CQC report reveals effect of falling mental health nurse numbers

A falling number of mental health nurses has been linked with 'increased risk' in a new England-wide Care Quality Commission (CQC) report.

A falling number of mental health nurses has been linked with 'increased risk' to patient safety in a new England-wide Care Quality Commission (CQC) report

Less mental health staff
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The State of Care in Mental Health Services report, published today, is based on the findings of inspections of all specialist mental health service providers by the CQC between 2014 and 2017.

The report states that between January 2010 to January 2017, the number of  full-time equivalent mental health nurses in England fell by 12%, from 40,719 to 35,845.

Numbers of community-based mental health nurses had increased, the CQC added, but not enough to offset the overall total decline.

Increased risk

CQC lead for mental health Paul Lelliot said: 'When you get a combination of wards that are poorly designed, with sometimes too few staff to safely observe all areas, then I do think you have increased risk.'

He said some inpatient services were struggling to fill ‘high numbers of vacancies’, while some wards had blind spots and ligature risks.

In the report patients told inspectors of not having enough one-to-one time with their named nurse and the shortage of nurses was ‘most apparent on acute wards’.

The report reveals that some agency staff were not 'sufficiently experienced or trained' before starting work, that patients on some wards had less confidence in agency staff and that a high turnover resulted in a lack of continuity of care.

Three quarters of providers’ core services were found to be good or outstanding but concerns were raised over safety, however the report stated that ‘mental health services can be proud of their staff’ who ‘genuinely cared’.

Skill mix

NHS England's mental health director and mental health nurse, Claire Murdoch, said there would be 'more than 10,000' extra staff in services by 2020-21.

But that figure is likely to include nursing associates, psychology graduates, apprentices, counsellors and others.

At a press conference ahead of the report's publication, Nursing Standard asked if there were fears staff shortages would result in a lower skill mix.

Dr Lelliot said: 'There have been occasions when we have been concerned with the wrong ratio with nursing assistants and qualified nurses, and we have also encountered wards where that ratio isn't meeting the expectations of the provider.’

Ms Murdoch said: 'In terms of the national plan, no, I am not concerned, I think we are getting the balance right… we have to have enough expert, qualified professionals, but we must have the opportunities of these new roles as well.

Asked if the 1% pay cap was a key issue, she said: 'Of course I would like to see a pay rise for nurses. But I don’t think it is only about money, I really don’t.’

She said staff motivation, continuing professional development and dissuading early retirement would all help.

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