"We rob off the in-patient unit": a qualitative study of the recruitment of CPNs by Mental Health Trusts

Abstract

This paper reports an audit of Mental Health Trusts in North West England. The aim of the study was to investigate recruitment of community psychiatric nurses (CPNs), and to explore the experiences of the professionals trying to recruit nursing staff. A telephone survey was carried out in Autumn 2003 of five Mental Health (MH) Trusts in North West England. Telephone interviews with Human Resources staff and senior managers were set up although some conversations took place by E-mail. Content analysis of the notes of the telephone and e-mail conversations was carried out. It was hard to establish a true picture of nurse vacancies initially because it was difficult to find the appropriate person to speak to. It became apparent that recruitment and vacancies were recorded in terms of a person or post rather than hours. Managers admitted than posts were often filled with part-time staff. Using nursing hours as a measure of staffing levels rather than counting individuals gives a more accurate picture of staffing levels but such data was not available. In addition, it was reported that a post unfilled for more than three months stops being counted as a vacancy. It was reported that the amount being spent on temporary or bank nurses has increased sharply in the past five years, which strongly suggests that there are not currently enough permanent nurses in post. In addition, an increase in international recruitment was reported and managers reported that recruitment to CPN posts was often at the expense of inpatient units. This study confirms the perception amongst Mental Health Trust Managers of a shortage of Psychiatric Nurses. The paper describes the difficulties in obtaining accurate vacancy data, and the perceived difficulties in recruitment of nursing staff. We suggest that current arrangements of care for people with mental health problems delivered by CPNs may not be sustainable.