Making the case for the mental health of the NHS workforce

College Dean, Professor Subodh Dave, writes about a recent appearance before a group in Parliament to discuss the mental health challenges faced by the UK health workforce.

On Monday 20 October I had the opportunity to represent the Royal College of Psychiatrists at a meeting of the All-Party Parliamentary Group (APPG) on Mental Health in Parliament. The focus of the meeting was the mental health challenges of the NHS and wider health and social care workforces and was chaired by the APPG’s Chair, Sojan Joseph MP. In total seven Parliamentarians attended the meeting, and asked a variety of pertinent questions about how they can assist the College on this important issue.

Alongside me were an excellent panel with representatives from across the sector:

• Mark Winstanley – Chief Executive Rethink Mental Illness
• Molly Taylor – Campaigner and Expert by Experience
• Dr Stephen Jones – RCN, UK Head of Nursing Practice
• Dr Jane Shears – National Director, Scotland and Northern Ireland, BASW
• Dr Afifa Qazi – Chief Medical Officer, Consultant, Psychiatrist, Kent and Medway Mental Health NHS Trust

What was most interesting is that across all of the speakers, some common themes emerged, which emphaised the importance of continued cross-sector partnership working so we can make the improvements required, in the interests of improving outcomes for patients and everyone who has to access the NHS. These common themes were as follows:

• Workforce pressures and retention challenges: There was broad consensus that while workforce numbers have increased, they have not kept pace with rising demand or the complexity of cases. Vacancy rates remain high in key professions such as nursing, psychiatry, and social work, with many services reliant on locum and agency staff.
• Staff wellbeing and mental health: Speakers highlighted the emotional toll on frontline staff, with data showing rising levels of stress, burnout, and even suicidal ideation linked to workplace conditions. There was strong agreement that staff wellbeing must be treated as a core quality measure, not an optional add-on.
• Fragmented care and long waiting lists: Lived experience contributions powerfully illustrated how delays and inconsistent access to care are putting lives at risk. Rethink discussed how there are nearly 1.8 million people currently waiting for mental health support, and the disparity between physical and mental health waiting times continues to widen.
• Need for joined-up workforce planning: Several panellists stressed the importance of integrating workforce strategies across health, education, and industry. There was particular concern about the shrinking pipeline into mental health social work and the lack of investment in training and development.
• Innovation and community-based models: There was interest in expanding roles such as mental health navigators and embedding mental health support within general practice and neighbourhood centres. However, concerns were raised about the lack of funding and consistency in service delivery across regions.

During my comments, I welcomed the Government’s consultation on the 10-Year Workforce Plan. I highlighted three areas that needed specific focus:

1. Workforce numbers: I showcased the College’s success in improving recruitment to Psychiatry but raised concerns about the obstacles to career pathway progression for UK Foundation trainees and impending bottlenecks from core to higher training.
2. Skill-mix: I pointed out that certain areas of clinical need- for example, Addictions and neurodevelopmental disorders had disproportionately low capacity of skilled workforce. I shared how RCPsych had been successful in rapidly building capacity, for example through the Eating Disorders credential programme – using relatively modest investment.
3. Workforce wellbeing: I stressed how vital it is that staff mental health and wellbeing are properly addressed within it. I also made the point that if the Government is serious about meeting its commitments in the 10-Year Health Plan, particularly around prioritising staff wellbeing, then supporting staff to reach their full potential must be central. This is key to improving retention and patient care.

We all know that NHS staff have been struggling for years with high workloads, administrative pressures, working environments out of step with the fundamental needs of staff, time pressures and poor work-life balance.1

The College’s recent capacity survey in England revealed a severe lack of local resources in mental health services and unacceptable gaps in treatment due to long-term underinvestment. This means that many patients are reaching crisis point because they can’t access timely psychiatric care, and even when they do, the lack of continuity makes it difficult to build therapeutic relationships.

What is true for patients, is true for staff – both in the public sector such as the NHS and in the private sector. I voiced concern at the lack of occupational mental health capacity and urged the government to consider investment in building this capacity on an urgent basis. Early intervention improves outcomes and helps people lead healthy and fulfilling lives.

There are other measures that can be taken to address some of these challenges, which is why the College recently published its Retention Charter, which offers a structured framework to help NHS organisations improve psychiatrist retention through a step-by-step, systemic approach. Over the next few months you will be hearing lots more from the College about how we are promoting the Charter across the NHS and with other key partners.

In terms of next steps, the minutes from the APPG meeting will be shared with Ministers and Officials in DH&SC as part of the Government’s consultation on the NHS Workforce Plan, and the College is also going to submit its own response.

I am looking forward to how the College and its members can continue to work with MPs, Peers, and the Government on this vitally important agenda.