Extra 4,000 mental health nurses needed for long-term plan

The new NHS Mental Health Implementation Plan for 2019-20 to 2023-24, which was published on Tuesday, sets out a framework explaining how the government arms’-length body NHS England aims to deliver on its commitments made for mental health services, as set out in its 10-year plan.

The NHS Long Term Plan, published in January, included promises to invest more in mental health services, with strategies such as 24/7 community-based mental health crisis response, liaison support in accident and emergency departments and the introduction of nurses in ambulance control rooms.

As part of the new implementation plan, NHS England has pledged that a ringfenced local investment fund, worth at least £2.3bn a year in real terms by 2023-24, will ensure the health service “provides high quality, evidence-based mental health services to an additional two million people”.

The 57-page document also gives a breakdown of “indicative” workforce numbers that it predicts will be needed to underpin the long-term plan’s ambitions for mental health services in the country.

Overall, the document recommends that, by 2023-24, there should be an additional 4,220 nursing staff working in mental health.

The plan suggested that the highest proportion of nursing staff was needed in children and young people’s mental health services, where it predicted that in five years’ time there should be an additional 2,110 nursing staff.

Meanwhile, for adult severe mental illness services in the community, the implementation plan recommends an extra 1,540 nurses will be needed by 2023-24 and that for perinatal mental health 110 extra nurses need to be in post in the same timeframe.

“It is good news that local areas will be more involved in developing their workforce, but we will need to see support from the centre”

Sean Duggan

NHS England said the numbers were meant only to be “indicative”, in order to help inform the local systems that will be developing local “people plans” to build a national picture of the workforce demand.

The local plan’s will then inform the final version of the NHS People Plan, which will provide a workforce strategy for the health service and is due later this year following the government’s next spending review. An interim version of the plan was published in June.

The indicative figures come on top of existing requirements specified for the workforce in the Stepping forward to 2020-21: the mental health workforce plan for England – which was published in 2017 and aimed to support the delivery of the Five-Year Forward View for Mental Health in England.

Back in 2017, it was suggested that an additional 8,100 nursing and midwifery staff were needed in mental health services by 2021.

NHS England’s latest plan for mental health also reiterates its pledge to introduce nurses and other health professionals into ambulance control rooms.

As outlined in the NHS Long Term Plan, health leaders want to introduce mental health nurses into this setting to help improve triage and response to mental health calls.

This forms part of the Mental Health and Ambulance Programme, which NHS England aims to deliver from 2020-21, according to the implementation plan.

NHS England has not specified how many nurses will be go into this role across the country, but it does suggest that the number of nurses working in the ambulance mental health provision should increase by 100 in the next five years.

“We must acknowledge that mental health services cannot succeed in a vacuum”

Sean Duggan

Interim chief executive at Avon and Wiltshire Mental Health Partnership Trust, Simon Truelove, told Nursing Times that it was “pleasing” to see the publication of the mental health implementation plan, as part of the wider long-term plan.

He said it set out a “clear and ambitious vision to transform mental health services and support increasing access to treatment and more specialised services, in a more personalised way”.

Mr Truelove said the trust particularly welcomed the “focus of a more localised approach to workforce and recruitment”, noting that attracting and retaining skills and expertise was “essential to provide first class treatment and support”.

“Having a plan for the short-term, as well as the medium and long-term will be crucial,” he said. “We are determined to take forward and implement this plan by addressing the challenges, transforming the services and ultimately provide the best possible care for those requiring mental health support.”

However, he told Nursing Times that investment was needed in the wider health and care system, including in social care, capital, public health and supported housing “if the vision of the long-term plan was to be achieved”.

Chief executive of the Mental Health Network, which is part of the NHS Confederation, Sean Duggan, said the implementation plan gave a “clear route” into “living the vision” of the NHS Long Term Plan, noting there was much to welcome.

Sean Duggan

Sean Duggan

Sean Duggan

However, he warned that workforce “remains a worry”.

“It is good news that local areas will be more involved in developing their workforce, but with mental health services suffering from particularly high vacancy rates, we will need to see support from the centre,” he said.

“And we must acknowledge that mental health services cannot succeed in a vacuum,” said Mr Duggan.

He added that mental health services should “work in partnership” with other parts of the system and reiterated the need for investment in the wider health and care system to help deliver the vision on the long-term plan.

Head of health policy and influencing at mental health charity Mind, Geoff Heyes, said this implementation plan “should help local areas to turn the ambitions in the NHS Long Term Plan into reality”.

“It is vital that every local area is clear on what it needs to include in its plan and we expect the planning process to involve as many people with experience of mental health problems as possible, as well as experts in the voluntary sector,” he said.

Mr Heyes said the charity was looking forward to seeing “ambitious and transformational plans across the country and real tangible improvements to mental health services”.