As winter pressures intensify across the NHS, Child and Adolescent Mental Health Services face unique challenges during the festive period. With mental health services receiving a record 5.2 million referrals during 2024, NHS trusts and healthcare commissioners must implement robust workforce strategies to maintain service continuity when demand peaks and staffing becomes particularly challenging.
The Reality of Winter Pressures in CAMHS
The winter months present a perfect storm of operational challenges for CAMHS providers. Recent data reveals that around 53,000 NHS staff absences were recorded weekly in January 2025, compounding existing capacity constraints. While traditional NHS services see obvious seasonal surges, nearly half of trust leaders confirmed that demand for mental health services increases over the winter months.
For young people experiencing mental health crises, the holiday season can be particularly difficult. The festive period often exacerbates feelings of isolation, family tensions, and anxiety, leading to increased referrals precisely when services are most stretched. Mental health needs among children aged 8-16 have increased from 12.5% in 2017 to 20% in 2023, with rates reaching 23% for 17-19-year-olds, creating unprecedented demand that shows no signs of abating during the holidays.
Understanding the Workforce Challenge
The recruitment and retention crisis in CAMHS represents one of the most critical barriers to maintaining service quality. Professor Chitsabesan identified workforce shortages as one of two critical challenges for NHS England in child and adolescent mental health, with high vacancy rates across all clinical staff and the greatest gaps in nursing.
Current CAMHS workforce data paints a concerning picture. While there has been a 128% increase in CAMHS staff since 2006 and a 50% increase since 2016, this growth has failed to keep pace with the exponential rise in demand. The treatment gap, where demand for care significantly outstrips capacity, widens further during holiday periods when permanent staff take annual leave, sickness absence rises, and bank staff availability becomes limited.
Trusts must also contend with the reality that current estimates put the mental health waiting list at 1.7 million people, with CAMHS services bearing a substantial proportion of this burden. The consequences of inadequate staffing during peak periods extend beyond waiting times to affect the quality of therapeutic interventions, crisis response capabilities, and ultimately, patient outcomes.
Strategic Workforce Solutions for the Holiday Season
1. Early Planning and Predictive Forecasting
NHS trusts should begin winter planning no later than September, using historical data to predict demand patterns and identify potential staffing gaps. Analyse previous years’ absence rates, referral volumes, and crisis presentations during December and January to build accurate capacity models.
Consider implementing dedicated winter surge teams that can be mobilised quickly during peak demand periods. These teams should include a mix of permanent staff working additional shifts and experienced bank or agency workers who understand your service protocols.
2. Flexible Staffing Models
Traditional permanent recruitment alone cannot address the seasonal fluctuations inherent in CAMHS service delivery. Progressive NHS trusts are adopting hybrid workforce models that combine:
Internal Staff Banks: Develop robust internal bank systems that encourage existing staff to work additional shifts during critical periods. Offering enhanced rates during the festive period and guaranteeing minimum shift allocations can improve uptake while maintaining service quality through continuity of care.
Specialist Agency Partnerships: Partner with specialist CAMHS recruitment providers who understand the unique complexities of child and adolescent mental health services. Unlike generalist agencies, specialist providers maintain pools of clinicians with relevant experience, appropriate DBS checks, and up-to-date safeguarding training; critical factors when working with vulnerable young people.
Block Booking Arrangements: For predictable gaps such as annual leave periods, arrange block bookings with agency staff well in advance. This ensures consistency of provision and allows temporary staff time to familiarise themselves with service procedures and protocols.
3. Retention-Focused Initiatives
Retaining existing CAMHS staff through the challenging winter period must be a priority. Consider implementing:
- Wellbeing support programmes: The holiday season takes a significant toll on NHS staff. One in three NHS workers have experienced mental ill health, and tragically, one in four have considered suicide. Proactive wellbeing initiatives, including access to confidential counselling and peer support networks, can reduce burnout and improve retention.
- Flexible rota patterns: Allow staff to express preferences for specific days off during the festive period and accommodate these where possible. This demonstrates organisational recognition of work-life balance and can improve morale significantly.
- Recognition schemes: Implement winter recognition programmes that acknowledge the extra effort staff make during this demanding period, whether through additional time off in lieu, thank-you bonuses, or public recognition.
4. Service Prioritisation and Pathway Management
During periods of capacity constraint, effective triage and prioritisation become essential. Implement clear decision-making frameworks that ensure:
- Urgent and emergency cases receive immediate attention
- Routine appointments are managed through active waiting list management
- Virtual delivery options are maximised for appropriate cases, reducing the need for face-to-face appointments
- Discharge planning is accelerated where clinically safe to free capacity
Consider establishing holiday-specific crisis pathways that provide alternatives to admission where appropriate, utilising intensive home treatment models or enhanced community support during the festive period.
5. Collaborative System Working
NHS trusts should strengthen partnerships with social care, education, third sector organisations, and primary care to distribute demand more effectively. Integrated care systems provide opportunities to pool resources, share workforce capacity, and develop joint protocols for managing complex cases during the holiday period.
Multi-agency training sessions before the winter period can ensure all partners understand referral criteria, escalation pathways, and mutual support arrangements, reducing inappropriate referrals and enabling more efficient use of specialist CAMHS capacity.
Quality Assurance and Governance
Maintaining service quality with increased reliance on flexible staffing requires robust governance arrangements:
- Enhanced supervision: Ensure bank and agency staff receive appropriate clinical supervision, particularly when working with complex or high-risk cases
- Competency verification: Implement systematic competency checks for all temporary staff, verifying credentials, experience, and familiarity with local safeguarding procedures
- Incident monitoring: Establish real-time monitoring of serious incidents and near-misses during winter months to identify any correlation with staffing patterns
- Patient feedback: Actively seek feedback from young people and families about their experiences during the holiday period to identify quality concerns early
The Business Case for Specialist CAMHS Recruitment Support
For NHS commissioners and service managers, the financial argument for partnering with specialist CAMHS recruitment providers extends beyond simple cost comparison. Consider:
Reduced recruitment burden: Internal HR teams stretched across multiple service areas often lack the specialist knowledge and networks to source CAMHS-experienced clinicians quickly. Specialist agencies maintain active relationships with qualified professionals specifically seeking CAMHS opportunities.
Faster fill rates: Recent data shows 54.2% of CAMHS vacancies were in psychology, 22.2% in nursing, and 7.2% in other professional groups, with many positions advertised for extended periods. Specialist agencies’ focused candidate pools significantly reduce time-to-hire.
Compliance assurance: The complexity of safeguarding requirements, enhanced DBS checks, and CAMHS-specific competencies means compliance verification is critical. Specialist agencies handle this comprehensively, reducing organisational risk.
Quality of candidates: Agencies specialising exclusively in CAMHS understand the unique skills, experience, and temperament required to work effectively with children and young people experiencing mental health difficulties, resulting in better candidate-role matching.
Looking Ahead: Building Resilience Beyond Winter
While implementing emergency measures to manage immediate winter pressures is essential, NHS trusts must simultaneously develop long-term workforce sustainability strategies. This includes:
- Career pathway development: Create clear progression routes within CAMHS to improve retention of experienced staff
- Training investment: Expand training places for child and adolescent psychiatrists, mental health nurses, and allied health professionals
- New roles development: Consider creating advanced practitioner and physician associate roles to expand workforce capacity
- Recruitment marketing: Actively promote CAMHS as an attractive career choice, challenging misconceptions and showcasing the rewarding nature of the work
Conclusion
Maintaining CAMHS service quality during the holiday season requires strategic foresight, flexible workforce solutions, and strong partnerships with specialist recruitment providers. As winter 2025 approaches, NHS trusts that have invested in comprehensive workforce planning, cultivated relationships with specialist agencies, and implemented robust quality assurance mechanisms will be best positioned to meet rising demand while supporting staff wellbeing.
The challenge is significant, but not insurmountable. By combining internal staff bank development with strategic use of specialist agency support, enhanced retention initiatives, and system-wide collaboration, CAMHS services can continue providing vulnerable young people with timely access to high-quality mental health care—even during the most challenging time of the year.
About CAMHS Professionals
CAMHS Professionals is the UK’s first and only staffing provider to work solely with child and adolescent mental health services. We provide temporary and permanent staffing solutions including ad-hoc bookings, block arrangements, locum cover, and fixed-term contracts to NHS trusts, local authorities, and private CAMHS providers nationwide.
For workforce planning support or to discuss your service’s specific needs, contact our specialist team today.
