Part 4 of a 4-part series exploring how acute hospital staff support patients in mental health crisis, and why this directly impacts NHS Oversight Framework metrics that determine organisational performance.
The Strategic Case for Mental Health
The NHS Oversight Framework assesses trusts’ effectiveness across multiple domains. We’ve addressed the strategic case for mental health investment across access to care, effectiveness and experience of care, and patient safety. Now we turn to hospital staff themselves.
The NHS Oversight Framework directly measures trusts in this domain by evaluating sickness absence rates and using the NHS Staff Survey to assess staff engagement. Mental health issues are the single biggest cause of staff sickness absence in acute trusts. Anxiety, stress, depression and other psychiatric illnesses have remained consistently the most common reason for staff sickness, accounting for up to 3 in 10 days of all full-time equivalent days lost for staff in acute trusts (NHS England, 2025).
This is a strategic issue. Supporting patients in mental health distress, without the tools or confidence to do so, is a significant contributing factor to staff burnout – and directly impacts sickness absence and engagement metrics that determine organisational performance.
Why This Happens
Providing hospital care is one of the most highly pressurised occupations. Recent years have intensified these pressures across the board. Research from the University of Bath in collaboration with the Royal College of Emergency Care found that unprecedented funding pressures, bed shortfalls and lack of investment are leading to increased staff burnout and attrition (RCEM, 2025). As many as 1 in 7 healthcare workers are actively seeking to leave the NHS (University of Bath, 2023).
But there is a very real case to be made that delivering mental health care without the tools or confidence to do so is a significant contributing factor to this burnout.
Staff are being asked to support patients in mental health crises, often without any training whatsoever. They face emotionally challenging demands and feel unqualified, unsupported and out of their depth. Good people burn out when they are asked to do a job they do not have the tools for.
Our own research confirms this. We found that caring for patients in mental health crisis is a significant source of emotional exhaustion for acute staff. 1 in 13 staff we surveyed reported stress so severe that they had missed at least one day of work over the preceding four weeks specifically due to the emotional toll of supporting patients in mental health distress (We Can Talk, 2026). That is around 7% missing work directly because of this one area of care alone.
The financial impact is substantial. The human cost is immeasurable. And behind every 1 in 13 who are distressed enough to warrant sickness absence, there are many more for whom this issue is contributing to mounting levels of stress, emotional exhaustion and dissatisfaction with their role.
Emotional exhaustion is a key driver of poor engagement. Staff survey analysis links staff burnout, stress and overload with higher levels of staff turnover. Burnout is driven by factors like poor supervision, teamworking and conflict – all of which are exacerbated when staff feel unequipped to handle challenging situations, leading to low scores in staff “Motivation” and “Involvement” used to measure engagement in the NHS Staff Survey (NHS Staff Survey, 2024; Kings Fund, 2025).
The Solution: Building Organisational Resilience
There are complex and systemic issues underlying staff burnout and attrition. We can’t magic away this reality. But we can offer staff the support to tackle an area of their job that creates significant emotional demand. We can fix this.
When staff have the foundational training necessary to do their job, everything shifts. After completing We Can Talk, 85% of staff feel more emotionally prepared to support patients in mental health distress. Staff are 51% more confident and 52% more knowledgeable (We Can Talk, 2026).
That’s more staff who are prepared and supported to face the demands asked of them. When staff are more emotionally prepared, they are less vulnerable to the emotional exhaustion that requires absence from work or that slowly corrodes motivation. When staff feel equipped with skills, knowledge and confidence, they are more resilient to the demands placed upon them.
Solving complex problems can be a matter of tackling one salient aspect at a time. We Can Talk is a simple yet effective solution: a one-hour session appropriate for all staff, with measurable impact across multiple NHS Oversight Framework domains.
If trusts can improve the experience of staff who require time off due to emotional exhaustion from supporting patients they feel ill-equipped to help, the investment in mental health training will quickly pay for itself many times over. Currently, staff are unprepared to meet the demands placed upon them by increasing mental health presentations. Lack of preparedness creates vulnerability – for patients and for staff.
It is up to trusts to ensure that staff have the foundational understanding to effectively carry out their roles. The resulting impact on motivation, engagement and sickness rates will be reflected in performance metrics under the NHS Oversight Framework.
Stay Updated on the NHS Oversight Framework Series
This is the final part in a four-part blog series exploring how acute hospital staff support patients in mental health crisis, and why this directly impacts NHS Oversight Framework performance.
Part 1 -Access to Services: The Mental Health Crisis in Emergency Care
Part 2 – Effectiveness and Experience of Care: The Hidden Crisis of Patient Experience
Part 3 – Patient Safety: Is Mental Health and Safety at Risk?
The underpinning policy evidence from this series is now available in our briefing report: The NHS Oversight Framework, Acute Hospitals, and Mental Health.