Staff shortages force mental health trusts to cancel patient activities and close wards, says King’s Fund

Authors: Abi Rimmer 

Publication date:  17 Jan 2018

Problems with staffing have forced mental health providers around England to cancel patient activities and close wards, a report by the King’s Fund has warned.[1]

The research by the healthcare think tank found that mental health providers were struggling with high staff vacancy rates and turnover, a reliance on bank and agency staff, and an inappropriate skill mix. It said that this had led to patient activities being cancelled, wards being closed owing to safety concerns, and patients being unable to leave wards because no staff members were available to accompany them.

The findings were based on NHS mental health, acute, and specialist provider trusts’ annual accounts and an analysis of national workforce data. The research also included a review of the Care Quality Commission’s inspection reports on each of the 54 NHS mental health trusts in England and a review of eight mental health trusts’ board papers.

It found that 84% of the trusts received a funding increase in 2016-17. However, from 2013 to 2015, around 40% of mental health trusts had seen a reduction in their cash budgets, and this rose to almost 50% the following year.

Including income from the sustainability and transformation fund, the research found that mental health trusts’ income grew by 6% from 2012-13 to 2016-17, while acute trusts’ income grew by 17%. The sustainability and transformation fund is a £1.8bn ringfenced fund administered by NHS Improvement, NHS England, the Department of Health, and the Treasury.

The slow growth in funding for mental health providers had increased variations in care, reduced access to services, and caused staffing problems, the report said. It also noted a 13% reduction in full time equivalent mental health nurses from September 2009 to August 2017.

“Nationally, approximately 10% of all posts in specialist mental health services in England are vacant,” it warned.

Helen Gilburt, author of the report and health policy fellow at the King’s Fund, said that, unless funding grew more quickly, mental health providers could end up implementing improvements to some services at the expense of others.

“Despite the commitment of national leaders, the funding gap between mental health and acute NHS services is continuing to widen, while growing staff shortages are affecting the quality and safety of care,” she said. “As long as this is the case, the government’s mission to tackle the burning injustices faced by people with mental health problems will remain out of reach.”


  1. Gilburt H. Funding and staffing of NHS mental health providers: still waiting for parity. King’s Fund. 18 Jan 2018. [Link] .

Abi Rimmer The BMJ

Cite this as BMJ Careers ; doi: