2025 surveillance of electroconvulsive therapy (technology appraisal guidanceTA59, NICE guideline NG222, NICE guideline CG178, NICE guideline CG185, NICE guideline CG192)

Comment on chapter: System impactSystem impact

In the UK, ECT is delivered in hospital settings and requires specialised equipment along with a multidisciplinary team, including psychiatrists, anaesthetists, and nursing staff. However, significant workforce challenges are threatening service delivery. The Royal College of Psychiatrists, in its 2023 call for urgent publication of the NHS Workforce Plan, highlighted a 15% shortfall in consultant psychiatrists across England, with only a 5.8% increase in numbers over the past decade. Similarly, the State of the Nation 2024 report points to a severe shortage of anaesthetists, which is limiting the NHS's capacity to reduce patient waiting lists, with the UK lagging behind other European countries in anaesthetic staffing levels. These shortages may directly impact the provision of ECT services, while broader funding constraints within the publicly funded healthcare system further restrict access and equity. ECT is a resource-intensive intervention, but it remains a crucial treatment option for certain severe mental health conditions, offering rapid relief when other options fail.

Public Health Scotland's audit of SEAN data (June to December 2023) reported that 60% of ECT episodes were completed as planned. Among patients, 53% were able to consent, with most being women aged 60+. Severe depression was the most common diagnosis (68%).