NHS Mental Heath Workforce definition

The list of values included in the definition from the National Workforce Data Set (NWD) version 3.4 and the NHS Occupation Code Manual version 20.0 are listed below. This definition covers the entirety of what is regarded as the NHS Mental Health Workforce – both registered and support staff, with no distinction between the two broad categories.

Note that Tertiary Area of Work (AoW) is the most granular level of AoW and is the only version visible to trust users who manage the data within their individual Electronic Staff Record (ESR) system. Values are grouped into the higher level of Secondary AoW and further grouped into Primary AoW within the ESR Data Warehouse for secondary use and analytical purposes. For ease of analysis most of the relevant records can be extracted by using the most grouped Primary AoW values, with the need to refer to only a limited number of Tertiary AoW values which do not nest directly into exclusively mental health related secondary or primary levels. In the listing below the values are presented to aid both those undertaking the initial coding of the NHS Mental Health Workforce and the subsequent analysis.

In the below definition, * represents any valid character. Anyone not familiar with the NHS Occupation Codes should refer to the Excel annex which accompanies this definition, or the latest version of the NHS Occupation Code Manual for more detail.

NHS Occupation Codes and corresponding care settings:

Primary AoWs are not visible to operational users of the ESR – the below table links the tertiary values visible to data inputters, to the secondary and primary values which can be used to simplify analysis:

Art Therapy
Art/Music/Dramatherapy
Counselling
Dramatherapy
Music Therapy
Clinical Psychology**
Child Psychotherapy**
Psychotherapy**
Learning Disabilities**
Substance Abuse**

This definition will be updated as the values within the NWD and NHS Occupation Codes are updated in response to service changes and the creation of new roles or teams – please refer to the latest published version of the NWD specification for further detail on the values available.

In late 2017 the size and nature of the mental health workforce became a priority area following the publication of the mental health workforce plan for England, and a number of exchanges in Parliament and via social media. Following this attention in late 2017, the head of regulation at the Office for National Statistics (ONS) instructed NHS Digital to develop statistics on the mental health workforce. 

Following the letter from the ONS, NHS Digital produced information as part of the January 2018 workforce statistics release which presented 3 ways to count the mental health workforce as well as a widest measure which included anyone in any of the 3 categories. 

There was no attempt at that time to determine what an optimal definition might be or present any single number for the mental health workforce – simply to illustrate that there are multiple ways in which this workforce can be counted.

In June 2018, the Workforce Information Review Group (WIRG) agreed the benefit of developing a single definition.

A sub-group of WIRG, comprising representation from Department of Health and Social Care (DHSC), NHS Digital, NHS England, Health Education England, NHS Improvement and mental health trusts, was established to undertake this task with a two-stage approach:

First, the development of a single definition using the existing data standards - meaning those data fields and lists of values already present on the National Workforce Data Set (NWD) and available to NHS Digital and others via the ESR.

Second, to consider whether this definition adequately captured the mental health workforce, or whether further development of the data standards would be necessary.

The sub-group reached agreement in December 2018, with subsequent confirmation from each represented body, that the definition using the existing data standards be on the following basis:

1. The two fields ‘Occupation Code’ and 'Area of Work' define the mental health workforce, and these two fields are the only determinants of the definition. The employing organisation type is not taken into account.
2. Records are included if the value of either of these two fields suggests mental health provision.
3. Codes pertaining to learning disability are included in the definition, whilst recognising that the underlying data enables such staff to be separately identified if necessary.
4. Codes that might potentially include staff delivering at least some provision of mental health services, but clearly a significant amount of non-mental health provision, are excluded – though a narrative should be drawn up to explain this.
5. It is acknowledged that for some specific purposes, different definitions may be considered to be more appropriate, but this should be explicit in their presentation.