Make the mental health of NHS staff a priority

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09 March 2023

Zosia Walecka
Policy Officer (Workforce)
NHS Providers


Stress, anxiety and depression are the most common reasons for staff absence in the NHS, with the latest figures showing they accounted for 520,460 days lost and over 22% of all sickness absences in October. As pressures continue to mount on the health service, a remedy is needed – and fast.

In 2021, 46.8% of staff became unwell due to work-related stress. Towards the end of that year, as the elective waiting list hit 7.07 million – 60% greater than before the pandemic – as many as 94% of trust leaders said they were concerned about the level of burnout across their workforce. Worryingly, there has been no reprieve.

Nearly one in 10 posts across the service are vacant and workloads are escalating.

Zosia Walecka    Policy Officer (Workforce)

In the last year, pressures across the NHS have increased significantly – and so has trust leaders' concern for their staff. Vacancy rates are at an all-time high, the cost-of-living crisis is taking its toll on services and staff, the NHS is contending with the most widespread industrial action in its history, and demand across the health and care system continues to pile up. Staff are feeling the impact of this day in, day out. 

Nearly one in 10 posts across the service are vacant and workloads are escalating. Trusts are working hard to deliver the NHS People Plan's wellbeing ambitions and implement and maintain local initiatives, but their efforts could be undermined if the planned funding cuts to staff wellbeing hubs – set up at the height of the pandemic – go ahead. NHS England's recently published occupational health and wellbeing roadmap (OHWB) is also a welcome step towards national prioritisation of staff wellbeing and empowering healthcare leaders to drive development in OHWB services, but this work is not sustainable without adequate funding. 

The cost-of-living crisis has also been taking its toll on the mental wellbeing of staff. Two thirds of trust leaders have reported an increase in mental health absence and leave due to stress. Rising costs and below-inflation pay rises are causing staff to look for roles in other sectors, further hindering the service's ability to manage operational pressures and exacerbating vacancies. One NHS HR director said that the cost-of-living crisis has been the "final straw for many staff who are fed up with not being valued by the NHS. [I'm] really worried about the personal impact on individuals".

Trust leaders understand why many NHS staff have made the difficult decision to take industrial action.

Zosia Walecka    Policy Officer (Workforce)

NHS leaders have put local support offers in place to help staff cope with financial hardships – setting up food banks, establishing shuttle services from local stations, offering debt counselling and increasing pay to staff in the lowest bands. However, there is a limit to how far they can mitigate the impacts of the increased cost of living for their employees.

In this difficult context, trust leaders understand why many NHS staff have made the difficult decision to take industrial action. Nurses and ambulance staff began strikes in December, while February saw the most widespread strike action in the NHS' history with further escalation planned for March involving the first junior doctors strike for years and an increase in ambulance strike activity.

While it's encouraging that the government has opened talks with the Royal College of Nursing on pay, we need to see similar negotiations take place with all striking unions. Without it, industrial action will continue. The most recent pay award was the trigger for the strikes, but the many persistent issues staff have been facing for years have also led to this – vacancies, workload and poor experience at work.

The NHS cannot function without its workforce or people – we need to invest in the right working conditions to sustain high-quality care for patients.

Zosia Walecka    Policy Officer (Workforce)

Looking after the health and wellbeing of NHS staff is crucial. National-level action has to complement and enable local initiatives to reduce stress, improve physical wellbeing and manage workloads. While chancellor Jeremy Hunt has helpfully committed to publishing a "comprehensive" NHS workforce plan, staff resilience can only be sustainably improved if this plan is coupled with funding for implementation and kept updated.

It is also vital that this plan addresses existing vacancy levels and adds the capacity needed to protect individual staff member's breaks, enable more flexible working patterns, and support staff retention. The NHS cannot function without its workforce or people – we need to invest in the right working conditions to sustain high-quality care for patients.

This blog was first published by HSJ.

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Zosia Walecka
Policy Officer (Workforce)

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