Mental health framework: developing a collective voice for nursing in Wales

Senior mental health nurses in Wales have produced a set of ambitions for mental health nursing to act as a basis for a future action plan

Senior mental health nurses in Wales have produced a set of ambitions for mental health nursing to act as a basis for a future action plan

Picture: iStock

The All Wales Senior Nurse Advisory Group for Mental Health (AGMH) has published a framework for mental health nursing to support policy intentions to improve services.

The AGMH is made up of senior mental health nurses from each health board and from higher education establishments across Wales.

Increased political interest

Group chair Hazel Powell explains: ‘We wanted to develop a collective voice for mental health nursing in Wales.


The proportion of staff providing NHS mental health services in Wales who are nurses

(Source: Skills for Health)

‘Politically, there has been an increased interest in mental health over the last few years in all the countries.

‘We felt, as part of a leadership group of senior mental health nurses, it was important we had a voice in Wales.’

Launched on the UK’s first-ever Mental Health Nurses’ Day, 21 February, the framework sets out the group’s belief in the potential for nurses to help transform mental health services.

Four areas

It is organised around four main areas:

  • Professionalism, voice and leadership.
  • Workforce and education.
  • Promoting population health.
  • Well-being and the quality and safety of care.

There are also a number of pledges, for mental health nurses to:

  • Work collaboratively with people living with mental health problems, their families and carers.
  • Have leadership opportunities.
  • Undertake clinical supervision.
  • Have effective continuous professional development and postgraduate programmes that offer career development.
  • Be research minded and support research in practice.

‘Meaningful action plan’

How to achieve these and other pledges will be tackled within a ‘meaningful action plan’, which health boards are expected to adopt after it is published by the summer.

‘This course has given me leadership direction’

The heads of mental health and learning disability nursing at Abertawe Bro Morgannwg University Health Board identified a need to upskill band 6 and 7 nurses with leadership and management skills.

Senior board staff thought they needed more nurses with these skills for succession planning as older, more experienced and senior nurses neared retirement.

A partnership was developed with Gower College Swansea, and 23 mental health and learning disability nurses were recruited onto an 18-month leadership and management programme.

Quality-improvement initiative

The programme has required students to undertake a quality-improvement initiative and offers opportunities to shadow members of the senior team and attend health board meetings.

A year on, the nurses involved gave positive feedback. One says: ‘This course has been able to give me direction, especially in leadership focusing on engagement and inspiring staff to help achieve set goals.’

The senior nurse team will now undertake a review to ascertain the measurable benefits; achieved outcomes and to inform future programme development.


Ms Powell says she hopes the framework will also inspire younger nurses coming into the system, and articulate a sense of identity for all mental health nurses in Wales.

Hazel Powell

As well as a ten-year plan for mental health, published in 2012, there are several Welsh Government policies with a focus on mental health.

Five priorities

In 2017, Prosperity for All reaffirmed its commitments to improving mental health by making it one of only five priority areas.

Last year, the government set out a ten-year plan for health and social services with the express purpose of supporting the citizens of Wales to live longer, healthier and happier lives, and to be able to remain active and independent, living in their own homes, for as long as possible.

Within the new framework, the AGMH says ‘significant social challenges’ in Wales related to poverty have a significant effect on mental health.

These affect families, contributing to adverse childhood events, leading to homelessness, suicide and other forms of self-harm, such as excessive alcohol consumption and gambling.


The UK’s first-ever Mental Health Nurses’ Day

Chief nursing officer for Wales Jean White says she is pleased to see the development of the framework and believes that the pledges will help deliver the political aspirations.

Professor White says: ‘Ensuring good mental health and well-being is vital for any society and is influenced by a wide range of factors throughout our lives.

‘Mental health nurses have an important role to play, including working with people to build resilience to life’s challenges, helping individuals understand the importance of adopting healthy lifestyle behaviours, and providing person-centred care when they become unwell.

‘My hope is that mental health nurses will be inspired when they read this framework to quickly adopt the good practices described herein for the betterment of care delivery.’

Commitment to improve practice

Professor White also congratulated the AGMH for their commitment to improve professional practice and care delivery in mental health services.

RCN Wales director Helen Whyley says the college welcomes the new framework and its ambition to support policy intentions to improve mental health services.

She says: ‘Mental health nurses, our members, provide professionalism and leadership every day to take care of people with mental health needs.’

Ms Whyley adds that it is ‘so important’ that the Nurse Staffing Levels (Wales) Act 2016 should be further extended into mental health settings.

‘Only with the right numbers of mental health nurses and healthcare support workers can they truly embrace the pledges set out in this framework,’ she explains.

‘The RCN looks forward to working with the AGMH in the future on our joint issues.’

Receiving timely nurse-led mental health assessments

The Felindre acute admissions ward at Powys Teaching Health Board has provided since 2017 a nurse-led out-of-hours assessment service for people with mental health difficulties.

This service is led by ward manager Lisa Hale and deputy ward manager Amy Prosser.

Nurse assessors receive referrals and offer people in Powys an assessment. If admission is required, the person is admitted to a crisis bed overnight with a follow-up review the next morning by one of the psychiatrists and another member of the multidisciplinary team.

Treatment and care plan

If the person needs to remain in hospital, they are transferred from the crisis bed to an admission bed on the main ward to continue their assessment and treatment and care plan.

An on-call psychiatrist is available to the team, but the nurse-led model means that people who require mental health services receive local and timely assessment and support before further arrangements are made.

This offers consistency for service users, families and carers outside core working hours. It also supports professional nursing development and the attainment of advanced skills in a multidisciplinary setting.


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