Staffing is the issue keeping NHS leaders awake at night – and which consumes two-thirds of trusts’ spending. The fortnightly The Ward Round newsletter, this time by HSJ mental health correspondent Emily Townsend, ensures you are tuned in to the daily pressures on staff, and the wider trends and policies shaping the workforce.
More than a third of the 40 flagship staff mental health hubs launched to help a traumatised workforce through the pandemic and beyond have closed, or are under threat of closure, The Ward Round has learned.
The hubs were established in October 2020 using an initial £15m of government funding, but this was non-recurrent and finally dried up in March, leaving some of them unable to continue operating.
Although some have argued the hubs have been under-used and take-up was revealed to be lower than expected in 2021, their first year of operation, research by professional bodies the British Psychological Society and the Association of Clinical Psychologists indicates an average 72 per cent year on year increase in referrals to 11 of the hubs when comparing October and November 2021 to 2022. One hub even reported a 244 per cent increase.
More widely, health leaders are all too familiar with the deteriorating mental health of the workforce, with staff sick days for anxiety, depression and stress increasing significantly in 2022 compared to pre-pandemic levels.
There is growing concern that staff will soon have nowhere else to turn, with occupational health treatment too short or unsuitable for more senior colleagues wanting anonymity, and public mental health waiting lists under impossible pressure.
There are further fears about the impact of poor staff wellbeing on patient safety: a Health and Safety Investigation Branch report in February identified a strong link, highlighting staff concerns that support often came too late, with long waiting lists for care and help.
HSJ has obtained a list of the staff hubs which have already closed or are at risk of stopping services.
Nottinghamshire Staff Support hub – closed 31 March
With Staff in Mind (Coventry and Warwickshire) – closing – stopped taking new referrals from 31 March and wrapping up support
Keeping Well South East London – closed 31 March
Keeping Well North East London – closing 30 June
Black Country Staff Mental Health and Wellbeing Hub – closed to new referrals – closing completely end of June
Lancashire and South Cumbria Psychological Wellbeing Hub – closed to new referrals
Bath, Swindon and Wiltshire Wellbeing Matters Hub – closed 5 May
Bristol, Somerset and South Gloucestershire Mental Health and Wellbeing Hub – closed
Leicestershire, Leicester and Rutland Wellbeing Hub – closed on 1 April
It is understood decisions to close a further five hubs have already been made, and announcements will be made in the coming weeks. Meanwhile, the remaining hubs are currently continuing to use underspend from 2022-2023 or through shorter-term funding arrangements.
Staff trauma ‘horrible to witness’
One hub employee, speaking to The Ward Round anonymously, claimed the closures were a “very short sighted decision”, warning suicide risk had increased among their patients since the pandemic.
“When we set the hubs up we knew the trauma [of the pandemic] was expected to come two years post incident,” they said.
“The closures are pretty horrific… It’s horrible to witness the moral injury of what is going to happen to the people who need us. The rationale is there are lots of other places for staff to get support… but the idea there is somewhere else to go to is a real myth.
“They could go to occupational health, but then it’s on their work record — the hubs are confidential. Confidentiality is critical to some senior leaders coming forward.”
They added that with occupational health only four or five sessions are offered, but the hubs have been able to provide evidence-based treatment for the length of time required.
“You could get talking therapies but you’ll be waiting up to a year. They could try and access secondary care, but we all know the pressures there, and even then some staff may not meet the threshold.”
Answering a written question to parliament this week, health minister Will Quince said the hubs were funded on a non-recurrent basis using government funding as short-term response to covid pressure on the workforce. He said a number of integrated care systems have chosen to continue to fund the work of the hubs.
He also said staff can continue to access NHS Practitioner Health, which supports staff with more complex mental health needs brought about by trauma or addiction.
However, this service only covers registered doctors and dentists and “other staff in England where there is a genuine reason why they cannot access care confidentially, eg; due to the seniority of their role”.
The hub employee told HSJ they were concerned about gaps in access and the inequalities caused by some staying and some shutting down. “What about all those on lower wages who cannot access therapy when their colleagues can?”
In response to these findings, the Department of Health and Social Care said the upcoming workforce plan — which is yet to materialise — aims to “recruit and retain more staff and make the service a great place to work”.