Mental health workforce challenges within the NHS
Dr Nicholas Andreou,
Co-Founder
The NHS is no doubt the UK’s greatest asset, delivering exceptional patient care for over 70 years. This was only proven further during the Covid-19 pandemic where over 1.3 million people went above and beyond the call of duty, becoming the nation’s heroes overnight.
But as our healthcare professionals worked non-stop to fight the virus, they also battled ongoing workforce challenges, from a historic backlog to poor work-life balance. These issues exist across the whole of the NHS. However, mental health organisations are facing a unique combination of concerns which have only been worsened by the pandemic.
The demand for mental health services has grown at a considerable rate - from 1.1 to 1.4 million people from 2016 to 2019 - yet the number of NHS staff delivering this support remains stagnant. It is also likely this surge will only escalate as the public continue to struggle with the psychological impact of the pandemic, with an estimated 10 million people in England needing new or additional help.
In this article, we share the challenges facing the NHS mental health workforce - and how innovative workforce management technologies such as Locum’s Nest, can help to overcome them.
The mental health workforce is stagnant
Over the last 10 years, there has been an increase in the total number of mental health employees. However, the rate is only an average of 1%, a minuscule amount in relation to the 21% growth in demand for support services.
Overall, most key staff groups have witnessed a decline. This is particularly true for mental health nurses, whose total number has diminished by 3% over the last decade.
Such shortages are caused by a lack of staff to fill available shifts across the board of mental health services. When asked whether or not they had rota gaps within their team, an astonishing 69% admitted there are shortages either most, or all of the time. This results in many professionals feeling concerned about skill mix and their ability to do their job well.
47% of Doctors, 57% of Clinical Psychologists and 65% of nurses were each missing one or more employee on their last shift — BMA, Mental Health Workforce Report
The challenge of workforce shortages has detrimental effects on not only the healthcare professionals, but also the quality of care they can provide. Over half of clinicians stated they were too busy to provide the care they would have liked during their last shift - an observation many found upsetting.
49% of mental health professionals state they are upset that they can’t provide the level of care they would like to — BMA, Mental Health Workforce Report
Workload and wellbeing is impacted
The widespread pressures facing mental health teams is a top concern. Impacting their wellbeing, morale and personal life, a lack of colleagues results in an unmanageable workload in an already challenging role.
44% of mental health employees said that their individual workload was either mostly unmanageable or unmanageable — BMA, Mental Health Workforce Report
According to You Okay, Doc? 80% of doctors are at high risk of burnout, with only half having sought psychological support. Even more worrying, is the rate of suicide within the medical profession. Doctors are up to five times more likely to take their own life than the general population. And exhausting shift patterns and immense demands have a role to play.
44% of clinicians revealed they felt demoralised during their last shift; while over a third of nurses have admitted to considering leaving their role within the next year. Poor work-life balance has also grown as a reason for leaving in the last 10 years, contributing to higher absenteeism and staff turnover.
Recruitment is an ongoing battle
Attracting and retaining talent has become a key topic to address across the entirety of the NHS. Sustaining a workforce may be challenging, yet building one to cater for demand is overwhelmingly difficult. And the story is no different within the mental health workforce.
In 2020, there were over 20,000 vacancies across mental health Trusts - a higher number compared to any other sector. Enrolling new mental health professionals, particularly at a higher level, is quite laborious.
Whilst overall fill rates for core psychiatry training has slightly improved over the last decade, those for specialty roles are worryingly scarce, with some as low as 21%. The consistent lack of psychiatric professionals is likely to remain for the foreseeable future and is thought to be down to stereotypical attitudes towards such roles.
Perceptions around mental health careers are still affected by a lack of awareness, false media narratives and concerns around low pay. A recent study found that whilst most psychology undergraduates wanted a career in mental health at the start of their degree, the number of those who didn’t more than doubled in their final year. Despite a rise in applications, many recognise shortcomings in progression - despite clear shortages in the profession.
The lack of training and career development opportunities in mental health are obvious. From not having the £1,000 personal development grant to limited offering within job adverts, clinical support workers are not presented with the same financial and educational benefits as other healthcare professionals.
Supporting the mental health workforce
Solving the NHS staffing crisis has always been the driving force behind our technology at Locum’s Nest. Long before the pandemic, we outlined our mission to empower better flexibility, accessibility to workers and support all NHS people’s mental health.
We believe that to begin overcoming the challenges facing the mental health workforce, we must start by maximising the deployment capacity of existing employees. This by no means signifies we should add more hours to their already overflowing plate. But, rather, that there’s opportunities to streamline how we deploy and retain the nation’s existing pool of mental health NHS staff.
Using our contingent workforce planning technology, mental health organisations can begin to overcome workforce shortages by advertising vacant shifts, rapidly recruiting and deploying staff to where they’re needed most. Locum’s Nest Match allows healthcare organisations to match vacant shifts with healthcare professionals, enabling organisations to advertise vacancies to a much wider pool of qualified and licensed NHS professionals. Available shifts can then be made visible to the 40,000+ healthcare professionals using our app, unlocking hidden capacity.
By leveraging the existing workforce, mental health organisations can improve shift fill rates, stop relying only on expensive agencies and benefit from better retention of staff who benefit from a fairer schedule and more flexibility.
Our total workforce solution has been implemented within London’s largest mental health trust (Central and North West London NHS FT) who partnered with Locum’s Nest to overcome their staffing challenges. Our workforce management solution will be adopted including our signature e-rostering technology, Locum’s Nest Rota.
These collaborative solutions will allow CNWL NHS FT to implement flexible shift work that caters to both patient demands and employee needs through simple features including leave requests, shift swapping, job advertisements and mobile app accessibility - each allowing the Trust to better anticipate and fill vacant shifts to reduce rota gaps.
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To learn more about how Locum’s Nest can help your mental health organisation better leverage its existing workforce, please get in touch with our co-founder, Dr Ahmed Shahrabani, on ahmed@locumsnest.co.uk or contact here the team here.