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Mental health workforce

• This theme is led by Paul Tiffin
• Paul Tiffin's publications

Over the next decade it is likely that much of the variation in quality of care, clinical outcomes and patient experience within the health service will be determined by workforce factors. This will be especially true of areas such as mental health, which have traditionally faced challenges in recruiting and retaining adequate numbers of staff. 

Patients using mental health services may be especially vulnerable to becoming victims of unprofessional behaviours and misconduct for a variety of reasons. Moreover, there is evidence that the mental health workforce may have higher rates of mental ill health and professionalism issues than many other comparable healthcare fields. In addition, mental health services often struggle to recruit UK-trained professionals and traditionally have relied heavily on staff from overseas. This may introduce linguistic and cultural factors which can potentially act as an impediment to the patient/professional relationship in a context which is very sensitive to such interactions. Along with surgeons and obstetricians, psychiatrists are over-represented, relative to other specialities, in terms of Fitness to Practise complaints received by the General Medical Council. Thus, there exists a situation where a vulnerable patient group is being cared for by a vulnerable staff population.

The issues identified in the Francis report (2013) and the abuses recorded at Winterbourne View have led to the requirement for 'Values Based Recruitment' (VBR) approach in the NHS; from March 2015 all healthcare providers were expected to implement VBR. However, the science of selection is lagging behind these political imperatives; it is not clear as to the extent to which such values can be operationalised and measured. Whilst the most cost-effective approach to VBR is currently unknown, the use of Situational Judgment Tests (SJTs), where knowledge of professional behaviour is evaluated via a candidate’s responses to presented social situations, offers a plausible, practical and legally defensible method. Emerging evidence regarding the validity of SJTs for medical selection suggests that the scores may predict performance in clinically orientated tasks. The work related to this theme intends to build on previous research in the field of medical education in order to develop ways of understanding and enhancing the effectiveness of the mental health workforce.

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