Challenges and Implications of Mental Health Services in the UK NHS System

This report analyzes the challenges and implications of mental health services in the UK NHS system. It highlights the staffing issues and the impact on users. It also provides recommendations and an action plan to improve the mental health services in the NHS system.

Report Analysis
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Assignment one
Part A
Introduction
The National Health System in the UK has evolved to be one of the largest health care
systems globally. In the UK white paper on Equity and Excellence, the need for Liberating
the NHS so as to create a more responsive and patient centered health care system which
achieves the needed outcomes for the population has been indicated (Bevan et al., 2014). The
UK health care system comprises of separate health care systems; National Health Service,
Health Social Services and Public Safety in Northern Ireland. In the year 2014, in a
commonwealth funded report, the UK NHS system was ranked the bests compared to other
countries. This system is largely public funded where persons opting for individualized
treatment go for private health care facilities. All the systems provide primary care, mental
health services, preventive medicines, and hospital services among others. The social system
in all the countries is designed to support the children and adults at risks with needs on
illness, disability, old age or poverty through engagement of social services programs
(Meacock, Doran & Sutton, 2015).
Currently, there is immense pressure on the delivery of mental health services in the UK.
Mental health care operational framework comprises of state, private and community sector
arenas. According to investigations undertaken in the year 2018, the NHS is currently
struggling to cope with merging costs and demand for mental care services. This range from
shortage of beddings, long delays for treatment care and inadequate care. Key issues being
faced by patients include anxiety, suicidal thoughts, and depression among school-age going
children (McManus et al., 2009).
A key critical aspect for the delivery of health care services is staffing issues. Reports
indicate that during 2017, there was an estimate of 34,260 unfilled staff positions for nursing
and midwifery positions (McManus et al., 2016). This signified the greatest number of
positions ever in the history of the health care system. It is estimated that about 23% of
women giving birth were left along during delivery time causing anxiety and danger on post-
delivery complications; this is linked to few housewives available, indicating a significant
health issue in the overall NHS (Metcalf, 2016).

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The implication of the issues
In most of the scenarios, mental health problems are not easily defined, while a larger
proportion of the population is likely to face mental health problems each year. In the year
2014, a survey on Adult Psychiatric Morbidity reported that 17% of the adults in England met
the criteria for mental diseases while most severe cases were likely to be accessing services
(NHS). In the year 2017 survey, 65%of the Britons experienced mental health issues while
26% had panic issues and 42% suffered from depression (Office for National Statistics, ONS,
2016).
The role and capacity of the NHS have been overly overstretched in care provision for mental
health services. In a report undertaken in 2018, the majority of mental health patients died
after NHS care failures. The report further found out that an estimate of 271 deaths occurred
in 2012-2017, the majority of these deaths were sliced based. The investigation further
revealed that NHS is struggling to cope with high demands for mental care services coupled
with patients facing a long delay in access to treatments cares. Various NHS providers and
mental health organizations have attributed to the challenges of adequate staff for mental
health services. Further multiple notices of inadequate supervision for those displaying risks
of suicide have been found, NHS staff ignoring families and various risks being neglected
regarding patient medication (NHS England, 2014).
In view of these issues raised there is an urgent need to focus on various issues which address
policies, regulations, and staff related issues. There is a need for a complete overhaul on
national policies and guidelines which guide the overall health care system in the UK.
Adoption of effective and enticing human resources frameworks and benefits is essential for
luring back the professional staff into the NHS system, thus addressing staffing issues being
witnessed (Kaplan et al., 2010).
Impact on the users
Majority of pregnant women and new mothers developing mental health issues often get
inadequate help. Some of them have gone to the extent of committing suicide among mothers
with previous tears. The NHS considers that an estimate of 20% of the 775,000 women
giving birth annually suffers from mental health and their problem is connected to carrying a
child. These problems include anxiety disorders, depressions and psychotic disorders such as
bipolar disorders and schizophrenia (Benning et al., 2011).

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There is an increased case of anxiety and depression and suicidal thoughts facing many
young children and adolescents. Schools face an immense challenge on mental health issues
with teachers being at the front addressing the challenges. They witness devastating impacts
on pressures such as anxiety, bullying, and family-related issues (Hardacre, et al., 2011).
Each year it is estimated that 1 in 4 UK citizens have a mental problem, while 1in 10 children
need support for mental health problems. These range from issues arising from depression
short spells, anxiety and massive disruptive life-threatening conditions. These mental health
problems have an immense impact on the physical impact on the healthy population. People
having schizophrenia are more likely to die from heart relate diseases compared to the
general populations (Laurance et al., 2011). Among the young population, they are more
likely to engage in behaviors which pose risks to their health statuses such as drug abuse,
smoking and other risky sexual behaviors (Atkins, 2010).
Inadequate health care staff has led to a huge impact on the quality of health care in the NHS.
Limited health care staff in the health care administrations in the NHS system has led to
rising in neonatal mortality rates rising from 2.6 deaths per 1000 in the year 2015 to 2.7 -3.8
deaths per 1000 live births in 2017. Further, there is an increased level of assaults on nurses
with records indicating a 9.7% increased in the year 2016-2017 compared to 2015-2016
(NHS, 2018).
Challenges faced
The mental health services arena has been over the past years been sidelined and overlooked
with regard to prioritized spending and treatment improvements. Coupling this is the declined
in the number of staff handling mental health care treatments in the NHS. Faced with
numerous crises, the NHS is struggling with the provision of cares services leading to a lot of
people reaching crisis level.
Mental health care costs have been identified as a barrier to health care attainment. A recent
study estimated that mental health sickness costs as much as £100 billion per year
(Mihalopoulos and Chatterton, 2015). Further, mental sickness was affecting more than 70
million sick days per year hence signifying a leading cause of sickness in the UK (Lynch and
Dickerson, 2018). Among adults, 75% of them have had access to mental health services
having recognizable conditions. Among children and young people, mental sickness
accounted for a significant proportion of the burden of health (Alderson et al., 2017).

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Current staffing challenges have put a strain on the overall productivity gains of the staff.
Calls on the 24/7 services by the NHS has yielded little or no fruit. The current contracts of
staffs do not allow such avenues and practice. Changes on long working hours for the few
remaining health staff means an increase in their contractual performance signifies high
remuneration. This has coupled to underfunded health care system is likely not to be achieved
(Saltz, 2016).
The less remuneration and enticement to the health care staff at NHS, has led to an indication
that UK is slowly turning to be less enjoyable and attractive to health care professionals
causing an alarm among the social care and health services domain (NHS, 2014).
Overcoming the challenges
Improved mental health treatment is crucial as it enables people facing mental health
problems in becoming more productive workers. Most of the patients facing psychosis often
do not get full medication package. Understaffing of the NHS mental units leads to avoidable
deaths. Majority of vulnerable patients with eating disorders often travel long distances to
getting patient services which have high costs per year. This leads to severe mental health
problems which need to be addressed. The response to NHS care towards mental health
issues has often been a problem. NHS needs to respond and be accountable and enhance
improvements on health care services (Lafond, Charlesworth and Roberts, 2016).
Despite the observed high costs among the individuals and society on the economic status,
mental health professionals still have a wide range of NICE-approved interventions offering
effective approaches management. In the recent past, there has been the failure of people to
reach ad access care services and evidenced-based treatments. Estimates indicate that a
quarter of both children and adults receive medication on mental health service (England,
2018). Due to this vital evidence on the gap, there is a need for greater awareness and
reduction of associated stigma. This is exacerbated by the long history of low investments in
mental health services currently not offered to the general population. Further integrating
health care across the continuum of services risks health problems being neglected often.
With the high rates of heart diseases such as lung disease and heart diseases in mental health,
smoking issues have become a taboo in all the NHS. Further in mental health smoking has
been observed as tolerated with significant long terms effects, indicating disconnect on the
mental and physical health of the people. Thus there is an opportunity to overcoming and

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improving the overall improvement on the mental and physical health of the people.
Enhancing apprentice management skills in various organizations in the NHS system is likely
to play a fundamental role in addressing the concerns of the workforce and retaining them in
the context within the NHS system and overall social care. High attention is needed to focus
on the need to address funding options on postgraduate education and access to affordable
accommodation, greater workplace flexibility and better and efficient use of technology.
There is a need for retaining staff as a crucial element on the immediate term strategy,
further, focus need to shift to attracting people to the health care system with a view of
retaining for long term benefits. Further expanding various programs designed to help the
employees to work differently and retained the diverse workforce is crucial. These programs
include apprenticeship, support groups and other avenues to support the staff need to be
implemented in order to motivate them.
Conclusion
NHS system is faced with many challenges which affect the broader development of health
and social care. The mental health status of the population has been for a long time been
neglected coupled with understaffing and funding challenges. Further, the high turnover of
staff in the health care sector and the limited number is affecting the delivery of services. The
effect of this is on mental health care is devastating as a huge population is exposed to
dangers of mental effects. Adoption of a wide range of services and factors are needed so as
to improve the total staff and access to mental care services by the population.

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Part B
Executive Report
The immense pressure facing NHS in the recent past has been the inability to deliver on its
founding principles, emerging to be the greatest threat to service delivery. The challenges
facing the NHS system range from service pressure, lack of political response to the health
care system, and care for the aged population are diminishing. The NHS system currently
faces numerous health care issues currently threatening its role and mandate (Metcalf, 2016).
The key issues identified include; mental health issues and medical staffing issues.
Mental health services
Currently, mental health problems take long to be addressed. The high access challenge to the
health care system is making them jobless and financial stress. Most of the patients battle
with a diagnosis for long periods as they wait for treatment. There is an over-reliance on
drugs and lack of compassion form the health care workforces. It is estimated that two-thirds
of a person’s facing depression in the UK do not receive any treatment while a high
proportion is ignored by the dysfunctional NHS system.
Majority of the patients facing mental health diseases affect 1 in 6 people in the UK. This
causes enormous personal distress. Mental health priorities in the UK have often been
influenced by treatment costs, disrupted employment and investment in the mental arena.
Justification
It is estimated that there are around 1 in 6 persons affected by mental health associated
problems each year. The overall population likely to get exposed to mental health problems
are estimated to be 25% of the whole population. In a report undertaken in 2014, it was found
that around 17% surveyed in England met criteria for mental disorder while 37% were
receiving treatment. Further, in 2017, it is estimated that about 65% of the citizens face
mental issues while 26% have experienced pain while 42% have suffered panic (NHS, 2018).
Recommendation
- Utilization of technological evolution to cut across the NHS so as to reach and
improve access to mental services to the population.

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- Adoption of video calling technology with support center to reach a wide population
network as it is effective, cost-effective and friendly
- Technology improvement for peer support networks
Action plan
There is a need to design policies and services which focus on responding to mental health
requirements, health and social care services, further an ongoing effort to accurately forecast
the number of periods accessing mental health support together to those likely to need to use
the support in the future. This will inform the appropriate planning of how to implement
mental health access programs.
Staffing challenges
The workforce is the topmost concern for NHS across the UK. Many professionals are
currently exiting the health sectors of the NHS. Right workforce entails the right skills and
support for effective and sustainable health care system. A report undertaken in 2016
identified that the ability of NHS was fatally compromised due to staff shortages, inadequate
planning and inability to make use of available skills (Murray et al., 2013).
Justification
The number of staffs across the NHS has fallen significantly based on the previous year’s
data. The number of other staffs at the NHS such as clinical support staff rose by 2% in the
year 2017 while a drop in the number of community nurses and mental health care
professionals. There is a decline observed in the number of full-time equivalents between
2016 and 2017 while the reduction in a number of nurses. The continued rising admissions
and a declining number of nurses are likely to cause an impact on the length of the status of
patients in NHS hospitals. The fall on the number of training being carried out to train nurses
are lower in the UK compared to other countries (McManus et al., 2016). There is a need to
focus on avenues which aim at attracting the younger generation towards enrolling in nursing
programs.
Recommendation
- Offering and restoring the bursary system on nursing education so as to increase the

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attraction of students to study nursing,
- Enrolment of the apprentice policy framework to guide NHS staff is key so as to
improve on the retention rates of the entire staff at NHS.
Action plan
Development of an effective coordinated workforce policy implementation will play a critical
role in ensuring that staffs are retained in the health care sector. Need for a sustained and
nationally focused workforce plan policy is essential for connecting the link between staff
and policy mitigations solutions.

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Assignment Two
Reflection
Mental health access and provision of medical care plays a fundamental role in any society.
The current challenges facing NHS have a toxic impact on the general population. There are
hundreds of person dying of mental health access attributing to failure by the NHS on
detecting and responding to these issues. The evidence found have suggested that the NHS is
currently struggling to cope with the high number of mental cases and patients facing log
delay in accessing the services. Further exercebaratin the situation are the findings on the
rising of depression and suicidal thoughts among school going children. Further, the NHS
system has show neglect of these vulnerable populations. The entries system has numerous
challenges which need to ca caused attention. Further, a key significant issue worsening the
state of mental health is staffing related challenges facing the NHS. Mental health patients are
currently facing numerous challenges with regard to access and inadequate care offered for
mental health care patients. These problems have been further highlighted by NHS providers,
mental health organizations and charity organizations warning of the impending challenge.
The current NHS staff handling mental health issues have encountered multiple notices on
supervision regarding suicide patients and various health care staff making diagnostic errors
to patients and medication management due to lack of proper assessment of patients having
mental disorders.
In light of these tremendous and profound issues, there is a lot of work to be initiated with
regard to the assessment of the overall NHS capacity to handle mental issues and staffing
challenges facing the entire organization. The need and urgency for NHS reorganization on
access and adoption of effective measures to mitigate the high staff turnover are essential.
There is a need for approaches to tame the high turnover through motivation programs and
reviews of remunerations to the staff. As much there are financial costs reductions in NHS,
the need to priorities staff for effective work delivery is essential. The state of affairs on these
two key issues thus will enhance my skills and how to approach the crucial issues facing the
NHS system. As a team player in the NHS system, pushing for adequate measures are key
towards addressing the turnover issues and focusing on how to broaden access to mental
health care among the population in general.
Undertaking this exercise on issues affecting the NHS system in the UK has led to the rising

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of fundamental issues. Issues of health workforce within the NHS system are threatening to
bring down the overall overarching goal of NHS. Focussing on areas on employee retention
avenues so as to tackle employee challenges facing the NHS system is vital. Further, focusing
my research on implemented methodologies with regard to access to mental health services
across a wider population spectrum will be key. Focusing on technology-based
implementation opportunities will broaden my understanding and enable key focus on how to
utilize technology to reach the mental health related persons.

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