Priority 4: Support our workforce

This is the fourth of five priorities we've included in Preventing mental illness, our manifesto for the next UK General Election.

Grow and support the wellbeing of the mental health workforce

Patient demand is growing and mental health services are critically overstretched. Staff retention and recruitment present significant challenges in the face of unmanageable workloads and poor work–life balance. Sickness absence rates across the NHS reached 5.6% in 2022 compared with 4.3% in 2019¹. Almost a quarter of sickness days were attributed to stress, anxiety, depression and other psychiatric illnesses. Due to mental illness in the NHS workforce, there is a reduced capacity to treat mental illness in the population.

Having qualified colleagues in post to support each other is the single biggest contributing factor to staff wellbeing. However, psychiatry and mental health nursing are understaffed and under-resourced, with one in five nursing posts and one in seven medical posts in NHS mental health trusts in England remaining vacant². Despite 99–100% recruitment into psychiatry, growth rates for psychiatry are significantly lower than growth rates for many other specialties.

In England, the number of full-time equivalent (FTE) consultant psychiatrists working for NHS organisations increased by 6.1% from 4,186.0 in June 2013 to 4,440.2 in June 2023³. Over the same timeframe, the number of FTE consultants across all other medical and dental specialties increased by 44.5%³ . However, in Scotland, there was a slight drop in FTE consultant psychiatrists from 524.0 in June 2013 to 517.3 in June 2023, equivalent to a 1.3% decrease⁴. Consultants across all other medical and dental specialties had a combined increase of 35.0% over the same period⁴. In Wales, the FTE number for consultant psychiatrists in June 2023 (193.1) was down 9.8% on September 2013 (214.0)⁵. Over that same timeframe, the number of FTE consultants in post across all other specialties rose by 28.0%⁵. In 2021, the overall consultant psychiatrist vacancy rates for the UK nations were reported to be 11.6% in Wales, 10.4% in England NHS trusts, 7.0% in Northern Ireland, 5.8% in Scotland, and 3.9% at independent and third sector providers⁶. In line with the approach taken by national bodies, our RCPsych 2021 workforce census did not count posts as vacant when filled by temporary locum doctors. As such, these figures are an underestimate. However, the RCPsych’s forthcoming 2023 workforce census will report two different forms of vacancy rate – one that excludes temporary locum positions and one that includes them.

Without a more supported mental health workforce, there will be more people with mental illness not receiving the care and support they need. This will be detrimental for all patients, not least those with severe mental illness.

Recommendations

• Fund NHS staff mental health and wellbeing initiatives that have demonstrated effectiveness.
• Address racism and discrimination in NHS workplaces by implementing actions such as those in the RCPsych Tackling Racism in the Workplace plan and the NHS equality, diversity and inclusion (EDI) improvement plan.
• Fund and deliver the doubling of medical school places, ensuring more are assigned to schools with a proven track record of delivering consultants in shortage specialties, including psychiatry.

References

1. NHS Digital, NHS Sickness Absence Rates, 2022
2. NHS Digital, NHS Vacancy Statistics (and previous NHS Vacancies Survey), 24 August 2023
3. NHS Digital, NHS Workforce Statistics - June 2023, 28 September 2023
4. NHS Education for Scotland, NHS Scotland Workforce, 5 September 2023
5. StatsWales, Medical and dental staff by specialty and year, 9 August 2023
6. RCPsych, Workforce Census, 2021