Workforce health and wellbeing in England

Workforce health and wellbeing relies on access to effective emotional and mental health support for nursing staff

Why it matters

To support health and social care staff during the COVID-19 pandemic, specialist mental health and wellbeing hubs were established in each integrated care system (ICS) in England.

The hubs were to provide health care workers with faster access to clinical assessment and mental health services, including counselling.

The pandemic shone a light on the pressures facing the nursing workforce. Widespread staff shortages, increasing levels of demand and rising complexity of patient needs put nursing staff at risk of stress, burnout and ill-health. The government recognised the need to provide additional health and wellbeing support during the pandemic but removed this funding in April 2023, despite ongoing high-stress environments.

Without support for health and wellbeing, the nursing workforce is at risk of increasing sickness absence, placing pressure on other staff members.

Image of male nurse outside a blue building

How we collected evidence

In April 2023, we carried out a survey of all 42 ICS in England. We asked them about their current health and wellbeing provision and plans for future funding.

We wanted to understand:

whether they continue to receive any funding for the mental health and wellbeing hubs set up during the pandemic
the types of support being offered to nursing staff by the hubs
the impact of the hubs on staff wellbeing

We'll repeat this survey in April 2025, to better understand how the provision of support has changed over time.

What we learnt

Several hubs that had remained open said they would be offering reduced services due to funding being withdrawn. Several ICS continue to offer services despite their hub’s closure, such as occupational health, employee assistance programmes and talking therapy services.

From the feedback provided, the hubs seem to have had a positive impact on those who accessed them. Most hubs said that users were better able to return to work and remain well at work after accessing the hubs. Some hubs had close to a 100% satisfaction rate.

Key statistics

12 The number of hubs still open, according to feedback from 28 ICS

91% The proportion of staff at one ICS who said the support they received kept them in work

£4.5k vs £396k The cost per staff member retained, versus total recruitment costs at one ICS

Our position on this issue

Access to health and wellbeing support is crucial for nurses

The pandemic has significantly affected wellbeing among nursing staff. Ill-health, burnout, reduced working hours and early retirement have all increased.

Registered nurses’ exhaustion can lead to emotional and cognitive detachment from work. This can lead to increases in patient infections and nurse workload. Nurses working in hospitals with fewer registered nurses per patient were more likely to report higher levels of burnout and intent to leave their job. Nurses are experiencing moral injury through sustained exposure to unsafe working conditions, and this may lead to more post-traumatic stress disorder and other mental health conditions within the workforce.

We have previously raised concerns about the closure of the hubs. Support for nursing staff is critical to combatting rising rates of suicide, burnout, mental ill-health and sickness absence.

Providing wellbeing support is good value for money

Rates of sickness absence and attrition are lower in workplaces where nurses are being supported in relation to their mental health and wellbeing.

The cost of funding access to services such as counselling and talking therapy are considerably lower than the cost associated with recruitment of new staff to replace those who are burned out, on extended sick leave or have left the profession altogether.

If hubs are discontinued, alternative services must be provided

The current levels of support being provided in the wake of hub closures is inadequate to meet the mental health and wellbeing needs of nurses. The most recent data on staff sickness from NHS England shows that more than 1.5 million nurse and health visitor days were lost in 2022 due to anxiety, stress, depression and other psychiatric illness. On average, 1 in every 5 sickness days were lost due to mental health issues.

We have previously called on the government to urgently provide funding for dedicated mental health service provision for nursing staff. If the government doesn’t view the hubs as successful or effective value for money, then it must provide alternative services.

Responses to our survey indicate that, while some ICS would continue to offer reduced services or alternative services, these were not consistent across ICS, and it was not clear that they would be provided in all cases. It’s crucial that, regardless of which ICS a nurse works in, they have access to quality, timely support for their mental health and wellbeing to allow them to return to and remain in work.

What local health and care leaders should do to address this issue

Integrated Care System leaders should:

Clearly advertise the support available to staff, and make sure it’s easily accessible
Urgently prioritise the provision of additional mental health and wellbeing support when allocating budget for services

Service providers should:

Use the RCN Workforce Standards to support a safe and effective nursing workforce. Ensure nurse leaders are involved in workforce planning, setting staffing establishments and developing individuals within their workforce. The relevant standard is:

The health and wellbeing of nurses is fundamental to the quality of care they can provide. Supporting the nursing workforce to practice selfcare will help improve recruitment to the profession as well as support retention of the current workforce.