20% boost to NHS mental health social worker numbers

The NHS increased the size of its mental health social work workforce by 20% from 2019-22, official figures show.

However, there appears to have been a sharp fall in the number of partnership arrangements between NHS trusts and councils to deliver services while vacancy rates also appear to have risen, according to a census of the mental health social care workforce carried out for NHS England.

It showed that, as of 31 March 2022, the 58 mental health trusts had 3,576 whole-time equivalent (WTE) social workers in post, up from 2,894 in 2019, marking a 20% rise when differences in the two datasets are accounted for. The figures includes trainee social workers in year one of the Think Ahead fast-track qualifying programme.

The rise in NHS staff exactly matches an ambition set in 2019 for the health service to recruit an additional 600 social workers to work in mental health to deliver on its long-term plan, including in improving access to services.

As well as the increase in numbers, there has been a shift towards the NHS directly employing its own social workers – as opposed to seconding them from local authorities – with 91% of NHS practitioners being on health service contracts, up from 76% in 2019.

Fewer NHS-council partnership arrangements

This was reflected in the fall in partnership arrangements between trusts and councils. While in 2019, just over a quarter (27%) of NHS trusts directly employed all of their social workers, this grew to 59% in 2022.

There were corresponding falls in the proportion of trusts with a mix of practitioners who were directly employed or deployed through partnerships – from 61% to 40% – and in the percentage with practitioners only deployed through partnerships (from 12% to 1%).

Partnerships, in which practitioners from councils and trusts work alongside each other, either through secondments or having their employment transferred to the other organisation, had historically been a common way to deliver mental health services.

However, they have fallen out of favour in recent years, with some councils having ended deals due to the alleged neglect of their statutory social care duties under the Care Act 2014 through having their social workers working to NHS priorities.

More social workers in management or newly qualified

Compared with 2019, more NHS mental health social workers (9% up from 7%) were in management, but there had also been an increase, from 5% to 7%, in those who were either Think Ahead trainees or on their assessed and supported year in employment (ASYE).

Social workers were deployed across the full range of community and inpatient NHS services, the census revealed.

Within adults’ community services, they were most often deployed in generic community mental health teams (in 82% of trusts), early intervention services (79%) and brief intervention and assessment teams (75%). They were also commonly found in perinatal (68%), older people’s (67%), forensic and single point of access services (both 65%).

In inpatient settings, social workers were most commonly deployed in children’s (59%), acute inpatient (53%) and low secure (45%) services.

The 2022 census also recorded councils employing 1,794 WTE mental health social workers – though data was only provided by 63 of the then 152 authorities – and 93 practitioners employed by the four independent providers who supplied information.

Vacancy rate up

Across the full dataset, the social worker vacancy rate was 15%, up from the 9% recorded for NHS trusts alone in 2019, while there were also significant variations between in the number of practitioners organisations employed per 100,000 population in 2022, which ranged from 1 to 41 WTE staff.

The social worker workforce across the NHS, councils and independent providers in 2022 was more ethnically diverse than that for NHS trusts alone in 2019, with 24% of staff being from black, Asian, mixed or Chinese/other ethnic groups, compared with 18% for trusts in the original census.

The 2022 figure is broadly in line with that for local authority children’s services (24%) but behind the proportion in council adults’ services (29%).

The rise in mental health social worker numbers was welcomed by the NHS Confederation’s mental health network, which represents providers.

“Good social care is crucial in helping deliver the care needs of people experiencing mental health issues, so health leaders will welcome the rise in the number of social workers working in the NHS to support these patients,” said network chief executive Sean Duggan.

“Members will be concerned about the regional variation in the number of mental health social workers, as well as the vacancy rate being 15% , but leaders know that these issues are similar in other mental health teams and the health workforce generally.”

Call for further investment in Think Ahead

He urged the Department of Health and Social Care (DHSC) to ensure that the long-awaited NHS workforce plan – due imminently addressed requirements for mental health social workers – and also called for Think Ahead to continue.

The fast-track programme trains practitioners over just over a year, through placements in NHS trusts or councils, with social workers then undertaking their ASYE with the same employer, while also studying for a master’s degree.

Under its existing contract with the Department of Health and Social Care, Think Ahead is due to train a further cohort of 160 participants this year, in order to qualify in 2024 and complete their master’s in 2025.

In its response to the social work workforce census, a DHSC spokesperson said: “Social workers are crucial in supporting people with their mental health and emotional wellbeing. Since 2016 the Think Ahead mental health social work programme has created 820 qualified social workers, who have gone on to join the mental health sector working in NHS Trusts and Local Authorities.

“The increase of social workers employed within the NHS helps to join up health and care for people needing mental health support, giving those using inpatient and community services for their mental health, the opportunity to access excellent social work interventions like assessment, crisis care, safeguarding and discharge planning.”