but demand has risen faster, and there is a real risk that the government will fail to meet its stated aims of achieving parity between mental and physical health. The recently announced workforce plan may go some way to addressing the problem, but it is likely to take a number of years before capacity meets demand. We agree with NHS Providers that a focus on prevention and early intervention is particularly important. Both the NHS and local councils need to be equipped with the resources to put those preventative measures in place.