Mental health transformation plan limited by nurse numbers

Ambitious NHS plan fails to acknowledge 'workforce hill we all must climb'

Ambitious NHS plan fails to acknowledge 'workforce hill we all must climb'

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With little fanfare, the NHS published a plan this summer for ‘the most ambitious transformation of mental healthcare England has ever known’.

True, it’s hard to get a word in edgeways in the news these days, but even so this announcement was covered by a handful of trade publications only.

It may be difficult to argue with the optimism surrounding this 'transformation', but mental health nurses dealing with endemic vacancies on their acute and inpatient wards could be forgiven for thinking this is a case of pie in the sky.

So can we glean anything from the report, published in July, to help distinguish fact from fiction? What will services provided by mental health nurses look like in five years from now?

Burden of mental illness is predicted to rise

One thing that may strike those who miraculously find the time to read through the report is how the burden of mental illness is predicted to rise.

NHS England hopes that two million more people will be able to access mental healthcare in five years’ time. At first it might seem alarming to think that levels of mental ill health could rise so steeply. But in fact this goal ties into all established wisdom that long-term conditions such as depression are much easier to manage if identified early.

The last five-year plan for mental health was heralded as a sea change in our approach to mental healthcare. While NHS England mental health director Claire Murdoch acknowledged last year that staff were working under pressure in difficult circumstances, she said mental healthcare had never been so high on the government’s agenda.

Enhanced role for mental health nurses

What’s changed is that we have much more detail about how the landscape of mental health will improve and what’s required to do it. The enhanced role conceived for mental health nurses in ambulance services shows a true recognition of the value nurses have in environments where they have not traditionally been represented.

But where nurses might get a sense of déjà vu is in the overwhelming feeling that policymakers have not owned up to the scale of the workforce hill we all must climb when it comes to recruitment.

An RCN analysis found the number of mental health nurses working in the NHS has shrunk in the past ten years. In acute and inpatient care, mental health nurse numbers have fallen by one quarter. This can’t redress the uptick in areas such as community care, which some nurses feel has a better work-life balance than hospital roles.

Perhaps one reason why the comprehensive plan was not promoted with the aplomb that would match its lofty ambition is that mental health nursing is in a slump.

This is an implementation plan, after all. As the largest professional group, mental health nurses will be at the heart of turning these plans into reality. To make that happen, there is a need to ensure they are recruited, retained in the workforce and on board.

'The government didn’t listen to the RCN'

This latest publication makes no secret of the fact that it is dependent on the NHS’s wider workforce strategies, which should be in the public domain soon.

Strange then to think the government didn’t listen to the RCN, which believes the workforce is the NHS’s biggest asset and that progress on the health service’s impressive ambitions will be limited until we know how many nurses we need and where they are coming from.

It’s essential and helpful to project how many mental health nurses the NHS will need to meet expanding patient demand. But, without acknowledgement of the downward trajectory the workforce is seemingly locked into, nurses won’t feel bolstered to keep pushing themselves further when the system isn’t prepared to have their back.

Catherine Gamble is the RCN professional lead for mental healthCatherine Gamble is the RCN professional lead for mental health and a member of the Mental Health Practice editorial advisory board



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