Recommendation 9

HM Government Accepted in Part

67. We accept this recommendation in part. 68. Following publication of the NHS LTP and the Mental Health Implementation Plan, in January and July 2019 respectively, Health Education England ( HEE ) has been working with the department, NHSEI , the Department for Education, and other partners, to implement transformation of the mental health workforce to FY 2023 to 2024, and beyond. 69. The NHS LTP builds on the achievements of the 5 Year Forward View for Mental Health, and HEE ’s roadmap to achieve this was outlined in the Stepping forward to 2021 – the mental health workforce plan for England (July 2017). 70. In FY 2020 to 2021, HEE commissioned a third NHS Benchmarking Network data collection, which highlights the significant progress that has been made to expand and develop the children and young people’s mental health workforce, through education and training, at a census point of 31 March 2021. 71. The report provides a snapshot in time of the children and young people’s mental health workforce size and shape, including valuable intelligence regarding the skill mix and diversity within the workforce delivering children and young people’s mental health services. 72. The report shows that the workforce has expanded to achieve, and exceed, the required growth of 4,500 whole-time equivalent ( WTE ) staff outlined in the Stepping forward workforce plan. NHS Benchmarking data allows us to calculate that the workforce has grown by 7,423 WTEs between March 2016 and March 2021, exceeding the requirements by 2,932 WTEs (65%). [footnote 2] 73. The delivery of improved access rates for mental health services for children and young people [footnote 3] has been enabled by HEE delivering the workforce supply required by ‘Stepping forward’ a year ahead of schedule (March 2020). Additionally, HEE provided training to upskill 3,400 staff across the existing children and young people’s mental health workforce. This upskilling activity does not show in the workforce growth figures provided by the Benchmarking census, but it contributes to service improvement and efficient delivery. 74. However, despite the growth and progress evidenced above, this must be considered within the wider context of significantly increased demand for children and young people’s mental health services, which has taken place following the COVID-19 pandemic. HEE is reflecting this in work to support greater expansion, where resources will allow, and development of the children and young people’s mental health workforce, for example by providing training for the workforce supporting children and young people presenting in a mental health crisis, and staff working in eating disorder services, which have seen a large increase in referrals. 75. HEE is commissioning the NHS Benchmarking Network to undertake a further census in 2022, to continue to develop our understanding of that workforce. 76. In addition to the growth outlined above, HEE has been implementing specific developments for the children and young people’s mental health workforce that have arisen from other policy drivers to address workforce capacity and training issues. This includes the government’s green paper, which initiated development of MHSTs in education settings, and the development of the new education mental health practitioner ( EMHP ) role providing early intervention, low-intensity support in schools settings for mild to moderate mental health problems. This has resulted in 520 WTE EMHP roles providing services within MHSTs , contributing to the overall workforce growth outlined by the report. 77. Further to the above, there has been and continues to be significant growth in the wider mental health workforce, including roles that provide services to children and young people but are not training pathways specific to children and young people (for example, mental health nurses). The NHS-employed mental health workforce grew from 109,000 in March 2016 to 127,000 in March 2021 – an increase of 18,000 whole time equivalents (16%). These figures do not include non-NHS providers. HEE has a commitment to confirm formally on the March 2021 position after the end of this financial year. 78. As of September 2021, the NHS-employed mental health workforce grew further to 128,300 ( NHS Digital workforce data ) and data confirms that the circa 19,000 additional posts have been filled – subject to the service maintaining the position on retention (that is, no increase in leaver rates), as although HEE has created sufficient supply, and the service is filling the posts, if leaver rates exceed joiner rates then the level of overall growth may not increase to the extent required. 79. The mental health workforce leaver rate fell from 8.2% in FY 2018 to 2019 to 7.7% in FY 2019 to 2020, and to 6.5% in FY 2020 to 2021. FY 2020 to2021 therefore continued the downward trend seen in recent years. The timing and consistency of patterns across regions and professions suggests that COVID may have had