Safety recommendation
HSSIB recommends that NHS England works collaboratively with relevant national bodies and stakeholders including professional regulators, the Department of Health and Social Care and relevant royal colleges to:
1) Identify and clarify the goals of acute mental health inpatient care and the roles, required skills and ongoing professional development needs of the multidisciplinary workforce team.
2) Review and update the NHS Long Term Workforce Plan with consideration of the concerns around changes in patients’ needs and the need for a multidisciplinary approach to ensure therapeutic care is provided.
3) Develop a strategic implementation plan to address workforce issues in mental health inpatient settings that identifies the social and technical barriers to implementation and sets out actions to address them.
This is to develop, enable, support and retain a future multidisciplinary mental health inpatient workforce that is able to deliver therapeutic and safe care to patients.
Response:
We welcome the opportunity to formally respond to safety recommendation R/2024/038 and are already delivering a number of education and training opportunities aimed at supporting the optimisation of the delivery of mental health inpatient safe and therapeutic care, including for people living with a learning disability and/or autism who are in receipt of such care and for all adult inpatients who are detained under the Mental Health Act. We remain committed to support the development and transformation of the mental health inpatient multidisciplinary team, including the medical workforce and the aspired models of care within the current Long Term Workforce Plan and further current/emerging policy.
The goals of acute mental health care are outlined within NHS England MHLDA guidance: NHS England » Acute inpatient mental health care for adults and older adults which was published in July 2023. This includes appendix 5 of the guidance which focuses on the skills and competencies for the inpatient workforce. NHS England have commenced further work to scope principles to support organisations to provide a workforce with the values, experience and skill mix needed to support and prioritise therapeutic care and relationships. At the time of responding to this recommendation, resource constraints mean that this work is currently unable to progress.
The NHS England MHLDA Quality Transformation Team have also developed a set of principles for the use of digital health technologies within mental health inpatient services. These have been co-produced with people with lived experience and frontline clinicians, are based on human rights principles and align to the Culture of Care Standards for mental health inpatient services.
Actions planned to deliver safety recommendation:
- Publication of principles for using digital technologies in mental health inpatient treatment and care. NHS England » Principles for using digital technologies in mental health inpatient treatment and care, by February 2025. Organisational lead: NHSE MHLDA Quality Transformation Team. This action is completed.
- Following publication of ‘Acute inpatient mental health care for adults and older adults’ in July 2023, launch of further work to scope principles to for organisations to provide a workforce with the values, experience and skill mix needed to support and prioritise therapeutic care and relationships, by March 2026. Organisational lead: NHSE MHLDA Quality Transformation Team. Additional comments: At the time of responding to this recommendation, resource constraints mean that this work is currently unable to progress.
- We will work with Integrated Care Boards/systems via our regions to support a multidisciplinary approach to the delivery of safe and therapeutic care, including the transition of young adults (18-25yrs) to adult services, by continuing to provide whole team learning opportunities to meet their Continuing Professional Development needs via a variety of learning opportunities ranging from short online modular courses to doctorate level in response to ICB/system Integrated Workforce Plans. By when: on-going. Organisational lead: NHSE WTE E&T MHLDA portfolio. Additional comments: Funded & commissioned activity in place for 24/25 25/26 - to be confirmed.
- All mental health care providers, including CYP residential and youth justice settings will have access to NHS England autism training via the national autism trainers programme and Oliver McGowan Mandatory Training (learning disability & autism focused). Organisational lead: NHSE WTE E&T MHLDA portfolio. Additional comments: Funded & commissioned activity in place for 24/25 25/26 - to be confirmed.
- Psychiatrists will undertake training leading to an Autism Credential aimed at improving care and treatment management in mental health care settings.
- Further expand the Approved Clinician to support the enactment of the current MH Act and the MH Bill currently being read in both Houses, which is expected to shortly attain Royal Assent.
- To support increased and improved clinical leadership, reductions in patient placement breakdown, inappropriate admissions, reduce length of stay, solitary confinement and improvements in early discharge and health inequality, mortality and morbidity rates, we will continue to offer 3yr Level 7 multidisciplinary Advanced Practice Learning Disability and Autism Practitioner upskilling. By when: on-going.
Response received on 22 January 2025 and updated on 3 June 2025.