NHS Workforce Strategy Consultation (England)

  • March, 2018

NHS Workforce Strategy Consultation (England)

Summary of Response

  1. A general approach to all healthcare groups is unhelpful because they vary hugely in terms of recruitment, retention and popularity as careers: cf Medicine versus psychiatric nursing. Each group requires its own analysis of recruitment factors and how these might be addressed for that group. The answers will be very different from one group to another.
  2. Although Chapter 8 addresses seven specific healthcare groups, clinical psychology is not mentioned: this is a missed opportunity given the extent to which clinical psychologists can make major contributions to the effectiveness, training and morale of all NHS workforce groups in both physical and mental healthcare.
  3. Chapter 4 highlights and prioritises mental health and learning disability services: however, given the major contributions that clinical psychologists make to these services in terms of both workforce and leadership, it is incongruent that no undertakings have been given for the expansion of and investment in clinical psychology posts and training. Moreover clinical psychologists are making significant contributions to other priority areas including cancer and urgent and emergency care. There remains great potential for the role of clinical psychologists in primary care, and although many GPs would welcome direct access and presence in primary care services, this is now rarely the case.
  4. Clinical psychologists are committed to multidisciplinary working and much of their training includes skills for the facilitation and leadership of teams.
  5. Clinical Psychology has unique potential in relation to workforce expansion given that pre-qualification doctoral training has always, and continues to attract, large numbers of high calibre graduate applicants with approximately six applicants for every training place nationally. There is therefore no difficulty in increasing the clinical psychology workforce at short notice, providing increased funding for postgraduate training was forthcoming. Clinical psychology has the best NHS employment and retention statistics (97.5% first post NHS employment). Moreover, given the longstanding and worsening difficulties in attracting junior doctors to a career in psychiatry and changes to the Mental Health Act in 2005, clinical psychologists are now capable of taking on statutory roles in relation to sectioning and the assessment of mental capacity which could reduce Trusts’ reliance on psychiatrists.
  6. Graduate or Associate training and employment schemes for psychology graduates have shown promise, but have not been properly supported by commissioners and management in recent times. This is regrettable given the potential of these roles.
  7. There is also no specific section in Chapter 8 on the broader psychological workforce and given its growing importance this is a serious omission. The psychological workforce makes an important contribution in all the areas prioritised in the strategy and should be included if the Workforce Strategy is to be fit for purpose for 2027.
  8. ACP-UK strongly supports the statement and recommendations made by the Psychological Professions Network Alliance in their document “Delivering Expansion in the Psychological Professions”. ACP-UK also considers there should be greater emphasis on the appointment of clinical psychologists in adult mental health and within IAPT services in high intensity and clinical leadership roles.
  9. More junior psychologists are leaving the NHS for the private sector than at any other time, frustrated at the lack of opportunities for promotion or progression.
  10. Feeling valued is of the utmost importance. Every survey on NHS staff says that they all value and enjoy the work they trained to do, but it is the environment and working conditions which lead to their unhappiness.
  11. Clinical psychologists can offer help and advice concerning systemic and interpersonal factors within teams and wards which may act to increase harm (e.g. Mid-Staffordshire) or benefit for patients. Clinical psychologists should play a greater role in the organization and delivery of multidisciplinary services and teams.

Mike Wang, ACP-UK – 23rd March 2018