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

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.