Mental health services safe staffing: A commissioned rapid scoping review for NHS England

Abstract This Rapid Scoping Review, commissioned by NHS England, examined recent evidence on safe staffing in mental health services, with a focus on mental health nurses across inpatients and community settings. Drawing on literature published between 2018 and 2024, the review addresses two key questions: the impact of nursing skill mix on patient outcomes and the impact of current deployment models in supporting safe, efficient care in mental health services. Findings revealed that inadequate staffing and poor skill mix were perceived to compromise quality and safety. Staff shortages were linked to medication errors, incomplete care and increased aggression, while the use of temporary staff and high absence rates were associated with poorer outcomes. Broader literature suggested that increased staffing may reduce suicide-related events, but mental health nurse specific data were limited. Evidence on shift patterns and deployment was also inconclusive. Overall, the evidence base was fragmented and of low quality, limiting the ability to make definitive policy recommendations. However, the findings may inform future pilot service evaluations and targeted improvements in mental health nurse staffing strategies. Competing Interest Statement The authors have declared no competing interest. Funding Statement This study was funded by NHS England Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability All data produced in the present study are available upon reasonable request to the authors