Analysis of changes in the national mental health nursing workforce in England, 2011-2021

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. Aims To characterise 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

Youth mental health services

The poster illustrates findings from an evaluation of a youth-specific mental health service that formed part of a broader project on youth mental health

The development of nurse prescribing in mental health services: Outcomes from five national surveys 2004–2019

The development of nurse prescribing in mental health services: outcomes from five national surveys 2004-19 ABSTRACT Background: Nurse prescribing is increasing worldwide. Reports describing long term developments after implementation are rare. Aim: To explore data from national surveys of nurse prescribing in England’s National Health Service mental health services Methods: Five surveys were distributed to all mental health organisations between 2004 and 2019 Results: Response rates increased from 54% (n = 45/83) in 2004 to 79% (n = 42/53) in 2019. The estimated proportion of mental health nurses who were prescribers increased to 4.3% by 2019. Distribution between clinical practice areas did not change significantly over time, with largest numbers in community mental health teams. The proportion of nurse prescribers actively prescribing increased from 76.4% in 2014 to 87.8% in 2019. Independent prescribing became the predominant approach, with supplementary prescribing rarely used as the sole model within organisations. The scale of implementation varied Conclusions: Although nurse prescribing in mental health services has grown over time, growth has slowed and is variable at local level. Implications for nursing management: Organisations considering the introduction or growth of nurse prescribing should note the evidenced preference for an independent prescribing model to date and consider how to avoid unwarranted variation in nurse prescriber role distribution

Mapping Point-of-Purchase Influencers of Food Choice in Australian Remote Indigenous Communities: A Review of the Literature

Closing the health gap between Indigenous and non-Indigenous Australians relies, in part, on addressing the poor levels of nutrition in remote Indigenous communities (RIC). This article identifies and maps key influencers of food choice at the point-of-purchase (POP) in Australian RIC and identifies gaps in our knowledge. It is based on a narrative review of the literature pertaining to food in RIC from a range of disciplinary perspectives including nutrition, ethnography, public health, anthropology, and remote health to map POP drivers of food choice. In particular, the role of habit is identified as a key factor that has previously not been discussed in the literature. The conceptual framework can be used as a basis for future POP research in RIC and provides guidance for social marketers, public health, nutrition, and policy workers operating in this field

What can the experiences of young adult carers tell us about what can make services more helpful for them and their families?

Young adults who provide unpaid care for older relatives have poorer outcomes than their peers in education, employment, health and wellbeing. Services that can potentially have a positive impact on their lives include services provided to the person they care for. However, survey research in England has indicated that receipt of such services is not necessarily linked to fewer negative consequences for young adult carers. We conducted in-depth interviews with fourteen young adult carers who had responded to the original survey. We explored their experiences with services for the care recipient and what factors limit or enhance the usefulness of those services. We found three interrelated themes. First, difficulties accessing services can add to stress, and make problems harder to address when services are implemented; second, lack of continuity of services, and practitioners, undermines relationships and future trust in services, whereas consistent relationships are beneficial. Third, young adult carers described the benefits that resulted from their being involved in discussions and decisions about services, and the problems when this does not happen. The wellbeing of the young adult carer and the person receiving care are shown to be inextricably interrelated; we draw out implications for efforts to improve services

Social care inequalities in England: evidence briefing

Adult social care in England is once again high on the political agenda. The government has announced the introduction of a lifetime cap on eligible care costs and a slightly less harsh means-test for publicly-funded care. These are important developments which bear on the inequity of the costs faced by people with modest (or greater) wealth who are unlucky enough to develop a condition with substantial long-term care requirements, such as dementia. But funding reform of this kind largely ignores major underlying inequalities: in care need and unmet need, in the receipt and experience of care, and in the burden of unpaid caring. This briefing focuses on these inequalities in adult social care. It arises from a workshop held with policymakers and practitioners on 'Joining up, avoiding silos: social policy and services organised around the person'. Both the workshop and this briefing form part of the Nuffield Foundation funded research programme, Social Policies and Distributional Outcomes in a Changing Britain (SPDO), which examines social policies and social inequalities between the General Election in May 2015 and early 2020, the eve of the COVID-19 pandemic

The role of energy cost in food choices for an Aboriginal population in northern Australia

Objective: To explore the relationship between dietary quality and energy density of foods (MJ/kg) and energy cost ($/MJ) for an Aboriginal population living in a remote region of northern Australia.Design: For a 3-month period in 2005, we collected food and non-alcoholic beverage supply data from food outlets available to the study population. From these data, we compared the energy density of foods with their energy cost.Main outcome measures: Energy density and energy cost of food purchases.Results: The diet of the study population was high in refined carbohydrates and low in fresh fruit and vegetables. Foods with high energy density were associated with lower costs and contributed disproportionately to energy availability.Conclusion: The energy–cost differential between energy-dense, nutrient-poor foods and energy-dilute, nutrient-rich foods influences the capacity of Australian Aboriginal people living in remote communities to attain a healthy diet. This is consistent with the “economics of food choice” theory, whereby people on low incomes maximise energy availability per dollar in their food purchasing patterns, and has particular relevance for developing nutrition policy and strategies in Aboriginal communities, where poor nutrition is a major determinant of preventable chronic disease