The 2010 Spending Review and recent health settlements pose major financial constraints on the NHS. The ‘Nicholson Challenge’ of achieving £15-20 billion efficiency savings by 2015 continues. This alters the roles of all healthcare professionals in mental health, and reduces the availability of funding to implement technology-based solutions and value-added services.

Funding constraints result in a smaller medical mental health workforce. The remaining workforce has high workloads and pressure, which impact on the quality of care, resulting in downward pressure on medical trainees.

Proposed workforce impact

• Reduced numbers of vacancies for the consultant workforce
• Psychiatrists expected to take on more work
• Increased demand for nurse prescribers and psychologists
• Upskilling the workforce and greater demand for the workforce to manage and budget for their services

Sources or references

• HM Treasury, 2010, Public spending and reporting, Spending review.
• www.budgetresponsibility.independent.gov.uk
• Bell, (2010), Improving quality and value for money, Mental health and the productivity challenge, the King’s Fund.
• Mangalore, (2012), Mental health economics, mental health policies and the human rights implications, LSE Research Online, Oxford University Press.
• NHS Choices, (2012), Mental illness ‘under-treated by NHS’.
• Smith, Warning issued over worrying cuts to mental health services, Mental Healthy.

Additional research questions

• How will psychiatrists’ roles be impacted by the Quality, Innovation, Productivity and Prevention (QIPP) agenda to provide efficient services?
• How will the mental health team be impacted by moving to provide efficient services?
• Where do psychiatrists add most value?
• Can high-quality mental health services be maintained with fewer consultant psychiatrists?

Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.