Analysis of changes in the national mental health nursing workforce in England, 2011-2021

Data regarding changes in characteristics of the MHN workforce is commonly cited in governmental publications, but is rarely analysed in peer reviewed journals, despite ongoing concerns regarding high vacancy rates within mental health services. Aims To characterise changes in the MHN workforce, implementation of new nursing roles/skills and alignment with national policy Method Analysis of nationally published workforce data, peer reviewed publications and governmental policy/planning documents. Results Nurse numbers declined from 2011 to 2017, subsequently returning to near 2011 levels, but remaining below national targets. Nurses in community settings increased to constitute more than half of all nurses, whilst inpatient numbers declined, although more slowly than bed numbers. The ratio between nurses and support workers changed due to more support workers in inpatient settings. New advanced skills and roles for nurses have increased, but are unevenly distributed, constituting a small proportion of the total workforce. Implications for practice This paper provides a case study against which comparisons may be made with the nursing workforce in other countries and specialities. Even clear policy commitment to nursing growth may not deliver planned changes in numbers and introducing new roles may have uneven impact, especially in the absence of a robust evidence base.