The report ‘Creating conditions for the delivery of safe and therapeutic care to adults in mental health inpatient settings’ detailed potential risks to patient safety with regards to the high vacancies and working conditions of the staff, aiming to point out potential improvements in safety and culture for both staff and patients.
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It detailed that ‘the high level of registered nursing (mental health) vacancies has been a recurrent reported concern nationally,’ and that due to this, ‘there has been high usage of bank, agency and locum staff (referred to as ‘temporary staff’), and recruitment of staff from overseas.’
As a result of these understaffed wards, mental health nurses were being promoted to supervisory roles with limited experience, and that challenges across the workforce affected the staff’s ability to form therapeutic relationships with patients, therefore compromising their safety and care.
These concerns were echoed by health leaders. ‘An urgent review is needed of the mental health estate,’ said Dr Layla McCay, director of policy at the NHS Confederation, ‘along with a strategic implementation plan to increase the workforce and to ensure all patients are treated with dignity.’
The HSSIB made recommendations to improve conditions following the report, such as reviewing staffing requirements according to patient needs, and ensuring adequate training of new and current staff. But the Royal College of Nursing say a long-term solution can only be found by boosting recruitment levels.
‘High levels of vacancies mean wards do not have enough specialist nurses, forcing services to turn to temporary staff, unfamiliar with the needs of patients. This can result in inappropriate care being delivered, putting patients and staff alike at risk,’ said Stephen Jones, UK Head of Nursing Practice at the Royal College of Nursing.
‘Mental health patients deserve high-quality care, but a system under severe strain is struggling to deliver it. The Government’s NHS reforms must include long term, sustainable funding and dedicated new investment to boost recruitment into mental health nursing.’
The report is the first of four from a review conducted by former Health Minister Lord Darzi, as part of an investigation into inpatient mental health care both within the NHS and in the independent sector. An interim report for the second investigation ‘Creating conditions for learning from deaths and near misses in inpatient and community mental health services’ has been published, with the final publication date for the remaining three to be confirmed.