NHS Education for Scotland (NES) Information Services Division (ISD) Workforce Planning for Psychology Services in NHS Scotland Characteristics of the Workforce Supply in 2005
Contents Page Summary... 3 The Workforce of Clinical and Applied in NHS Scotland...4 Skill-Mix in the Organisation of Psychology Services.15 Adult Mental Health Services... 21 Service Role... 23 Tier... 29 The Characteristics of the Workforce... 30 Clinical and Applied... 30 Other Categories of Clinical Staff... 33 Acknowledgements and Contact Information... 38 2
Summary This is the fifth in a series of reports concerned with workforce planning for psychology services in NHS Scotland. The report presents data to describe the characteristics of the workforce engaged in the delivery of psychology services at 30 th September 2005. In total there were 455 Clinical (409.12 wte) and 36 Applied (32.47 wte) employed in NHS Scotland in September 2005. This represents a notional staffing level of 1wte Clinical Psychologist per 12 413 of the general population of Scotland. Mental Health is the principal area of work, employing 231.49 wte Clinical and Applied. The rest of the workforce is distributed across services for people with learning disabilities, physical health, neuropsychology, forensic and other specialty services. Staffing of psychology services varies with the age of the target client population. The notional staffing ratio is 1 wte Clinical and Applied Psychologist per 12 030 population for those aged under 20, 1 wte per 10 683 for those aged 20-64 yrs old, and 1 wte per 39 266 for those aged 65 and over. There are significant differences in staffing levels in psychology services across Health Boards in NHS Scotland. Shetland is the only Island Health Board with a resident psychology service, and there is limited visiting provision for neuropsychology and services for children to Orkney and Shetland. In mainland services the population served by 1wte Clinical and Applied Psychologist in the Health Board with the lowest staffing level is over twice the population notionally served by 1wte in the area with the highest staffing levels. Psychology services increasingly employ a skill-mix of staff (including assistant psychologists, cognitive behavioural therapists, counsellors, other therapists and other clinical staff). Overall the ratio is approximately 3.5wte Clinical and Applied Psychologist to 1wte Other Clinical Staff. In 2005, Clinical and Applied spent 63% of their time in direct service provision, 14% of their time in the clinical training/supervision of others, 10% in management activities, 5% in research and audit, and the remaining time in their own professional development activities or other e.g. travel to clinics. 3
The Workforce of Clinical and Applied in NHS Scotland: 2005. Table 1: Clinical and Applied (wte) employed in psychology services in NHS Scotland at 30 th September 2001, 2002, 2003, 2004 and 2005. Year Clinical Applied *Population of Scotland Population per 1 wte Clinical Population per 1 wte of all Applied Grade B Grade A 2001 135.80 175.20 14.10 325.10 5 064 200 16 284 15 577 2002 141.10 197.50 20.70 359.30 5 064 200 14 956 14 095 2003 152.50 190.80 27.70 371.00 5 057 800 14 733 13 633 2004 165.34 223.79 29.47 418.60 5 078 400 13 051 12 132 2005 169.79 239.33 32.47 441.59 5 078 400 12 413 11 500 *Source: General Register Office for Scotland 2004 (GROS). http://www.gro-scotland.gov.uk/statistics/library/recently-published-population-estimates/index.html Percentage increase in All Applied from 2004 2005: 5.49% (22.99 wte). Table 1a: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005. Applied Psychologist Group Grade B wte Grade A wte NRO* wte Clinical Psychologist 157.04 221.42 0.50 378.97 Counselling Psychologist 4.00 15.06 1.51 20.57 Health Psychologist 1.00 3.00. 4.00 Clinical Health Psychologist 1.00 5.00. 6.00 Forensic Psychologist 1.00 2.00 0.80 3.80 Clinical Forensic Psychologist 6.50 3.70. 10.20 Neuropsychologist 1.60 1.00 1.00 3.60 Clinical Neuropsychologist 5.25 9.20. 14.45 177.39 260.38 3.81 441.59 * Grade not relevant to post. 4
Table 2: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work. Area of Work Clinical Percentage ratios of Grades B : A for Clinical Applied wte of all Clinical and Applied Grade B Grade A Mental Health 80.21 134.32 37 : 63 16.96 231.49 Learning Disabilities 24.78 31.05 44 : 56 1.00 56.83 Physical Health 18.06 30.69 37 : 63 6.85 55.61 Neuropsychology 7.71 11.43 40 : 60 1.55 20.69 Other 29.64 20.97 59 : 41 3.51 54.13 Forensic 9.39 10.86 46 : 54 2.60 22.85 169.79 239.33 42 : 58 32.47 441.59 Table 2a: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work: Physical Health. Physical Health Area wte Percentage of Physical Health wte Physical Health General 13.93 25.05% Coronary heart disease/cardiac rehabilitation 3.35 6.02% Sexual Health- HIV/AIDS 1.90 3.42% Cancer/Palliative Care 9.57 17.21% Stroke 3.95 7.10% Long Term Illnesses eg diabetes, renal 7.02 12.62% Pain 8.45 15.20% Other* 7.44 13.38% 55.61 *includes sleep disorders, chronic fatigue syndrome, cystic fibrosis, and maternity & neonatal. 5
Table 2b: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work: Other. Other Area wte Percentage of Other wte Academic 6.75 12.47% Alcohol and Substance Misuse 7.50 13.86% Dentistry - - Healthcare for the Elderly and Dementia 15.66 28.93% Occupational Health 1.80 3.33% Promotion 0.75 1.39% Prevention 2.75 5.08% Prison Service - - Services to Cultural Minorities 1.20 2.22% Student Health - - Psychosexual 1.08 2.00% Other 16.64 30.74% 54.13 Table 2c: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work: Learning Disability. Learning Disability Area wte Percentage of Learning Disability wte General 32.90 57.89% Offenders 5.68 9.99% Mental Health 4.85 8.53% Challenging Behaviour 6.25 11.00% Autism 7.07 12.44% Attention Deficit Hyperactivity Disorder 0.08 0.14% 56.83 Table 2d: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work: Forensic. Forensic Area wte Percentage of Forensic wte Offending Behaviours 6.36 27.83% Mental Health 11.83 51.77% Other 4.66 20.39% 22.85 6
Table 2e: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work: Mental Health. Mental Health Area wte Percentage of Mental Health wte General Mental Health 169.32 73.14% Early Intervention 9.92 4.29% Mild To Moderate 27.94 12.07% Severe & Enduring 22.91 9.90% Eating Disorders 1.40 0.60% 231.49 Table 3: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Target Age of clients/patients served. Clinical Other Applied All Applied Population* Population per 1 wte of Clinical Population per 1 wte of All Applied Grade B Grade A Child 34.39 63.25 2.10 99.74 1 199 858 12 289 12 030 0-19 years Adults 113.60 143.53 28.57 285.69 3 051 988 11 869 10 683 20-64 years Older Adults 9.60 11.45. 21.05 826 554 39 266 39 266 65+ years Age Non 10.00 14.88 1.00 25.88 - - - specific# Child & Adult 2.20 6.23 0.80 9.23 - - - 169.79 239.33 32.47 441.59 5 078 400 12 413 11 500 *Source: General Register Office for Scotland 2004 (GROS). http://www.gro-scotland.gov.uk/statistics/library/recently-published-population-estimates/index.html #psychologists providing services across a wider age range than the categories listed. 7
Table 3a: Clinical and Applied (wte) employed in psychology services in NHS Scotland in 2005, by Target Age of clients/patients served: child and adolescent. Clinical Other Applied All Applied Population* Population per 1 wte of Clinical Population per 1 wte of All Applied Grade B Grade A Child 7.25 14.00. 21.25 871 907 41 031 41 031 0-14 years Adolescent 2.69 6.65 0.30 9.64 327 951 35 113 34 020 15-19 years Child & Adolescent 24.45 42.60 1.80 68.85 - - - *Source: General Register Office for Scotland 2004 (GROS). http://www.gro-scotland.gov.uk/statistics/library/recently-published-population-estimates/index.html Table 4: All Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work and Target Age: all age groups. Area of Work Child 0-19 yrs Adults 20-64 yrs Older Adults Child & Adult Age Non- Specific# wte 65+ yrs Mental Health 62.55 154.81 4.20 4.28 5.65 231.49 Learning Disabilities 14.38 37.75. 3.70 1.00 56.83 Physical Health 10.93 33.81 0.75 1.18 8.95 55.61 Neuropsychology 2.13 11.24 2.03. 5.30 20.69 Other 7.96 27.04 14.08 0.08 4.97 54.13 Forensic 1.80 21.05... 22.85 99.74 285.69 21.05 9.23 25.88 441.59 #psychologists providing services across a wider age range than the categories listed. 8
Table 4a: All Applied (wte) employed in psychology services in NHS Scotland in 2005, by Area of Work and Target Age: child and adolescent. Area of Work Child Adolescent Child & Adolescent wte 0-14 yrs 15-19 yrs 0-19 yrs Mental Health 14.78 9.15 38.62 62.55 Learning Disabilities 2.03. 12.35 14.38 Physical Health 2.68. 8.25 10.93 Neuropsychology 0.95 0.10 1.08 2.13 Other 0.83 0.39 6.75 7.96 Forensic.. 1.80 1.80 21.25 9.64 68.85 99.74 Table 5: Ratio of per capita population to 1 wte of All Applied in NHS Scotland in 2005, by Health Board area. <10 000 10 000 14 999 15 000 19 999 >20 000 1. Fife (7 065) 3. Lothian (10 794) 7. Tayside (15 705) 13. Shetland (21 940) 2. Greater Glasgow (8 124) 4. Grampian (10 805) 8. Ayrshire & Arran (16 010) 5, Dumfries & Galloway (10 933) 9. Arygyll & Clyde (16 049) 6. Borders (13 832) 10. Highland (17 466) 11. Forth Valley (18 178) 12. Lanarkshire (19 045) 9
Table 5a: Clinical by Grade and Applied (wte) in NHS Scotland 2005, by Health Board Area. Clinical Psychologist Grade B Clinical Psychologist Grade A Other Applied Psychologist wte of All Applied Population* per 1 wte of All Applied Argyll & Clyde 10.50 13.40 2.00 25.90 16 049 Ayrshire & Arran 11.00 10.10 1.86 22.96 16 010 Borders 3.20 3.70 1.00 7.90 13 832 Dumfries & Galloway 8.55 2.98 2.00 13.53 10 933 Fife 16.20 29.98 4.00 50.18 7 065 Forth Valley 8.40 6.30 0.80 15.50 18 178 Grampian 10.05 32.65 5.80 48.50 10 805 Greater Glasgow 45.90 55.93 4.90 106.73 8 124 Highland 3.80 8.30. 12.10 17 466 Lanarkshire 9.70 16.00 3.50 29.20 19 045 Lothian 28.29 39.06 5.61 72.96 10 794 Shetland 1.00.. 1.00 21 940 State Hospital 2.70 6.74 1.00 10.44 - Tayside 10.50 14.20. 24.70 15 705 Scotland 169.79 239.33 32.47 441.59 11 500 *Source: General Register Office for Scotland 2004 (GROS). http://www.gro-scotland.gov.uk/statistics/library/recently-published-population-estimates/index.html Note: There were no resident Psychology services on Orkney or Western Isles at 30 th September 2005. Please see page 17 for details on visiting Psychology Services to Orkney and Shetland, and information on the Western Isles. 10
Table 6: All Applied (wte) in NHS Scotland in 2005 by Area of Work and Health Board Area. Mental Health Learning Disability Physical Health Neuro- Psychology Other Forensic wte of All Applied Argyll & Clyde 19.63 4.25 1.30 0.30 0.43. 25.90 Ayrshire 11.33 4.92 3.65 0.80 2.25. 22.96 & Arran Borders 6.70. 0.40. 0.60 0.20 7.90 Dumfries & 7.32 2.00 1.20 1.00 1.80 0.20 13.53 Galloway Fife 30.25 5.00 3.80 1.65 8.48 1.00 50.18 Forth Valley 8.15 3.10 2.10 0.15 0.60 1.40 15.50 Grampian 30.13 8.35 3.05 2.43 3.05 1.50 48.50 Greater Glasgow 49.83 9.50 23.25 3.75 13.95 6.45 106.73 Highland 4.95 3.80 0.10 0.70 2.55. 12.10 Lanarkshire 17.93 2.63 1.45 0.35 5.60 1.25 29.20 Lothian 33.20 8.60 13.16 6.76 9.43 1.81 72.96 Shetland 1.00..... 1.00 State Hospital 0.70 0.18. 0.30 0.25 9.01 10.44 Tayside 10.38 4.50 2.14 2.50 5.15 0.03 24.70 Scotland 231.49 56.83 55.61 20.69 54.13 22.85 441.59 Note: There were no resident Psychology services on Orkney or Western Isles at 30 th September 2005. Please see page 17 for details on visiting Psychology Services to Orkney and Shetland, and information on the Western Isles. 11
Table 7: All Applied (wte) in NHS Scotland in 2005, by Health Board Area and target age. Child 0-19 yrs Adult 20-64 yrs Older Adult Child & Adult Age Non Specific# wte of all Applied 65+ yrs Argyll & Clyde 3.70 20.60.. 1.60 25.90 Ayrshire & Arran 6.40 14.56 2.00.. 22.96 Borders 1.60 6.30... 7.90 Dumfries & Galloway 2.00 8.65 0.90 0.98 1.00 13.53 Fife 11.80 26.10 2.40 6.20 3.68 50.18 Forth Valley 4.40 11.10... 15.50 Grampian 11.70 32.00 1.60. 3.20 48.50 Greater Glasgow 29.85 59.58 4.00 1.80 11.50 106.73 Highland 5.00 6.10 1.00.. 12.10 Lanarkshire 5.30 20.90 1.50. 1.50 29.20 Lothian 15.39 49.28 5.65 0.25 2.40 72.96 Shetland 1.00.... 1.00 State Hospital. 10.44... 10.44 Tayside 1.60 20.10 2.00. 1.00 24.70 Scotland 99.74 285.69 21.05 9.23 25.88 441.59 Note: There were no resident Psychology services on Orkney or Western Isles at 30 th September 2005. Please see page 17 for details on visiting Psychology Services to Orkney and Shetland, and information on the Western Isles. #psychologists providing services across a wider age range than the categories listed. 12
Table 7a: All Applied (wte) in NHS Scotland in 2005, by Health Board Area and target age : child and adolescent. Child Adolescents Child & Adolescent wte 0-14 yrs 15-19 yrs Argyll & Clyde.. 3.70 3.70 Ayrshire & Arran 1.00. 5.40 6.40 Borders 1.00. 0.60 1.60 Dumfries & Galloway.. 2.00 2.00 Fife. 1.00 10.80 11.80 Forth Valley.. 4.40 4.40 Grampian 3.35 1.35 7.00 11.70 Greater Glasgow 11.50 4.00 14.35 29.85 Highland.. 5.00 5.00 Lanarkshire. 0.30 5.00 5.30 Lothian 3.40 2.99 9.00 15.39 Shetland.. 1.00 1.00 State Hospital - - - - Tayside 1.00. 0.60 1.60 Scotland 21.25 9.64 68.85 99.74 Note: There were no resident Psychology services on Orkney or Western Isles at 30 th September 2005. Please see page 17 for details on visiting Psychology Services to Orkney and Shetland, and information on the Western Isles. 13
Table 8: Population estimates for Health Board areas, by target age (2004). Child Adolescent Adult Older Adult population (0-14yrs) (15-19yrs) (20-64 yrs) (65 + yrs) Argyll & Clyde 71 624 27 071 247 371 69 592 415 658 Ayrshire & Arran 63 386 23 787 215 626 64 791 367 590 Borders 18 959 6 064 63 262 20 985 109 270 Dumfries & Galloway 24 468 8 765 84 858 29 839 147 930 Fife 61 892 23 353 210 633 58 641 354 519 Forth Valley 50 819 17 948 168 619 44 378 281 764 Grampian 89 332 33 249 319 286 82 153 524 020 Greater Glasgow 145 482 59 509 526 936 135 156 867 083 Highland 36 947 12 603 125 179 36 611 211 340 Lanarkshire 101 596 36 704 334 864 82 950 556 114 Lothian 130 522 49 750 489 977 117 255 787 504 Orkney 3 404 1 220 11 458 3 418 19 500 Shetland 4 264 1 391 13 048 3 237 21 940 Tayside 64 770 24 950 225 919 72 269 387 908 Western Isles 4 442 1 587 14 952 5 279 26 260 Scotland 871 907 327 951 3 051 988 826 554 5 078 400 Source: General Register Office for Scotland 2004 (GROS). http://www.gro-scotland.gov.uk/statistics/library/recently-published-population-estimates/index.html 14
Skill-Mix in the Organisation of Psychology Services: 2005 Table 9: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2001, 2002, 2003, 2004 and 2005, expressed as a percentage of total workforce in service. All Applied Assistants Cognitive Behavioural Therapists Counsellors Other Therapists* Other Clinical Staff# Ratio of All Applied : Other Staff (%) 2001 325.10 50.20 7.00 14.40 4.70 6.60 408.00 80 : 20 79.70% 12.30% 1.70% 3.50% 1.20% 1.60% 2002 359.30 73.30 11.00 15.90 5.00 7.60 472.00 76 : 24 76.10% 15.500% 2.30% 3.40% 1.10% 1.60% 2003 371.00 76.90% 65.50 13.60% 16.50 3.40% 18.30 3.80% 8.30 1.70% 2.80 0.60% 482.40 77 : 23 2004 418.60 67.10 16.90 21.31 6.10 2.80 532.81 79 : 21 78.56% 12.59% 3.17% 4.00% 1.14% 0.53% 2005 441.59 64.90 17.55 21.21 5.10 6.90 557.24 79 : 21 79.25% 11.65% 3.15% 3.81% 0.92% 1.24% * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 15
Table 10 : Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2005, expressed as a percentage of the total workforce in service, by Health Board area. All Applied Assistants Cognitive Behavioural Counsellor s Other Therapists Other Clinical wte Therapists Staff Argyll & Clyde 25.90 6.70 1.00 3.00.. 36.60 70.77% Ayrshire & Arran 22.96 18.31% 4.45 2.73% 6.60 8.20% 6.12 1.00. 41.13 55.82% Borders 7.90 10.82% 1.00 16.05% 0.15 14.88% 2.43%... 9.05 Dumfries & 87.29% 13.53 11.05% 2.50 1.66% 1.70 5.25 0.70 4.10 27.78 Galloway 48.70% Fife 50.18 9.00% 10.50 6.12% 6.00 18.90% 3.60 2.52% 14.76%. 1.00 71.28 70.40% Forth Valley 15.50 14.73% 2.00 8.42% 5.05%. 1.20 1.40%.. 18.70 82.89% Grampian 48.50 10.70% 9.00 6.42%. 1.54 0.40. 59.44 81.59% Greater Glasgow 106.73 15.14% 9.40 2.59% 0.67%... 1.00 117.13 91.12% Highland 12.10 8.03% 2.00 0.85%.... 14.10 85.82% 14.18% Lanarkshire 29.20. 1.10. 3.00. 33.30 87.69% Lothian 72.96 14.35 3.30% 9.01%... 0.80 88.11 82.81% Shetland 1.00 100.00% State Hospital 10.44 16.29% 0.91%..... 1.00..... 10.44 100.00% Tayside 24.70 3.00 1.00 0.50.. 29.20 84.59% Scotland 441.59 10.27% 64.90 3.42% 17.55 1.71% 21.21 5.10 6.90 557.24 79.25% 11.65% 3.15% 3.81% 0.92% 1.24% Note: There were no resident Psychology services on Orkney or Western Isles at 30 th September 2005. Please see page 17 for details on visiting Psychology Services to Orkney and Shetland, and information on the Western Isles. 16
Table 11: Population per 1wte of all clinical staff in psychology services in NHS Scotland in 2005, by Health Board area. Population per 1wte <8 000 8 000 9 999 10 000 14 999 15 000 19 999 1. Fife (4 974) 4. Grampian (8 816) 8. Borders (12 074) 11. Forth Valley (15 068) 2. Dumfries & Galloway 5. Ayrshire & Arran 9. Tayside (13 285) 12. Lanarkshire (16 700) (5 325) (8 937) 3. Greater Glasgow (7 403) 6. Lothian (8 938) 10. Highland (14 989) 13. Shetland (21 940) 7. Argyll & Clyde (11 357) Services to the Islands: The NHS Shetland Clinical Psychology Service has begun to develop since March 2005 when a full-time Consultant (B Grade) was employed to provide a service for Children and Adoloscents. Please see Tables 5a, 6, 7 and 10 for data on Sheltand s resident Psychology Services. There were no resident Psychology services on Orkney or Western Isles at 30 th September 2005. Grampian Health Board Clinical Psychology staff have contractual obligations to Orkney and Shetland in the following areas: Adult Neuropsychology in Orkney: 3 days every 3 months; in and out patients seen by 1 staff member, Grade A. Adult Neuropsychology in Shetland: 3 days every 3 months; in and out patients seen by 1 staff member, Grade A. Adult Learning Disabilties in Shetland: 2 days every visits 4 months; 1 staff member, Grade A. Adult Eating Disorders in Orkney and Shetland: 1 staff member, Grade B, sees on average 3 Shetland patients and 1-2 Orkney patients per week via videoconferencing. 17
Child Psychology in Orkney: 3 days every 3 months, I staff member, Grade A. There are currently no psychology specific contracts between Yorkhill and the Western Isles, however, patients from the Western Isles may have input from psychologists as part of tertiary services. No Neuropsychology services from the Southern General in Glasgow are supplied at local level on the Western Isles. However, neuropsychologists at the Institute of Neuroscience and a psychologist from the Spinal Unit of Scotland may assess and treat patients from the Western Isles when they are in Glasgow for specialist treatments in eg Neurology and Neurosurgery. 18
Table 12: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2005, expressed as a percentage of total workforce in service, by Area of Work. All Applied Assistants Cognitive Behavioural Therapists Counsellor s Other Therapists* Other Clinical Staff# Clinical staff wte (% of total) Mental Health 231.49 21.23 16.38 14.81 2.10 1.80 287.80 80.43% Learning 56.83 Disabilities 69.22% Physical Health 55.61 81.62% Neuropsychology 20.69 82.96% Other Areas of 54.13 Work 77.41% Forensic 22.85 7.38% 20.68 25.19% 12.00 17.61% 4.25 17.04% 5.25 7.51% 1.50 5.69% 5.15% 0.73% 0.63%. 1.20 2.40 1.00 82.10 1.46% 2.92% 1.22% 0.53... 68.13 0.78%.... 24.94 0.65 5.20 0.60 4.10 69.93 0.93% 7.44% 0.86% 5.86%.... 24.35 Staff Group 93.84% 441.59 6.16% 64.90 17.55 21.21 5.10 6.90 557.24 79.25% 11.65% 3.15% 3.81% 0.92% 1.24% * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 19
Table 13: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2005, expressed as a percentage of total workforce in service, by Target Age: all ages. All Applied Assistants Cognitive Behavioural Counsellor s Other Therapists* Other Clinical wte Therapists Staff# Child 0-19 yrs 99.74 84.57% 16.60 14.07%. 0.20 0.17% 0.40 0.34% 1.00 0.85% 117.94 Adult 20-64 yrs 285.69 76.08% 40.80 10.87% 17.40 4.63% 21.01 5.60% 4.70 1.25% 5.90 1.57% 375.50 Older Adult 65+ years 21.05..... 21.05 Child & Adult 9.23 90.22% 1.00 9.78%.... 10.23 AgeNon Specific~ 25.88 79.56% 6.50 19.98% 0.15 0.46%... 32.53 Staff Group 441.59 79.25% 64.90 11.65% 17.55 3.15% 21.21 3.81% 5.10 0.92% 6.90 1.24% 557.24 ~clinical staff providing services across a wider age range than the categories listed. Table 13a: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2005, expressed as a percentage of total workforce in service, by Target Age: child&adolescent. Child 0-14 yrs Adolescent 15-19yrs Child& Adolescent Staff Group All Applied 21.25 80.80% 9.64 77.80% 68.85 86.88% 99.74 84.57% Assistants 3.45 13.12% 2.75 22.20% 10.40 13.12% 16.60 14.07% Cognitive Behavioural Therapists Counsellor s. 0.20 0.76% Other Therapists* 0.40 1.52% Other Clinical Staff# 1.00 3.80% wte 26.30.... 12.39.... 79.25. 0.20 0.17% 0.40 0.34% 1.00 0.85% 117.94 * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 20
Adult Mental Health Services Table 14: Categories of clinical staff (wte) employed in psychology services for Adult Mental Health in NHS Scotland in 2001, 2002, 2003, 2004 and 2005, and expressed as a percentage of the total workforce in psychology services for Adult Mental Health. Year All Assistants Cognitive Counsellor Other Other Applied Behavioural s Therapists* Clinical wte Therapists Staff# 2001 156.90 17.70 7.00 12.80 2.60 2.00 199.00 78.80% 8.40% 3.50% 6.40% 1.30% 1.60% 2002 164.50 25.40 11.00 14.30 3.50 3.00 221.70 74.20% 11.50% 4.90% 6.50% 1.60% 1.30% 2003 137.70 16.30 14.50 12.60 2.50 0.80 184.40 74.70% 8.80% 7.80% 6.80% 1.50% 0.40% 2004 147.41 17.45 14.83 15.41 1.70 0.80 197.60 74.60% 8.83% 7.51% 7.80% 0.86% 0.40% 2005 154.81 12.85 16.23 14.61 1.70 0.80 201.00 77.02% 6.39% 8.07% 7.27% 0.85% 0.40% * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 21
Table 15: Number (wte) of All Applied employed in psychology services for adult (20-64 years) and older adult (65+ years) Mental Health in NHS Scotland in 2005. Severe & Enduring Mild to Moderate Early Intervention General Mental Eating Mental Illness Mental Illness Health Disorders Adults Older Adults Older Adults Older Adults Older Adult Older Adults Adults Adults Adults Adult wte Argyll& Clyde 1.90 11.60%... 0.25 1.53%. 14.23 86.87%... 16.38 Ayrshire& Arran 1.70 21.36%. 1.00 12.56%... 5.06 63.57%.. 0.20 2.51% 7.96 Borders.. 4.60 90.20%... 0.50 9.80%... 5.10 Dumfries& Galloway...... 4.55 100.00% Fife 1.80..... 14.65 10.62% 86.43% Forth Valley 0.08..... 4.78 1.65% 98.56%... 4.55 0.50 2.95%.. 16.95... 4.85 Grampian 1.00 4.18% Greater 5.40 Glasgow 18.51% 0.20 1.00 0.84% 4.18%. 5.45 18.68%... 20.90 87.45% 0.30.. 17.15 1.03% 58.77%. 0.80 3.35% 0.88 3.02%. 23.90.. 29.18 Highland 0.05 1.96%. 0.35 13.73%... 2.15 84.31%... 2.55 Lanarkshire 2.20 17.70%. 1.80 14.48%... 7.68 61.79% 0.75 6.03%.. 12.43 Lothian 4.36 17.87%. 1.99 8.16%. 0.10 0.41%. 16.58 67.95% 1.38 5.66%.. 24.40 Shetland - - - - - - - - - - - State 0.70 100.00% Hospital Tayside 2.23 22.12% Scotland 21.41 13.46%......... 0.70. 1.03 10.22% 0.20 17.21 0.13% 10.82%. 0.64 6.35% 0.30 0.99 0.19% 0.62%. 5.79 57.44%. 114.00 71.69%. 0.40 3.97% 3.50 1.20 2.20% 0.75%. 10.08 0.20 159.01 0.13% Note: There were no resident psychology services on Orkney or Western Isles at 30 th September 2005. 22
Service Role Table i: Services Roles (wte) undertaken by all clinical staff employed in psychology services in NHS Scotland in 2005. Service Role All Applied Assistants Cognitive Counsellors Other Other Percentage Behavioural Therapists Therapists* Clinical Staff# wte Client&carer 276.58 38.70 13.65 16.54 3.95 6.00 355.41 63.78% service delivery Management 44.83 0.00 0.19 0.08.. 45.09 8.09% Research& 22.11 17.80 0.94 0.35 0.10 0.03 41.32 7.42% Audit Professional 33.66 0.00 0.34 0.03 0.03. 34.04 6.11% Development of Clinical Psychol trainees Professional 27.65 0.63 0.75 0.80 0.15 0.03 30.01 5.39% Development of other clinical staff Own CPD 25.85 5.66 1.31 1.83 0.75 0.35 35.75 6.42% Other 10.98 2.11 0.38 1.59 0.13 0.50 15.68 2.81% 441.59 64.90 17.55 21.21 5.10 6.90 557.24 * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 23
Service Role Table ii: Services Roles undertaken (wte) by all Clinical and Applied psychologists employed in psychology services in NHS Scotland in 2005. Service Role Clinical Other Applied All Applied wte Percentage Grade B Grade A Client & carer 91.50 164.69 20.40 276.58 62.63% service delivery Management 30.16 11.80 2.86 44.83 10.15% Research & 8.84 11.44 1.83 22.11 5.01% Audit Professional 15.69 15.80 2.17 33.66 7.62% Development of Clinical Psychol trainees Professional 12.46 12.90 2.29 27.65 6.26% Development of other clinical staff Own CPD 7.49 16.06 2.30 25.85 5.85% Other 3.65 6.69 0.64 10.98 2.49% 169.79 239.33 32.47 441.59 24
Service Role Table iii: Services Roles undertaken (wte) by all Clinical and Applied psychologists employed in psychology services in NHS Scotland in 2005, by target age: all ages. The percentage of total wte by target age for each service role is shown in parentheses. Service Role Child 0-14 years Adult 20-64 years Older Adults 65+ years Age nonspecific# Child & Adult Child & Adolescent 0-19 years Adolescent 15-19 years wte by service role Client & carer service delivery 14.46 68.05% 175.69 61.50% 13.89 65.99% 15.54 60.05% 5.91 64.03% 44.88 65.19% 6.21 64.42% 276.58 62.63% Management 2.03 30.75 1.85 2.60 0.59 6.31 0.70 44.83 9.55% Research & Audit 0.50 10.76% 14.47 8.79% 1.05 10.05% 1.76 6.39% 0.54 9.16% 3.22 7.26% 0.58 10.15% 22.11 Professional 2.35% 1.44 5.06% 22.33 4.99% 1.73 6.80% 1.50 5.85% 0.80 4.68% 5.09 6.02% 0.78 5.01% 33.66 Development of Clinical Psychol 6.78% 7.82% 8.22% 5.80% 8.67% 7.39% 8.09% 7.62% trainees Professional 1.25 17.56 1.25 1.90 0.79 4.16 0.75 27.65 Development of other clinical 5.88% 6.15% 5.94% 7.34% 8.56% 6.04% 7.78% 6.26% staff OwnCPD 1.29 16.21 1.05 1.53 0.60 4.68 0.50 25.85 6.07% Other 0.29 5.67% 8.70 4.06% 0.24 5.91% 1.05 6.50% 6.80%. 0.58 5.19% 0.13 5.85% 10.98 wte by target 1.36% 21.25 3.05% 285.69 1.14% 21.05 4.06% 25.88 9.23 0.84% 68.85 1.35% 9.64 2.49% 441.59 age #psychologists providing services across a wider age range than the categories listed. 25
Service Role Table iv: Services Roles undertaken (wte) by all other clinical staff (assistants, CBT therapists, Counsellors, Other therapists, Other clinical staff) employed in psychology services in NHS Scotland in 2005, by target age: all ages. The percentage of total wte by target age for each service role is shown in parentheses. Service Role Child 0-14 years Adult 20-64 years Client&carer 4.24 63.85 service delivery 83.96% 71.09% Management. 0.26 Older Adults 65+ years Age nonspecific# Child & Adult Child & Adolescent 0-19 years Adolescent 15-19 years wte by service role. 2.80 0.85 6.00 1.10 78.84 42.11% 85.00% 57.69% 40.00% 68.17%..... 0.26 Research & Audit 0.25 0.29% 11.14. 3.10 0.08 3.25 1.40 0.22% 19.21 4.95% Professional 0.03 Development of 0.59% Clinical Psychol trainees Professional 0.08 Development of 1.58% other clinical staff Own CPD 0.41 12.40% 0.36 0.40% 2.08 2.32% 7.94 46.62% 8.00% 31.25% 50.91% 16.61%..... 0.39 0.34%. 0.05. 0.10 0.05 2.35 0.75% 0.96% 1.82% 2.03%. 0.45 0.05 0.95 0.10 9.90 8.12% Other 0.05 8.84% 4.18 6.77%. 0.25 5.00% 0.03 9.13% 0.10 3.64% 0.10 8.56% 4.70 0.99% 4.65% 3.76% 3.00% 0.96% 3.64% 4.06% wte 5.05 89.81. 6.65 1.00 10.40 2.75 115.66 by target age #clinical staff providing services across a wider age range than the categories listed. 26
Service Role Table v: Services Roles undertaken (wte) by all Clinical and Applied employed in psychology services in NHS Scotland in 2005. The percentage of total wte by age band for each service role is shown in parentheses. Service Role <25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+ wte by service role Client&carer service delivery - 11.53 69.46% 81.25 71.01% 55.27 62.82% 37.70 59.50% 26.11 57.45% 33.21 55.42% 24.53 58.82% 6.99 57.30% 276.58 62.63% Management - 0.51 5.70 7.30 7.80 5.00 10.18 6.39 1.95 44.83 3.07% 4.98% 8.30% 12.31% 11.00% 16.99% 15.32% 15.98% 10.15% Research & Audit - 0.51 5.21 4.99 2.69 2.87 3.58 1.85 0.41 22.11 Professional 3.07% - 0.46 4.55% 6.34 5.67% 7.32 4.25% 5.99 6.31% 4.14 5.97% 4.92 4.44% 3.73 3.36% 0.76 5.01% 33.66 Development of Clinical Psychol 2.77% 5.54% 8.32% 9.45% 9.11% 8.21% 8.94% 6.23% 7.62% trainees Professional - 0.66 5.96 5.45 4.47 3.50 4.07 2.56 0.98 27.65 Development of other clinical staff 3.98% 5.21% 6.19% 7.05% 7.70% 6.79% 6.14% 8.03% 6.26% Own CPD - 1.43 7.72 5.53 3.36 2.35 2.89 1.94 0.64 25.85 8.61% Other - 1.50 6.75% 2.25 6.29% 2.11 5.30% 1.36 5.17% 1.48 4.82% 1.09 4.65% 0.71 5.25% 0.48 5.85% 10.98 wte by age 9.04% - 16.60 1.97% 114.43 2.40% 87.98 2.15% 63.36 3.26% 45.45 1.82% 59.92 1.70% 41.70 3.93% 12.20 2.49% 441.59 band 27
Service Role Table vi: Services Roles undertaken (wte) by all Clinical and Applied employed in psychology services in NHS Scotland in 2005, expressed as percentage of total wte for each gender. Service Role Clinical Psychologist Grade B Clinical Psychologist Grade A Other Applied Female Male Male Female Male Female Male Female percentage percentage wte wte Client&carer 37.93 53.58 30.61 134.08 9.86 10.53 198.18 63.39% 78.40 60.81% service delivery Management 11.88 18.29 3.32 8.48 1.53 1.34 28.11 8.99% 16.72 12.97% Research & Audit 4.38 4.47 2.39 9.05 0.79 1.04 14.56 4.66% 7.55 5.86% Professional 5.45 10.24 3.00 12.80 1.31 0.85 23.90 7.64% 9.76 7.57% Development of Clinical Psychol trainees Prof Development 3.97 8.49 2.21 10.69 1.01 1.27 20.45 6.54% 7.20 5.58% of other clinical staff Own CPD 2.94 4.55 2.86 13.20 1.20 1.10 18.85 6.03% 7.00 5.43% Other 0.91 2.74 1.08 5.61 0.31 0.33 8.68 2.78% 2.30 1.78% 67.45 102.34 45.46 193.86 16.01 16.46 312.66 128.93 28
Tier Table i Tiers operated in by all clinical staff employed in psychology services in NHS Scotland in 2005, expressed as a percentage of the total staff headcount. Tier Headcount % of total headcount working in the corresponding Tier Community 153 10.90% Primary 227 16.17% Intermediate 339 24.15% Secondary 450 32.05% Tertiary 235 16.74% 1404 Tier Table ii Tiers operated in by Clinical and Applied psychologists employed in psychology services in NHS Scotland in 2005, expressed as a percentage of the total staff headcount. Tier Clinical Other Applied Headcount All Applied Percentages Grade B Grade A Community 52 60 5 117 10.14% Primary 64 101 11 175 15.16% Intermediate 101 166 16 278 24.09% Secondary 153 205 24 379 32.84% Tertiary 88 97 20 205 17.76% 458 629 76 1154 29
The Characteristics of the Workforce: 2005 The data presented in this section refer to the headcount of staff in psychology services. Table 16: Clinical and Applied : Years qualified and time in present post for all Applied in NHS Scotland in 2005 (headcount). Clinical Clinical Other Applied N=491 Grade B Grade A N=36 N=187* N =274* Years qualified: Range 7 39 0 36 1 30 0 39 Median 21 10 9 18 Time in present post: Range 0 32 0 23 0 11 0 32 Median 8 4 3 6 *Please note: the actual headcount of Clinical is 455. 6 individuals worked on both a Clinical Grade A and Clinical Grade B contract as at 30 th September 2005. Table 16a: Age Distribution of All Applied in NHS Scotland 2005 by gender. Age Range % of total Male workforce (total headcount=135) % of total Female workforce (total headcount=356) <25 - - 25-29 2.94% 3.67% 30-34 11.76% 28.81% 35-39 19.12% 21.75% 40-44 14.71% 15.82% 45-49 10.29% 11.58% 50-54 23.53% 9.04% 55-59 13.24% 7.06% 60+ 4.41% 2.26% 30
Table 17: Grade and Gender of all Clinical in NHS Scotland in 2005 (headcount). Women (N=335) Men (N=120) (N=455) No. of Grade B % 117 34.93% 70 58.33% 187 41.10% No of Grade A % 223 66.57% 51 42.50% 274 60.22% Table 17a: Percentage of All Applied (headcount) at Grades B and A in NHS Scotland, 2005, by age and gender. Age Range Female Grade B Male Grade B Female Grade A Male Grade A N=60 N=120 N=75 N=236 <25 - - - - 25-29.. 13 4 30-34 1. 100 15 35-39 17 8 60 18 40-44 28 11 31 9 45-49 26 9 15 5 50-54 21 28 10 3 55-59 20 14 6 5 60+ 7 5 1 1 120 75 236 60 Table 18: Clinical and Applied in NHS Scotland in 2005: percentage with part-time and fixed-term contracts (headcount). Clinical Psychologist Grade B N=187 Clinical Psychologist Grade A N=274 Other Applied N=36 Fixed-term (n) 15 55 10 % Fixed-term 8.02% 20.07% 27.78% Full-time 120 160 18 Part-time 70 121 18 % part-time 37.43% 44.16% 50.00% 31
Table 18a: Headcount of All Male Applied engaged in full-time and part-time working in NHS Scotland, 2005, by age, and expressed as a percentage of the total male headcount. Age Range Male WT Male % WT Male PT Male % PT <25 - - - - 25-29 4 4.12%. - 30-34 9 9.28% 7 16.67% 35-39 18 18.56% 8 19.05% 40-44 16 16.49% 5 11.90% 45-49 9 9.28% 5 11.90% 50-54 25 25.77% 8 19.05% 55-59 12 12.37% 7 16.67% 60+ 4 4.12% 2 4.76% 97 42 Table 18b: Headcount of All Female Applied engaged in full-time and part-time working in NHS Scotland, 2005, by age, and expressed as a percentage of the total female headcount. Age Range Female WT Female % Female PT Female % PT WT <25 - - - - 25-29 11 5.50% 2 1.23% 30-34 73 36.50% 33 20.25% 35-39 43 21.50% 35 21.47% 40-44 15 7.50% 42 25.77% 45-49 18 9.00% 24 14.72% 50-54 19 9.50% 14 8.59% 55-59 17 8.50% 9 5.52% 60+ 4 2.00% 4 2.45% 200 100.00% 163 32
Table 19: Age and sex of other categories of clinical staff employed in psychology services in NHS Scotland in 2005 (headcount). Assistant N= 66 Cognitive Behavioural Therapists Counsellors N= 32 Other Therapists* N=6 Other Clinical Staff# N= 132 N=19 N=9 Men 14 7 4 2-27 Age Range for men and 23 62 34 59 34 62 38 60 34 50 23 62 women Median age range 30 43 55 46 43 41 * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. Table 20: Years since qualifying and years in present post for other categories of clinical staff in psychology services in NHS Scotland in 2005 (headcount). Assistant Cognitive Counsellors Other Other clinical Behavioural Therapists* Staff# N=132 N=66 Therapists N=32 N= 6 N=9 N=19 Years qualified: Range 0 14 1 20 1 24 1 21 7 28 0 28 Median 4 7.5 8 9.5 16 8 Years in present post: Range 0 7 0 8 0 10 1 8 0 7 0 10 Median 2 4 4 3 2 3 * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 33
Table 21 : Characteristics of the contracts of other categories of clinical staff in psychology services in NHS Scotland in 2005 (headcount). Assistant N=66 Cognitive Behavioural Therapists Counsellors N=32 Other Therapists* N=6 Other Clinical Staff# N=132 N=19 N=9 Whitley 35 17 26 5 9 92 contracts (n) % 53.03% 89.47% 81.25% 83.33% 100.00% 69.70% Whitley Fixed- term 61 4 10 1 6 82 %Fixed- term 92.42% 21.05% 31.25% 16.67% 66.67% 62.12% Part-time 8 5 23 2 7 45 % Part-time 12.12% 26.32% 71.88% 33.33% 77.78% 34.09% * includes group analytical therapists, creative therapists. # includes nursery nurses, self-help workers, clinical scientists. 34
Table 22: Characteristics of the workforce of all clinical staff in psychology services in NHS Scotland in 2005, by area of work. Area of Work ( no. of clinical staff, headcount) Mental Health (n=388) Learning Disabilities (n=112) Physical Health (n=124) Neuropsychology (n=50) Forensic (n=37) Other (n=142) (N=623)* % Female % part-time Age range of whole workforce Median 74.23% 38.66% 23 66 44 70.54% 28.57% 23 62 43 75.81% 46.77% 23 63 41.5 70.00% 42.00% 23 59 39.5 72.97% 54.05% 26 59 38.5 73.94% 44.37% 24 62 43.5 73.79% 40.19% 23 66 44 % of workforce with MHO status 23.71% 19.64% 18.55% 22.00% 27.03% 25.35% 22.19% *please note that staff could record up to 4 areas of work. 35
Table 23: Characteristics of the workforce of all clinical staff in psychology services in NHS Scotland in 2005, by target age of patients/clients served. Target Age ( No. of Clinical Staff, headcount) Child (n=31) Adult (n=436) Older Adults (n=25) Age non-specific# (n=39) Adolescent (n=15) Child & Adolescent (n=89) Child & Adult (N=12) (N=623) %female % part-time Age range of whole workforce (Median) 74.19% 35.48% 23 62 37.5 69.95% 44.50% 23 66 44 76.00% 36.00% 28 61 41 84.62% 38.46% 23 59 38 93.33% 46.67% 26 56 35 86.52% 26.97% 23 62 42 75.00% 41.67% 25 50 34.5 73.79% 40.19% 23 66 44 % of workforce with MHO status 22.58% 23.85% 36.00% 12.82% 6.67% 16.85% - 22.19% Please note: a total greater than the 2005 all clinical staff headcount of 623 reflects individuals with more than 1 contract. #clinical staff providing services across a wider age range than the categories listed. 36
Table 24: Characteristics of the workforce of all clinical staff in psychology services in NHS Scotland in 2005, by Health Board area. Health Board Area (total number of Clinical Staff, headcount) %female % part-time Age range of whole workforce (Median) % of workforce with MHO status Argyll & Clyde (n=39) 74.36% 23.08% 23 62 41 Ayrshire & Arran (n=47) 70.21% 29.79% 23 62 42.5 Borders (n=13) 61.54% 46.15% 24 57 28.21% 36.17% 7.69% Dumfries & Galloway (n=34) 76.47% 58.82% 25 62 47 43 20.59% Fife (n=80) 72.50% 32.50% 23 62 41 Forth Valley (n=26) 65.38% 65.38% 29 59 45.5 Grampian (n=66) 81.82% 34.85% 23 60 42 Greater Glasgow (n=124) 75.81% 30.65% 26 59 41 Highland (n=15) 66.67% 26.67% 34 53 40.5 Lanarkshire (n=38) 68.42% 47.37% 31 66 11.25% 26.92% 21.21% 20.97% 20.00% 34.21% 43.5 Lothian (n=104) 72.12% 54.81% 23 65 19.23% 42.5 Shetland (n=1) 100.00% - - - State Hospital (n=15) 73.33% 73.33% 29 57 36 Tayside (n=33) 81.82% 45.45% 23 61 6.67% 30.30% (n= 623) 41 73.79% 40.19% 23 66 44 22.19% Please note: a total greater than the 2005 all clinical staff headcount of 623 reflects individuals with more than 1 contract. There were no resident psychology services on Orkney or Western Isles at 30 th September 2005. 37
Dr Ann Smyth National Director of Training for Psychology Services, NHS Education for Scotland, Edinburgh EH2 2NN. Dr Alison Rowlands Associate Director of Training for Psychology Services, NHS Education for Scotland, Edinburgh EH2 2NN. Dr Liz Jamieson ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. Ms Barbara Moore ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. Mr John Quinn ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. We gratefully acknowledge the contribution of the following people: The Heads of Psychology Services in Scotland Group. All of our contacts in Psychology services throughout NHS Scotland for their time and assistance on the data collection. Scott Heald Head of Healthcare Information Group, ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. David Allan, David Greig, Simon Payne & Benji Larbi. IT Department, ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. For further information on the NES-ISD Psychology Workforce Project, please contact: Dr Liz Jamieson Psychology Workforce Project Manager, ISD, Healthcare Information Group, Gyle Square, 1 South Gyle Crescent Edinburgh EH12 9EB. Tel: 0131 275 6422 Fax: 0131 275 7511 Email: elizabeth.jamieson@isd.csa.scot.nhs.uk http://www.isdscotland.org 38