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We must look after those who care for us

To stop NHS and social care staff leaving the profession, we need greater investment into their mental health and well-being.

By Roman Raczka

We can almost be forgiven for becoming desensitised to headlines about the NHS crisis.

Stories of soaring waiting lists, delays to treatment, crumbling hospital buildings and an NHS crippled by winter pressures are so common, it has sadly become the norm.

Behind it all, battling to keep the wheels turning, is a workforce that is struggling to maintain the standards of care it desperately wants to deliver. The pandemic might have shone a spotlight on the mental health of NHS and social care staff, but the issue did not begin there, and it certainly hasn’t ended there.

There are concerning levels of mental health problems in the healthcare workforce, and staff are facing unprecedented workload pressures and strain. The moral injury is significant.

In October 2023, NHS staff were off work for more than half a million (584,892) working days for mental health reasons, the most recent month for which statistics are available; in 2022, six million days were lost in total. Our own research at the British Psychological Society (BPS) finds the picture is as equally bleak in social care.

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All signs are pointing to a need for psychological support for staff now more than ever. Yet ring-fenced government funding for the NHS Staff Mental Health and Wellbeing Hubs, which were set up to provide health and care staff with rapid access to dedicated local psychological help, was ended last March.

This left integrated care boards either scrambling to find the cash to keep their hubs open – many offering a dramatically reduced service – or closing their doors for good. Unfortunately £2.3m funding from NHS England in July was too little, too late. So far, at least 18 out of the 40 hubs have shut, and four are closing at the end of this month.  A further nine hubs are under threat of closure. Quick access to high quality psychological support for staff has become a postcode lottery.

New research shows the annual bill for temporary NHS staff passed £10bn in 2022-23. The cost benefits of investment in mental health and well-being services are well established, with a return on investment of £5 for every £1 spent. Despite the potential for cost savings, the government would not commit to providing £38.5m to fund the hubs or similar services, at a relative fraction of the cost.

The remaining hubs report ongoing high demand for their psychological support services for individuals and teams, treating staff presenting with complex, moderate-to-severe mental health needs. This is helping to relieve pressure on the mainstream mental health services they would otherwise need to access, giving them the intensive, tailored support they need to remain in or return to work. 

There is no quick fix to solve staff well-being issues and no single service will be a replacement for the systemic change needed to improve working conditions and culture. Alongside instilling ambitious staff recruitment and retention targets, the NHS long-term workforce plan places a welcome focus on staff mental health and well-being by asking integrated care boards to invest in locally tailored staff provision from April 2024.

However, with systems struggling to balance their books and navigating stringent budget cuts, prioritising local investment in staff mental health and well-being services is likely to be challenging for health and care leaders.

Improving staff well-being requires investment at scale. Surely the government must support integrated care boards, and prioritise long-term investment in ring-fenced funding for staff mental health support services, to deliver on the ambitions of the workforce plan.

Only with this investment will we be able to properly look after those who dedicate their lives to caring for us at our most vulnerable, and ultimately deliver the best outcomes for patients.

Read the BPS’s report “Learning from the NHS Staff Mental Health and Wellbeing Hubs“.

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