Mental health strategy 2017-2027: second progress report

5. Investment in the Workforce

We have made significant investments in the mental health workforce. We remain in constant dialogue with Integration Authorities about their recruitment plans under Action 15. This is our commitment for 800 additional mental health professionals in GP practices, A&E departments, prisons and custody suites by 2021/22. A quarterly Reporting Framework has been agreed with Integration Authorities and we are seeing good progress with 268 additional whole time equivalent (WTE) staff employed as of 1 July 2019. 

In December 2018, following the recommendations of the Children and Young People’s Mental Health Taskforce, the Scottish Government also announced that an extra 80 mental health professionals will be recruited to work with children and young people in Scotland. This is part of a £4 million investment. The additional staff will be made up of psychologists, nurses, allied health professionals and administration workers. The recent uplift in the CAMHS workforce – up 4% in the last year – suggests that we are starting to see the impact of this investment on staff resources.

As already noted, the Scottish Government has invested £58 million to support NHS Boards over four years (2016-20). This investment has contributed to the work of NHS Education in Scotland in workforce development and training. It has also supported workforce growth. As a result, there has been an increase of 59 WTE in CAMHS (up by 6% from 993.5 WTE in March 2016 to 1,052.4 WTE in June 2019) and 101 WTE psychology services posts (up by 9% from 1,079.2 WTE in March 2016 to 1,179.9 WTE in June 2019). 

The funding has also been vital in facilitating improvement work. The Mental Health Access Improvement Team (MHAIST) was established to support NHS Boards, using quality improvement methodology, to provide every board with local capacity from an Information Services Division analyst, and to improve access and reduce waiting times. MHAIST is working with NHS Health Improvement Scotland and Information Services Division to provide health information to the NHS to review the impact of this work.

MHAIST is supporting NHS Boards to develop and deliver frontline improvement projects through a collaborative. It is also supporting individual Boards to understand strategic improvement issues. Examples of improvements include the following.

• NHS Fife is increasing self-referral to low intensity psychological therapies through the use of web-based services. The Access Therapies Fife website removes the need for GP referral to lower intensity interventions, and allows more capacity within the clinical team for provision of support to those needing higher intensity therapies. The site has allowed more than 1,700 people to manage their support by self-referring to a range of therapy groups, with support being received within six  weeks of referral.
• NHS Lanarkshire has focused on reducing ‘do not attends’ (DNAs) in Psychological Therapies. DNAs have a significant impact on all staff and patients, impacting on caseload, therapeutic relationships and waiting times. This work has resulted in a further reduction in waiting times from 13 to 11 weeks. 
• NHS Ayrshire and Arran CAMHS has taken a whole system approach to mental health support aligning specialist CAMHS teams with developing initiatives in partnerships with North Ayrshire schools, primary care and other parts of the community. They worked with parents, GPs and CAMHS nurses and clinicians to develop a service guide, improve information sharing and increase access to the right service at the right time and now 99% of GP referrals are made to named clinicians. As a result, the demand and average wait from referral to routine assessment in Kilwinning has reduced. The Ayrshire and Arran Wellness Model has significantly influenced, managed and changed the demand pressures placed on specialist mental health services to children and young people in the locality, ensuring those individuals with serious mental health concerns are seen timeously and appropriately.

Lastly, as part of the work of the Children and Young People’s Mental Health and Wellbeing Programme Board, NHS Education in Scotland is taking forward a programme of training and skills development across the range of workforces supporting mental health and wellbeing in Scotland.