Building capacity to better meet growing and changing demand

In NHS Providers' autumn 2024 survey of trust leaders, more than 9 out of 10 respondents from mental health trusts said they were worried about their trust’s capacity to meet demand over the next 12 months.  

At a local level, there are steps mental health trusts can take to maximise the inpatient capacity they do have available such as by improving patient flow and reducing variation in the length of time patients stay in hospital. Effective partnership working with physical health and community services is also vital to maximising their inpatient capacity and make best use of resources more generally. Mental health trust leaders have told us there is significant variation in the availability and consistency of community-based support. This needs to be addressed to enable the effective flow of patients through services appropriate for their needs. Trust leaders have also been clear that delivering the shifts to prevention and managing more risk safely and effectively in the community cannot be done without trusts being adequately resourced. 

Retaining staff with the right skills and experience to work in core mental health services is a challenge for many trusts and so will be important to focus on to build and sustain the sector’s capacity. We should explore and share the work of trusts that have been successful in this area to enable the rest of the sector to learn from. Retaining staff with the right skills and experience in community mental health teams has been raised as particularly challenging. It is an area that needs focus in the short to medium term, given these staff are a fundamental element of a well-functioning system of mental health care. It would also be helpful to explore bringing together mental health teams in trusts as a collective resource, rather than having several specialised teams that draw staff away from core services. 

The challenges facing the social care sector have also been highlighted by mental health trust leaders as a further significant issue and amplifier for the capacity pressures felt in their services. A lack of social care capacity has a significant impact on the ability of trusts to discharge patients when they are ready with the packages of care support provided by social and community services the need, which would in turn free up capacity for others who require inpatient care.  

Greater access to capital funding is another key enabler to mental health trusts being able to ensure they have the right amount of capacity to meet local need, in addition to improving patient care and making best use of resources more broadly, which we explore in more detail in another section of this briefing.