Workforce planning – the key to success in mental health support

The new integrated care systems (ICSs) bring with them opportunity for new ways of working across mental health. Considering the workforce planning approach in both the NHS and VCSE support organisations will be key to their success.

The NHSE/I operational priorities and planning guidance for 2022 anticipates growth and improvement of mental health services. With this in mind, it states: “Systems are asked to develop a mental health workforce plan to 2023/24 in collaboration with mental health providers, HEE and partners in the voluntary, community and social enterprise (VCSE) and education sector.”

In this week’s mental health workforce planning and ICS event, jointly hosted by GGI and the Association of Mental Health Providers (AMHP), speakers from the NHS and VCSE providers looked at innovative ways to understand and manage workforce planning in mental health.

Dr Sri Kalidindi, Chair of the Association of Mental Health Providers and Consultant Psychiatrist, South London and Maudsley NHS Foundation Trust, chaired the event and said that there is “opportunity to consider the best complement of staff between the NHS and VCSE providers and working together going forward.”

Relationship of equals?

Raymond Sheehy, CEO of Bridge Mental Health, questioned whether the relationship in mental health between the NHS and VCSE providers is equal. He said: “Language and funds seem quite NHS heavy. The VCSE sector have worked hard to have a place at the table and this is now happening. With this in mind, I’m keen not to repeat previous models, so looking at joint approaches to training everyone in the system needs to work with local people not necessarily systems.”

Gail Kay, Mental Health ICS Programme Director for North East and North Cumbria ICS, agreed that working together is key to the success of workforce planning. She said: “The work plan continues to evolve aligning with the recommendations from national documents, for example the NHS People Plan. The plan has been prepared jointly with Health Education England and the ICS Workforce programme leads and is continuously reviewed to ensure progress and that timely required enhancements are made. The future workforce model continues to require a commitment to a fundamental culture shift for both the existing and future workforce by challenging traditional ways of working.”

Sarah Maguire, the CEO at Choice Support said that “the VCSE sector has always been good at joint working arrangements” – so there is real opportunity for both sides to learn from and with each other when developing an approach to mental health workforce.

Skill development

Jane Hughes, CEO for Mental Health Matters, agreed that alliances are key, but felt that differences between the NHS and VCSE organisations should be recognised and utilised as well. She said: “Some of the smaller VCSE groups have a smaller voice, but because of their focus have really specialised skills, especially with marginalised groups. With this in mind it’s so key we don't lose sight of these smaller organisations to support all aspects of mental health care.”

Liam Gilfellon, Director of Relationships at Mental Health Concern, agreed that the skill mix between experience and education must be considered to enable a sustainable mental health workforce. He said: “In terms of our learning from embedding a number of the new types of roles across the system, the usual reaction from the clinical workforce is ‘what are you qualified in’. My standard answer is that these roles are expert in listening, allowing a person time to explore and identify their needs, developing trust and walking a journey with that person. To do that well, you need to be a people person with good life experience, this doesn't necessarily mean you need to have had an academic route into health and social care, in fact it often helps if you haven't.”

Strategy and operational support

“As well as the VCSE sector being involved at strategic level at the ICB, it also needs to be involved at an operational working level for success”, said Jane Hughes. “An example of this is the increasing challenge with agency and bank staff – the NHS and VCSE organisations are all competing for the same people. With this in mind, we should collectively consider skills needed across the sector. Agency staff must be reflected in workforce development work.”

She also said that, strategically, “governance within the agencies needs to be considered - senior leadership in VCSE will have a good understanding of change and will be keen to be part of process.”

Margaret Hanson, CEO of Imagine Independence, recognised that working together is key to the change process. She said: “A lot of people in the NHS and third sector have spent a long time getting to where they are. Systems are resistant to change, so it will take a lot to take people on this journey.”

Rachel Peacock suggested a shared approach to some of the practical elements of workforce development – “with L&D budgets we have the opportunity in these new systems to all come together, share skills and approaches.”

Parity of esteem

Ultimately, argued Margaret Hanson: “The proof of pudding in this work is how these changes enable the VCSE mental health sector and NHS to improve inequalities, especially on items such as shifting intergenerational exclusion. If we don't do this, it's all for nothing.”

Questions for integrated care boards

In order for integrated care boards (ICBs) to be in the best possible position with workforce planning in mental health, the event team poses these questions to be asked and managed:

• Is the language being used one of equals? Does it all align?
• How do we work together as a default rather than a nice-to-have, so that the VCSE sector are always part of the conversation?
• What opportunities are there to combine core skills from education and experience to develop better working arrangements across the sector?
• As well as strategic alignment, are you aligned operationally on a daily basis?
• Could your training budgets be shared and aligned with partners?
• Is the work driving the bigger picture – developing parity of esteem?