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Millions wait for mental health support as growth in nursing workforce slows

Millions wait for mental health support as growth in nursing workforce slows

Millions of people seeking mental health support from the NHS are facing long waits and a ‘poor experience’ as growth in the nursing workforce has slowed, a report from the National Audit Office has found.

While the spending watchdog praised the NHS’ rapid expansion of services and the introduction of waiting time standards, the report found that the knock-on effects of Covid and deepening staff shortages made it unlikely that wait times would be shortened.

Since 2016, the number of patients seeking to access mental health services has grown rapidly. However, the report found that the workforce has not kept pace with the expansion in demand.

While the total NHS mental health workforce has expanded by 22% since between 2016-17 and 2021-22, the number of people in contact with NHS mental health services has risen 44% over the same time period.

In 2021-22 there were 4.5m people in contact with the mental health services, up almost a million from only five years ago.

This massive expansion in growth has led to increased wait times and worse outcomes for those seeking mental health support, particularly for under 18s, the LGBT+ community, and minority ethnic groups.

The report found that ‘NHS mental health services are under continued and increasing pressure and many people using services are reporting poor experience’.

NAO added: ‘While funding and the workforce for mental health services have increased and more people have been treated, many people still cannot access services or have lengthy waits for treatment.’

In 2015 the NHS of ensuring that 95% under-18s with a suspected eating disorders are seen within a week. However, by April-June 2022 just 68% were seen within this time.

Likewise, although NHSE set out an ambitious plan to provide more integrated community services, offering an additional £1bn of funding by 2023-24, there are still financial and workforce constraints meaning that 1.2 million people are still waiting for help from community based services. 

NHS Providers’ deputy chief executive Saffron Cordery, said: ‘Overstretched mental health services are under huge pressure, doing all they can to provide the best possible care in the face of ever-growing demand.

‘The progress that has been made is testament to the hard work of the sector and highlights what can be achieved when services are prioritised and better resourced.’

The report found that NHS mental health trusts highlighted ‘particular concerns about shortages of medical and nursing staff’ with many trusts pointing out that nurse shortages were particularly concerning.

While the workforce as a whole grew, the number of mental health nurses actually grew less than Health Education and NHSE had predicted, increasing by 9% rather than the expected 16%.

However, the number of nurses as a proportion of the mental health workforce actually fell over the last decade. In 2021-22 nurses made up 40% of the total workforce, down from 47% in 2011-12.

The report also raised concerns over the age of the nursing workforce, pointing out that 22% of all mental health nurses in the NHS were over 55 years old; putting a sizable proportion of the workforce close to retirement.

Responding to the NAO report on mental health services, RCN professional lead for mental health nursing, Stephen Jones said: ‘This report reflects the huge strain that mental health services are under, particularly since the pandemic which has led to soaring demand.

‘That some young people, including those with severe illnesses like eating disorders, are unable to access the care they need is especially concerning. Like the rest of nursing, mental health nursing is in the grip of an acute workforce crisis and this report highlights the need for much greater investment in staffing.’


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