Abstract:
WHAT IS KNOWN ON THE SUBJECT?: Nurses work in mental health services around the world, constituting the largest professional group. Nurses have been identified as being potentially able to carry out a much wider range of functions than are typically allowed in practice, when provided with suitable training. There are long-term concerns regarding shortages of mental health nurses in England and many other countries. Workforce data is rarely subject to analysis in peer-reviewed journals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper provides a case study of the workforce patterns of a national mental health nurse (MHN) workforce overtime allowing comparison with other countries and specialities. MHN numbers reduced from 2011 to 2017, then increased to near the 2011 level by 2021, not meeting ambitious national plans for increasing numbers. The mental health nursing proportion of the total NHS nursing workforce decreased through this period. Advanced practice roles and skills are widely, but unevenly, distributed and are provided by a small proportion of nurses. The proportion of nurses working in community settings has increased to constitute more than half of all nurses for the first time. The ratio of support workers to nurses increased in inpatient settings and will continue to change. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Historical challenges in recruiting MHNs suggest that future plans to expand the profession are overly optimistic. To support the development of advanced practice roles and new skill sets, clearer research evidence of impact is required and clearer national guidance regarding best practice models. Good workforce data are essential to inform good workforce planning. ABSTRACT: Introduction Data regarding changes in characteristics of the MHN workforce is commonly cited in governmental publications, but is rarely analysed in peer-reviewed journals, despite ongoing concerns regarding high vacancy rates within mental health services. Aim The aim of the study was to characterize changes in the MHN workforce, implementation of new nursing roles/skills and alignment with national policy. Method Analysis of nationally published workforce data, peer-reviewed publications and governmental policy/planning documents. Results Nurse numbers declined from 2011 to 2017, subsequently returning to near 2011 levels, but remaining below national targets. Nurses in community settings increased to constitute more than half of all nurses, whilst inpatient numbers declined, although more slowly than bed numbers. The ratio between nurses and support workers changed due to more support workers in inpatient settings. New advanced skills and roles for nurses have increased, but are unevenly distributed, constituting a small proportion of the total workforce. Implications for Practice This paper provides a case study against which comparisons may be made with the nursing workforce in other countries and specialities. Even clear policy commitment to nursing growth may not deliver planned changes in numbers and introducing new roles may have uneven impact, especially in the absence of a robust evidence base.
摘要:
关于这个主题的知识是什么?:护士在世界各地的精神卫生服务部门工作,构成最大的专业群体。护士被认为可能能够执行比实践中通常允许的更广泛的功能。如果提供适当的培训。在英国和许多其他国家,人们对心理健康护士短缺存在长期担忧。劳动力数据很少在同行评审的期刊上进行分析。论文对现有知识有什么帮助?:本文提供了一个案例研究,研究了国家心理健康护士(MHN)劳动力加班的劳动力模式,可以与其他国家和专业进行比较。MHN的数量从2011年减少到2017年,然后到2021年增加到接近2011年的水平,没有达到雄心勃勃的国家计划。在此期间,心理健康护理在NHS护理人员总数中所占比例有所下降。高级实践角色和技能广泛,但不均匀,由一小部分护士提供。在社区工作的护士比例首次增加到所有护士的一半以上。在住院环境中,支持人员与护士的比例有所增加,并将继续变化。实践的含义是什么?:招聘MHN的历史挑战表明,未来扩大职业的计划过于乐观。为了支持高级实践角色和新技能的发展,需要更清晰的影响研究证据,以及关于最佳实践模式的更清晰的国家指南。良好的劳动力数据对于制定良好的劳动力计划至关重要。摘要:介绍有关MHN劳动力特征变化的数据通常在政府出版物中引用,但很少在同行评审的期刊上进行分析,尽管人们一直担心心理健康服务中的高空缺率。目的这项研究的目的是描述MHN劳动力的变化,实施新的护理角色/技能,并符合国家政策。方法分析全国公布的劳动力数据,同行评审的出版物和政府政策/规划文件。结果护士人数从2011年到2017年下降,随后恢复到2011年的水平,但仍低于国家目标。社区护士占护士总数的一半以上,虽然住院人数下降,虽然比床号慢。护士和支持人员之间的比例发生了变化,因为住院环境中有更多的支持人员。护士新的高级技能和角色增加了,但是分布不均匀,占劳动力总数的一小部分。对实践的启示本文提供了一个案例研究,可以与其他国家和专业的护理人员进行比较。即使对护理增长的明确政策承诺也可能无法实现计划中的数字变化,并且引入新角色可能会产生不均衡的影响。尤其是在缺乏有力证据的情况下.