Staff shortages and work pressure holding back mental health improvements – report

Pressure on staff and a shortage of workers are holding back improvements in NHS mental health services, MPs have warned.

There is also growing concern that the Government has not made clear how mental health will be treated with equal priority as physical health – an ambition that was outlined 12 years ago.

A report by the Public Accounts Committee (PAC) claims 17,000 staff left the NHS mental health workforce in 2021/22, with 14% of those citing work-life balance reasons.

While the NHS mental health workforce increased by 22% overall in 2021/22 compared to 2016/17, referrals to the services they provide were up by 44%.

The PAC warned that burnout and increasing workloads are a risk for remaining workers and a factor in high staff turnover.

In June, figures from NHS Digital revealed 24.6% of staff sickness absences in NHS England were down to anxiety, stress, depression and other psychiatric illnesses during the month.

The PAC also said it is “concerned” with a lack of progress on the Government’s “parity of esteem” goal, which was announced 12 years ago.

In 2011, the Government pledged to improve support for patients with mental health problems and treat services with equal priority as physical NHS services.

Dame Meg Hillier (pictured), chairwoman of the committee, said the findings “must serve as a warning”.

“NHS mental health staff deal with some of the most challenging care needs there are,” she said.

“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 ensure it can recruit doctors, nurses, therapists and other clinical and non-clinical staff in the mental health sector.

NHS England and DHSC should also make it clear how they will achieve equality between mental and physical health in practice, including access and waiting times.

Elsewhere, the PAC’s report said data and information on NHS mental health services “lags behind that for physical services”. It recognised improvements have been made since 2015, but 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 is also concerned integrated care boards (ICBs) could “struggle” to prioritise mental health in the face of funding issues and backlogs, and said DHSC and NHS England have not yet committed to rolling out waiting times standards to all mental health services.

Dame Meg added: “The short-term actions being taken by the Government and NHS England to tackle ongoing pressure are welcome. But these numbers are still going in the wrong direction, as demand for care well outpaces the supply of staff to provide it.”

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, the chief executive of Centre for Mental Health, welcomed the PAC report. He said: “While NHS mental health services are growing and seeing more people, referrals are rising and in many places access is limited by long waiting lists and high thresholds for support.

“Government inaction on the prevention of mental ill health, and austerity in public health, education, and social care services, is increasing demand for NHS mental health services, especially in the aftermath of the Covid-19 pandemic and the current cost-of-living crisis. This is unsustainable.”

A DHSC spokesperson said: “As set out in the report, we have significantly increased the mental health workforce over recent years and remain fully committed to recruiting as well as retaining and re-skilling them to ensure we meet current and future needs.

“The first ever NHS Long Term Workforce Plan, backed by over £2.4 billion of government funding, will deliver the biggest training expansion in NHS history and recruit and retain hundreds of thousands more staff over the next 15 years, including those who work in mental health services.”

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