Our members are ready to play a crucial role in expanding the NHS’s mental health workforce and supporting the public’s psychological wellbeing.

That’s the message from Matt Smith-Lilley, our Policy and Engagement Lead for Mental Health, as he responded to the National Audit Office’s (NAO) report Progress in improving mental health in England published today.

The report highlighted staff shortages and the speed of expanding the existing workforce as a major constraint on improving NHS mental health provision. It also said that retaining staff was a challenge, with 17,000 (13%) leaving the NHS mental health workforce during 2021-22.

The NAO said reasons for shortages included difficulties recruiting and retaining staff, high turnover between service areas, and competition from health and non-health sectors.

Skilled and experienced

Matt said: "Our members' skills, experience and high standards of professional practice could be a key element in meeting the current level of need.

"But at the moment they're overlooked, undervalued, under-utilised, and struggling to get into the NHS workforce, despite widespread difficulties in recruiting and retaining mental health staff."

The NAO report found that between 2016-17 and 2021-22, the number of people in contact with NHS mental health services increased from 3.6 million to 4.5 million.

NHS mental health services achieved new waiting time standards for talking therapy services and early intervention in psychosis services, but not for eating disorder services for children and young people. The NHS made good progress against these standards until 2019-20 but the pandemic has disrupted performance, the NAO said.

For young people's eating disorder services, waiting times increased following surges in demand during the pandemic. During April-June 2022, just 68% of young people who were urgently referred were seen within a week, against a standard of 95%.

Since the pandemic, demand for mental health services is higher than the 2019 NHS Long Term Plan anticipated, particularly among young people, the NAO said.

“This is likely to mean it will take longer to reduce the gap between demand for mental health services and provision,” it added.

Parity of esteem

The NAO said that neither the Department for Health and Social Care nor NHS England has defined what parity of esteem between mental and physical health services entails.

It said: “The NAO therefore remains unclear how far the current initiatives take the NHS towards its long-held end goal, including what else is needed to achieve it.”

The NAO said that while further service expansion is planned, the forecast rates under the current programme mean that by 2023-24 there will still be sizeable treatment gaps.

“For example, the ambition for 1.9 million people to access talking therapy services by the end of next year represents just a quarter of those with a diagnosed need estimated before the pandemic,” the NAO said. “NHSE also estimates that the number of people with mental health needs not in contact with NHS mental health services, as of 2021, is 8 million.”

Matt said: “The NAO’s report makes for stark reading. The silver lining of increases in availability of some services is overshadowed by the reality that availability, while expanded, lags far behind the current level of need for services.

“A postcode lottery remains for many across the country with waiting times for vital help being so variable. Funding is up but by less than half of 1% and far short of what’s required to achieve the pledged parity of esteem, and workforce expansion and retention remain one of, if not the, biggest challenges facing NHS mental health services.

Urgent action

“Today’s report exposes challenges that will be further exacerbated by the ongoing cost of living crisis. The strong correlation between financial distress and increasing demand for mental health services is well evidenced and underlines why urgent action is needed now.

“We again call on the Government to not delay in acting to tackle the problems facing mental health services. The recent scrapping of the 10 Year Mental Health strategy in favour of the yet to be published Major Conditions Strategy is yet another delay to taking meaningful action.

“The Government needs to do better in supporting the NHS adequately to meet the needs of the public,” he added.