Characteristics of the Workforce Supply in 2004

Transcription

1 NHS Education for Scotland (NES) Information Services (ISD) Workforce Planning for Psychology Services in NHS Scotland Characteristics of the Workforce Supply in 2004

2 Contents Page Summary 2 The Workforce of Clinical & Applied 4 Psychologists in NHS Scotland Skill-Mix in the Organisation of Psychology Services 14 Contents Adult Mental Health Services 19 Service Role 21 Tier 27 The Characteristics of the Workforce 29 Clinical and Applied Psychologists 31 Other Categories of Clinical Staff 33 Membership of the Psychology Workforce Steering Group 37 Acknowledgements 37 1

3 Summary This is the fourth in a series of reports concerned with workforce planning for psychology services in NHS Scotland. The first report (NES, reviewed the factors relevant to workforce planning for psychology services. Summary The second and third reports presented data to describe the characteristics of the workforce engaged in the delivery of psychology services at 30thSeptember 2001 and and n2003.pdf). This report presents data to describe the characteristics of the psychology workforce at 30th September In total there were 437 Clinical Psychologists (389.13wte) and 34 Applied Psychologists (29.47wte) employed in NHS Scotland in September This represents a notional staffing level of 1wte Clinical Psychologist per of the general population of Scotland. Mental Health is the principal area of work, employing wte Clinical and Applied Psychologists, an increase of 4.85wte on 2003 data. Staffing of psychology services varies with the age of the target client population. The notional staffing ratio in services for children and adolescents (0-19 years) is 1wte Clinical/Applied Psychologist per of the Scottish population under 20years. In services for adults the ratio is 1wte per of the general population aged 20-64years but for older adults the ratio falls to 1wte per of the population aged 65 years and over. 2

4 There are significant differences in staffing levels in psychology services across Health Boards in NHS Scotland. At 30th September 2004, there were no resident psychology services in any of the Island Health Boards and limited visiting provision for neuropsychology and services for children to Orkney and Shetland. Shetland now has a small Child&Adolescent Mental health Services team. In mainland services the population served by 1wte Clinical/Applied Psychologist in the Health Board with the lowest staffing level is twice the population notionally served by 1wte in the area with the highest staffing levels. The variation in staffing across Health Board areas does not reflect variation in social deprivation indices. Summary Psychology services increasingly employ a skill-mix of staff (including Assistant Psychologists, CBT therapists, counsellors and other clinical staff/therapists). Overall the ratio is approximately 3wte Clinical/Applied Psychologist to 1wte Other Clinical Staff. By employing a wider skill-mix the ratio of population served by 1wte of the workforce in psychology services may be reduced (in 2 areas to 1 wte for less than 8000 of general population) although these data give no information about the range of services offered. In psychology services, 65% of the time of all clinical staff is spent in service delivery to patients and carers. The specific proportion varies with professional group. While the portion of time spent in direct service delivery is 68% for other clinical staff, this falls to 63% among Clinical and Applied Psychologists in line with the aspiration to redesign their roles to spend more time in support of the delivery of psychological interventions by others. In 2004 Clinical and Applied Psychologists spent 14% of their time in the clinical training/supervision of others; 10% in management activities; 5% in research or audit and the remaining time in their own professional development activities or other e.g. travel to clinics. 3 3

5 The Workforce of Clinical and Applied Psychologists in NHS Scotland: 2004 Table 1: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland at 30th September 2001, 2002, 2003 & Year Clinical Psychologists Applied Total Population Population per 1 Population per 1 Psychologists of Scotland wte Clinical wte of all Applied Psychologist Psychologists Grade B Grade A *Source: General Register Office for Scotland 2004 (GROS). Table 1a: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in Applied Psychologist Group Grade B wte Grade A wte NRO* wte Clinical Psychologist Counseling Psychologist Health Psychologist Clinical Health Psychologist Forensic Psychologist Clinical Forensic Psychologist Neuropsychologist Clinical Neuropschologist Total * Grade not relevant to post. The wte of Grade B Clinical Psychologists, Grade A Clinical Psychologists and Applied Psychologists have all risen relative to 2003 data. The breakdown by Clinical and Applied Group (Table 1a) indicates that the greatest rises relative to their 2003 figures have occured in Clinical Psychologists Grades A and B. The 2004 figures do include some data from staff at the State Hospital who were not included in the 2003 survey (6.2wte 2003; 9.15wte 2004). 4 6

6 Table 2: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work. Area of work Clinical Psychologists Percentage Applied Total wte of all ratios of grades Psychologists Clinical and B : A for Clinical Applied Psychologists Psychologists Grade B Grade A Mental Health : Learning Disabilities : Physical Health : Neuropsychology : Other : Forensic : Total : Table 2 shows that the wte of those categorising their area of work as Mental Health has increased since In the previous survey, 197.2wte of all Applied Psychologists were employed in this area. The categories used to describe areas of work in Physical Health, Other, Learning Disabilities and Forensic were expanded in 2004 following feedback on the previous survey. Mental Health as an area of work is broken down in more detail for the first time (Table 2e). Table 2a: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work: Physical Health. Physical Health Area wte Percentage of Total Physical Health wte Physical Health General % Corony heart disease/cardiac rehabilitation % Sexual Health HIV/AIDS % Cancer/Palliative Care % Stroke % Long Term Illnesses eg diabetes, renal % Pain % *Other % Total % *includes eating sleep disorders, chronic fatigue syndrome, cystic fibrosis and maternity & neonatal. 5 67

7 Table 2b: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work: Other. Other Area wte Percentage of Total Other wte Academic % Alcohol and Substance Misuse % Dentistry - - Healthcare for the Elderly and Dementia % Occupational Health % Promotion % Prevention % Prison Service - - Services to Cultural Minorities % Student Health - - Psychosexual % Self Help Workers - - Other % Total % Table 2c: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work: Learning Disability. Learning Disability Area wte Percentage of Total Learning Disability wte General % Offenders % Mental Health % Challenging Behaviour % Autism % Attention Deficit Hyperactivity Disorder % Total % Table 2d: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work: Forensic. Forensic Area wte Percentage of Total Forensic wte Offending Behaviours % Mental Health % Other % Total % 6 86

8 Table 2e: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work: Mental Health. Mental Health Area wte Percentage of Total Mental Health wte General Mental Health % Early Intervention % Mild To Moderate % Severe & Enduring % Eating Disorders % Total % Table 2a shows a rise in the wte working in the area of physical health, with an increase in wte in those working in Stroke and Cancer. However, the input of psychologists to physical health remains thinly spread across a range of specialties. There has been a continued rise in the wte working in Healthcare of the Elderly, and an increase in those working in the field of Alcohol and Substance misuse. Table 2c illustrates an increase in Learning Disabilities in 2004, most notably in the General category. The increased wte in forensic psychology services (Table 2d) relative to the 2003 data, reflects the increased participation of the State Hospital in the data collection exercise. Table 2e illustrates further breakdown of mental health areas of work. The large majority of Clinical and Applied Psychologists working in mental health categorised their work as general mental health (71%). 7 96

9 Table 3: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Target Age of clients/patients served. Clinical Applied All Applied Population Population Population Psychologists Psychologists Psychologists * per 1wte per 1wte of all (CPs) (APs) of CPs APs Grade B Grade A Children years Adults years Older Adults years Age Non specific Child & Adult Not known Total *Source: General Register Office for Scotland 2004 (GROS). The total wte of Clinical and Applied Psychologists working with 0-19 year olds has increased steadily since There has been a continued rise in those providing services to a wider age range than the specified categories ( Age Non Specific ). Table 3a illustrates an increase in wte working with Adolescent, and Child & Adolescent compared to the 2003 wte. 6 8

10 Table 3a: Clinical and Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Target Age of clients/patients served: child and adolescent. Clinical Applied All Applied Population Population Population Psychologists Psychologists Psychologists * per 1wte per 1wte of all (CPs) (APs) of CPs APs Grade Grade B A Children years Adolesent years Child & Adolesent *Source: General Register Office for Scotland (GROS). Table 4: All Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work and Target Age: All age groups. Area of work Child Adults Older Child & Adult Not Age Non- Total 0 19 yrs yrs Adults known Specific wte 65+ years Mental Health Learning Disabilities Physical Health Neuropsychology Other Forensic Total

11 Table 4a: All Applied Psychologists (wte) employed in psychology services in NHS Scotland in 2004, by Area of Work and Target Age: child and adolescent. Area of work Child Adolesent Child & Adolesent Totals 0 14 yrs yrs 0 19 yrs Mental Health Learning Disabilities Physical Health Neuropsychology Other Forensic Total Table 4 and 4a illustrates further the increase in input to Adult Mental Health service and Child & Adolescent Mental health services since Table 5: Ratio of per capita population to 1 wte of All Applied Psychologists in NHS Scotland in 2004, by Health Board area. < Greater Glasgow (8 587) 3. Dumfries & Galloway(10 681) 8. Ayrshire & Arran (15 872) 2. Fife (8 626) 4. Borders (10 927) 9. Highland (16 133) 5. Grampian (12 141) 10. Lanarkshire (16 453) 6. Lothian (12 931) 11. Argyll & Clyde (16 693) 7. Tayside (13 805) 12. Forth Valley (17 181) The number of wte Clinical and Applied Psychologists employed by each Health Board was examined relative to the total population served by that Health Board area. The data were expressed as the size of the population notionally served by 1 wte Applied Psychologist in each Health Board area. (Table 5) The indicative staffing ratio identified as the workforce target in the first workforce report for psychology services (Clinical Psychology Workforce planning, NES 2002) was 1wte per 5,000 of general population. 6 10

12 With the exception of Forth Valley, all Health Board areas have an increased wte compared to 2003 data. There have been differences across NHS Scotland in the use of a skill mix in psychology services. In comparing the workforce across Health Board areas reference should therefore also be made to Tables 10 and 11 which take account of the skill mix employed in psychology services. Table 5a: Clinical Psychologists by Grade and Applied Psychologists (wte) in NHS Scotland 2004, by Health Board Area. Clinical Clinical Other Applied Total wte of all Applied Population* per 1wte Grade B Grade A Psychologists of all Applied Psychologists Argyll & Clyde Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasgow Highland Lanarkshire Lothian State Hospital Tayside Scotland *Source: General Register Office for Scotland 2004 (GROS). 6 11

13 Table 6: All Applied Psychologists (wte) in NHS Scotland in 2004 by Area of Work and Health Board Area. Mental Learning Physical Neuro- Other Forensic wte of all Applied Health Disability Health Psychology Psychologists Argyll & Clyde Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasgow Highland Lanarkshire Lothian State Hospital Tayside Scotland Table 7: All Applied Psychologists (wte) in NHS Scotland in 2004, by Health Board Area and target age. Children Adult Older Adult Child & Not Age Non wte of all Applied 0 19 yrs yrs 65+ years Adults Known Specific Psychologists Argyll & Clyde Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasgow Highland Lanarkshire Lothian State Hospital Tayside Scotland

14 Comparing 2004 Tables 6 & 7 with those of 2003, Greater Glasgow Mental Health and Learning Disabilities of Adults appear to be the key areas of significant wte increase compared to the 2003 data. The 4 Health Boards with no psychological services for older adults in 2003 still had no services at the time of the 2004 survey. Table 7a: All Applied Psychologists (wte) in NHS Scotland in 2004, by Health Board Area and target age : child and adolescent. Children Adolesent Child & Totals 0 14 yrs yrs Adolesent Argyll & Clyde Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasgow Highland Lanarkshire Lothian State Hospital Tayside Scotland Table 8: Population estimates for Health Board areas, by target age (2004). Children Adolesent Adult Older Adult Total 0 14 yrs yrs (20 64 yrs) (65 + yrs) Population Argyll & Clyde Ayrshire & Arran Borders Dumfries & Galloway Fife Forth Valley Grampian Greater Glasgow Highland Lanarkshire Lothian Tayside Scotland Source: General Register Office for Scotland (GROS). 6 13

15 Skill-Mix in the Organisation of Psychology Services: 2004 Table 9: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2001, 2002, 2003 and 2004, expressed as a percentage of total workforce in service. All Assistant CBT Counsellors Other Other Total All Applied Applied Psychols Therapists Therapists Clinical Psychologists Psychols Staff : Others (%) : % 12.3% 1.7% 3.5% 1.2% 1.6% 100% : % 15.5% 2.3% 3.4% 1.1% 1.6% 100% : % 13.6% 3.4% 3.8% 1.7% 0.6% 100% : % 12.59% 3.17% 4.00% 1.14% 0.53% 100% 6 14

16 Table 10 : Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2004, expressed as a percentage of the total workforce in service, by Health Board area. All Assistant CBT Counsellors Other Other Total Applied Psychols Therapists therapists Clinical staff Psychols Argyll & Clyde % 16.47% 2.89% 8.67% 100% Ayrshire & Arran % 16.17% 12.94% 15.07% 2.31% 100% Borders % 9.09% 100% Dumfries & Galloway 58.44% 10.55% 5.49% 22.57% 2.95% 100% Fife % 15.52% 9.80% 5.88% 1.64% 100% Forth Valley % 4.65% 100% Grampian % 21.01% 2.70% 0.70% 100% Greater Glasgow % 6.98% 0.91% 100% Highland % 18.63% 100% Lanarkshire % 8.93% 6.69% 8.93% 100% Lothian % 18.22% 1.06% 100% State Hospital % 100% Tayside % 3.38% 1.7% 100% Scotland % 12.59% 3.17% 4.00% 1.14% 0.53% 100% 6 15

17 Table 11: Population per 1wte of all clinical staff in psychology services in NHS Scotland in 2004, by Health Board area. < Fife (5 793) 4. Ayrshire & Arran (8 493) 7. Lothian (10 437) 12. Forth Valley (16 382) 2. Dumfries & Galloway 5. Grampian (9 177) 8. Argyll & Clyde (12 013) (6 242) 3. Greater Glasgow (7 909) 6. Borders (9 934) 9. Lanarkshire (12 413) 10. Tayside (13 105) 11. Highland (13 127) Table 11 takes into account the skill mix in psychology services in calculating the size of the population in each Health Board area notionally served by 1 wte of all clinical staff. Services to the Islands: At 30th september 2004, the Island Boards did not have resident psychology services. However, Grampian staff have a contractual obligation to Orkney and Shetland in the following areas: Neuropsychology in Orkney: 3 days every 3 months; in and out patients seen by 1 staff member. Neuropsychology in Shetland: 3 days every 3 months; in and out patients seen by I staff member. Child service: 3 days every 3 months for both Orkney & Shetland. Urgent referrals from the above categories are flown to Grampian and seen there. Adult mental health: there are no visiting psychology services to either Shetland or Orkney at present. Patients can be referred to Aberdeen and treated under the terms of a Service Level Agreement between Grampian and the referring Health Board. 6 16

18 Table 12: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2004, expressed as a percentage of total workforce in service, by Area of Work. All Assistant CBT Counsellors Other Other Total Applied Psychologists Therapist Therapists Clinical (% of total) Psychologists Mental Health % 9.45% 5.68% 5.61% 0.75% 0.65% 100% Learning Disabilities % 23.15% 1.48% 3.95% 1.24% 59.31% Physical Health % 13.74% 0.88% 100% Neuropsychology % 11.82% 100% Other Areas of Work 77.65% 13.65% 0.82% 6.69% 1.19% 100% Forensic % 8.09% 100% Staff Group Total 78.56% 12.59% 3.17% 4.00% 1.14% 0.53% 100% Table 13: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2004, expressed as a percentage of total workforce in service, by Target Age: all ages. All Applied Assistant CBT Counsellors Other Other Total Psychol Psychol Therapist Therapists Clinical Staff Children yrs 82.09% 16.50% 0.18% 0.35% 0.88% 100% Adult yrs 75.85% 11.81% 4.41% 5.85% 1.58% 0.50% 100% Older Adult yrs 94.67% 5.33% 100% Child & Adult % 9.61% 9.61% 100% Age Non Specific % 12.82% 100% Total % 12.59% 3.17% 4.00% 1.14% 0.53% 100% 6 17

19 Table 13a: Categories of clinical staff (wte) employed in psychology services in NHS Scotland in 2004, expressed as a percentage of total workforce in service, by Target Age: child&adolescent. All Applied Assistant CBT Counsellors Other Other Total Psychol Psychol Therapist Therapists Clinical Staff Children yrs 85.69% 7.95% 0.79% 1.59% 3.98% 100% Adolesent yrs 79.84% 20.16% 100% Child & Adolesent 81.30% 18.70% 100% Totals % 16.50% 0.18% 0.35% 0.88% 100% Considering services by their target age groups (Table 13), differences appear across services in the skill mix of clinical staff employed. There are increases in all clinical staff for all target age groups since The largest wte increase is in all Applied Psychologists working with adults. Overall 66% of the workforce in the 2004 were deployed in delivering services directed to adults in the age range years and it is in these services that the use of a skill mix of psychologists and non-psychologists is most apparent. This figure is unchanged from

20 Adult Mental Health Services 2004 Year All Table 14: Categories of clinical staff (wte) employed in psychology services for Adult Mental Health in NHS Scotland in 2001, 2002, 2003 and 2004, and expressed as a percentage of the total workforce in psychology services for Adult Mental Health. Assistant CBT Counsellors Other Other Total Applied Psychol Therapists Therapists Clinical Psychol Staff % 8.4% 3.5% 6.4% 1.3% 1.6% 100% % 11.5% 4.9% 6.5% 1.6% 1.3% 100% % 8.8% 7.8% 6.8% 1.5% 0.4% 100% % 8.83% 7.51% 7.80% 0.86% 0.40% 100% Table 14 brings together the data from the last three years describing the skill mix of clinical staff (wte) employed in delivering psychology services in the area of Adult Mental Health. The wte of Applied Psychologists in this area has increased since 2003, and is at a similar level to that of

21 Table 15: Number (wte) of All Applied Psychologists employed in psychology services for adult and older adult Mental Health in NHS Scotland in Severe & Enduring Mild to Moderate Early General Eating Mental Illness Mental Illness Intervention Mental Health Disorders Adults Older Adults Older Adults Older Adults Older Adults Older Total Adults Adults Adults Adults Adults wte yrs 65+ yrs Argyll & Clyde % 82.55% 100% Ayrshire & Arran 21.36% 15.07% 63.57% 100% Borders % 20.00% 100% Dumfries & Galloway 100% 100% Fife % 82.09% % Forth Valley % 87.09% 100% Grampian % 4.93% 88.67% 3.94% 100% Greater Glasgow 17.34% 17.52% 62.09% 3.05% 100% Highland % 100% Lanarkshire % 30.18% 5.49% 53.36% 3.43% 100% Lothian % 8.85% 77.36% 2.30% 100% Tayside % 62.63% 9.06% 100% State Hospital % 100% Scotland % 12.51% 0.53% 71.41% 1.52%1.23% 100% Table 15 shows that there has been an overall increase in the wte of all Applied Psychologists working in adult and older adult mental health

22 Service Role Table i: Services Roles (wte) undertaken by all clinical staff employed in psychology services in NHS Scotland in Service Role All Assistant CBT Counsellors Other Other Total Percentages Applied Psychol Therapists Therapists Clinical wte Psychol Staff Client & carer service delivery % Management % Research & Audit % Prof development of CP trainees % Prof development - other clinical staff % Own CPD % Other % Total % The data collected show that Clinical/Applied Psychologists in NHS Scotland distribute their time across the categorised service roles in a pattern similar to that of Overall in NHS Scotland 65% of clinical staff time in psychology services is spent in service delivery. As expected this proportion is less among trained Applied Psychologists (63%) because of the range of other roles they require to fulfil. The proportion among other clinical staff in 2004 was 68%, a decrease since 2003 (77%). If we are moving to a skill mix model that maximises the use of scarce but highly skilled Clinical/Applied psychologists then the proportion of time spent by that group of staff on client and carer contact may need to be considered relative to the time invested in developing the skills of other staff. 6 21

23 For example, if the percentage of time spent on direct patient contact were to drop to around 40% overall this would allow the time spent in the development of other staff to increase to around 25% and the time involved in training other psychologists to increase to around 13%. This would require both a change in expectations about the key roles of Clinical/Applied psychologists and the development of better, formal arrangements for their involvement in the training, support and supervision of other staff. It may be that the time taken up with basic administrative duties could be handled more efficiently and cost effectively by an administrator. The relative low input to research and audit among Clinical and Applied Psychologists (Table ii) is of concern given the extent of their research training. 51% of Clinical and Applied Psychologists reported being active in research and audit. Details are not available to discriminate between the categories of research and audit, but the involvement of those active in this category ranged from 0.25 to 25.0 sessions in a 4-week period. The low input into research and personal CPD may be due to pressure from waiting lists and service managers to focus time on direct service delivery. Individuals may arrange to have their time bought out if they are serious about research. For 6 22

24 Service Role Table ii: Services Roles undertaken (wte) by all Clinical and Applied psychologists employed in psychology services in NHS Scotland in Service Role Clinical Psychologist Applied Total wte Percentages Psychologists Grade B Grade A Client & Carer % service delivery Management % Research & Audit % Prof development CP trainees % Prof developmant other clinical staff % Own CPD % Other % Total % 6 23

25 Service Role Table iii: Services Roles undertaken (wte) by all Clinical and Applied psychologists employed in psychology services in NHS Scotland in 2004, by target age: all ages. The percentage of total wte by target age for each service role is shown in parentheses. Service Role Child Adult Older Age Child & Child & Adolescent Total wte Adult non- Adult Adolescent by service years years 65+ years specific 0-19 years role Client & carer service delivery (68.26%) (62.59%) (65.92%) (59.84%) (61.79%) (64.03%) (63.73%) (63.08%) Management (9.51%) (10.48%) (8.68%) (10.78%) (6.07%) (9.25%) (7.35%) (10.02%) Research & Audit (2.69%) (5.11%) (4.73%) (6.90%) (6.31%) (4.90%) (6.43%) (5.11%) Prof development CP trainees (7.15%) (7.90%) (8.90%) (6.20%) (8.93%) (7.95%) (8.72%) (7.85%) Prof development other clinical staff (5.66%) (5.93%) (6.25%) (8.51%) (10.60%) (6.24%) (7.16%) (6.26%) Own CPD (6.08%) (5.85%) (5.30%) (5.69%) (6.43%) (7.07%) (5.51%) (6.01%) Other (0.65%) (2.12%) (0.28%) (2.08%) (0.00%) (0.58%) (1.19%) (1.67%) Total wte by target age (100%) (100%) (100%) (100%) (100%) (100%) (100%) (100%) 6 24

26 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 2004, by target age: all ages. The percentage of total wte by target age for each service role is shown in parentheses. Service Role Child Adult Older Age Child & Child & Adolescent Total wte Adult non- Adult Adolescent by service years years 65+ years specific 0-19 years role Client & carer service delivery (88.61%) (72.02%) (63.00%) (42.13%) (54.00%) (70.36%) (38.18%) (19.14%) Management (0.00%) (0.30%) (0.00%) (0.00%) (0.00%) (0.00%) (0.00%) (0.06%) Research & Audit (1.39%) (11.55%) (0.00%) (51.2%) (40.00%) (18.93%) (52.73%) (4.08%) Prof development of CP trainees (0.83%) (0.24%) (0.00%) (0.00%) (0.00%) (0.00%) (0.00%) (0.06%) Prof development - other clinical staff (2.22%) (2.49%) (0.00%) (0.00%) (1.50%) (0.71%) (0.00%) (0.57%) Own CPD (5.83%) (10.62%) (0.13%) (5.33%) (5.00%) (9.14%) (4.73%) (2.70%) Other (1.39%) (2.77%) (0.13%) (1.33%) (0.00%) (0.93%) (4.73%) (0.70%) Total wte by target age (100%) (100%) (100%) (100%) (100%) (100%) (100%) (100%) 6 25

27 Service Role Table v: Services Roles undertaken (wte) by all Clinical and Applied Psychologists employed in psychology services in NHS Scotland in The percentage of total wte by age band for each service role is shown in parentheses. Service Role < Total wte by service role Client & carer service delivery (69.52%)(70.37%) (64.20%) (57.59%) (57.64%) (56.27%) (59.94%) (60.00%) (63.08%) Management (4.50%) (4.79%) (8.34%) (14.03%) (13.08%) (15.07%) (15.43%) (12.63%) (10.02%) Research & Audit (4.88%) (4.80%) (4.61%) (4.95%) (6.09%) (6.88%) (3.66%) (3.51%) (5.11%) Prof development CP trainees (5.85%) (6.11%) (9.08%) (8.89%) (9.53%) (9.07%) (6.25%) (8.19%) (7.85%) Prof development - other clinical staff (5.22%) (5.32%) (5.89%) (7.42%) (7.41%) (6.61%) (6.34%) (8.89%) (6.26%) Own CPD (8.79%) (6.62%) (6.58%) (6.05%) (4.72%) (4.78%) (4.97%) (5.38%) (6.01%) Other (1.35%) (1.99%) (1.29%) (1.05%) (1.53%) (1.30%) (3.44%) (1.52%) (1.67%) Total wte by target age (100%) (100%) (100%) (100%) (100%) (100%) (100%) (100%) (100%) 6 26

28 Service Role Table vi: Services Roles undertaken (wte) by all Clinical and Applied Psychologists employed in psychology services in NHS Scotland in 2004, expressed as percentage of total wte for each gender. Service Role Clinical grade B Clinical Grade A Applied Female Male Psychologists Male Female Male Female Male Female Total % Total % wte wte Client & carer % % service delivery Management % % Research & % % Audit Prof % % development of CP trainees Prof % % development - other clinical staff Own CPD % % Other % % Total % % Tier The Tiers were defined as for 2003 data collection: Community Community Health and Wellbeing in the Neighbourhood/Locality. Primary Care Early intervention, generic caseload/teaching etc for Primary Care Team. Intermediate Care Specialist working within primary care. Referrals mainly from primary care i.e. sessions based in surgeries, health centres or local out patient clinics; mainly generic work. Secondary (Specialist) Care is attached to specialist teams/inpatient services, and/or providing specialist service. Tertiary Care Area wide/ supra-area service. High level of specialist expertise. 6 27

29 Tier Table i :Tiers operated in by all clinical staff employed in psychology services in NHS Scotland in 2004, expressed as a percentage of the total staff headcount. Tier Total Headcount % of total headcount working in the corresponding Tier Community % Primary % Intermediate % Secondary % Tertiary % Total % Tier Table ii : Tiers operated in by Clinical and Applied psychologists employed in psychology services in NHS Scotland in 2004, expressed as a percentage of the total staff headcount. Tier Clinical Psychologists Applied Total Percentages Psychologists Headcount Grade B Grade A Community % Primary % Intermediate % Secondary % Tertiary % Total % 6 28

30 The Characteristics of the Workforce: 2004 The data presented in this section refer to the headcount of staff in psychology services. Table 16: Clinical and Applied Psychologists: Years qualified and time in present post for all Applied Psychologists in NHS Scotland in 2004 (headcount). Clinical Grade B Clinical Grade A Applied Psycholgists Total N=182* N=258* N=34 N=469 Years qualified: Range Median Time in present post: Range Median * the total headcount for Clinical Psychologists in 2004 is 437 (3 individuals reported working on 2 contracts: 1 at Grade A, the other at Grade B). Table 16a: Age Distribution of All Applied Psychologists in NHS Scotland 2004 by gender. Age Range % of total Male workforce % of total Female workforce (total headcount = 131) (total headcount = 338) < % 5.33% % 31.66% % 20.41% % 13.31% % 11.54% % 8.88% % 6.80% % 2.07% Total 100% 100% 6 29

31 Table 17: Grade and Gender of all Clinical Psychologists in NHS Scotland in 2004 (headcount). Women (N=322) Men (N=115) Total (N=437) No. of Grade B % 34.57% 60.34% 41.36% No. of Grade A % 65.43% 39.66% 58.64% Women represent 73% of the workforce in terms of the headcount in Clinical Psychology. There continues to be a marked difference between the sexes in the proportion who are employed at Grade B relative to Grade A. This difference, 61% men: 35% women at Grade B, is not satisfactorily explained by the different age distribution of the sexes. Table 17a: Percentage of Applied Psychologists (headcount) at Grades B and A in NHS Scotland, 2004, by age and gender. Age Range Female Grade B Male Grade B Female Grade A Male Grade A N=112 N=70 N=212 N=46 < Total

32 Table 18: Clinical and Applied Psychologists in NHS Scotland in 2004: percentage with part-time and fixed-term contracts (headcount). Clinical Clinical Applied Psychologists Grade B Grade A N=34 N=182* N=258* Fixed-term (n) % Fixed-term 8.24% 16.67% 20.59% Full-time Part-time % part-time 36.26% 40.31% 52.94% * the total headcount for Clinical Psychologists in 2004 is 437 (3 individuals reported working on 2 contracts: 1 at Grade A, the other at Grade B). Table 18a: Headcount of All Male Applied Psychologists engaged in full-time and part-time working in NHS Scotland, 2004, by age, and expressed as a percentage of the total male headcount. Age Range Male WT Male% WT Male PT Male % PT < % % % % % % % % % % % % % % % Total % % 6 31

33 Table 18b: Headcount of All Female Applied Psychologists engaged in full-time and part-time working in NHS Scotland, 2004, by age, and expressed as a percentage of the total female headcount. Age Range Female WT Female% WT Female PT Female % PT < % % % % % % % % % % % % % % % % Total % % Table 19: Age and sex of other categories of clinical staff employed in psychology services in NHS Scotland in 2004 (headcount). Assistant CBT Counsellors Other Other Total Psychologists Therapists therapists clinical N=69 N=18 N=35 N=35 staff N=132 N=7 Men Age Range for men and women Median age range

34 Table 20: Years since qualifying and years in present post for other categories of clinical staff in psychology services in NHS Scotland in 2004 (headcount). Assistant CBT Counsellors Other Other clinical Total Psychologists Therapists N=35 Therapists Staff N=132 N=69 N=18 N=7 N=3 Years qualified: Range Median Years in present post: Range Median Table 21: Characteristics of the contracts of other categories of clinical staff in psychology services in NHS Scotland in 2004 (headcount). Assistant CBT Counsellors Other Other Total Psychologists Therapists therapists clinical N=69 N=18 N=35 N=7 staff N=132 N=3 Whitley contracts (n) % 55.07% 100% 82.86% 85.71% 100% 71.21% Whitley Fixed-term % Fixed-term 92.75% 11.11% 28.57% 28.57% 0.00% 59.10% Part-time % Part-time 10.14% 16.67% 74.29% 28.57% 33.33% 29.55% 6 33

35 Table 22: Characteristics of the workforce of all clinical staff in psychology services in NHS Scotland in 2004, by area of work. Area of Work % Female % part-time Age range of % of workforce with (total no. of clinical whole workforce MHO status staff, headcount) Median Mental Health 76.17% 36.79% % (n=386) 39 Learning Disabilities 70.27% 27.03% % (n=111) 37 Physical Health 76.07% 46.15% % (n=117) 38 Neuropsychology 72.55% 41.18% % (n=51) 38 Forensic 74.29% 48.57% % (n=35) 36 Other 73.19% 34.78% % (n=138) 41 Total 74.54% 37.10% % (N=601)* 39 *staff can have more than one area of work 6 34

36 Table 23: Characteristics of the workforce of all clinical staff in psychology services in NHS Scotland in 2004, by target age of patients/clients served. Target Age % Female % part-time Age range of % of workforce with whole workforce MHO status (Total No. of Clinical Staff, headcount) (Median) Children, young 76.67% 40.00% % people and families 35 (n=30) Adult 70.92% 41.37% % (n=423) 40 Older Adults 77.27% 31.82% % (n=22) 41 Age non-specific 80.00% 37.14% % (n=35) 36 Adolesent 93.75% 37.5% % (n=16) 32.5 Child & Adolesent 85.54% 24.10% % (n=83) 35 Child & Adult 83.33% 33.33% % (n=12) 33.5 Total 74.54% 37.10% % (N=601)

37 Table 24: Characteristics of the workforce of all clinical staff in psychology services in NHS Scotland in 2004, by Health Board area. Health Board Area % Female % part-time Age range of % of workforce with whole workforce MHO status (Total No. of Clinical Staff, headcount) (Median) Argyll & Clyde 78.38% 21.62% % (n=37) 43 Ayrshire & Arran 76.00% 32.00% % (n=50) 43 Borders 66.67% 46.67% % (n=15) 44 Dumfries & Galloway 69.70% 51.52% % (n=33) 52 Fife 75.36% 34.78% % (n=69) 39 Forth Valley 65.22% 65.22% % (n=23) 41 Grampian 80.95% 31.75% % (n=63) 37 Greater Glasgow 74.58% 31.36% % (n=118) 35 Highland 70.59% 23.53% % (n=17) 39 Lanarkshire 72.92% 22.92% % (n=48) 38 Lothian 72.22% 52.22% % (n=90) 40 State Hospital 76.92% 69.23% % (n=13) 35 Tayside 79.41% 47.06% % (n=34) 43 Total 74.54% 37.10% % (N=601)

38 Membership of the Psychology Workforce Steering Group Dr George Deans Dr Liz Jamieson Ms Barbara Moore Mrs Ruth Salter Dr Ann Smyth (Chair) Mr Hugh Toner Mr John Quinn Head of Adult Mental Health Directorate, Royal Cornhill Hospital, Aberdeen ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. Head of Adult Clinical Psychology, Forth Valley Primary Care Operating Division Old Denny Road, Larbert National Director of Training for Psychology Services, NHS Education for Scotland, Edinburgh EH2 2NN. Area Head, Fife Clinical Psychology Services, Stratheden Hospital, Cupar ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB. Acknowledgements The Steering Group gratefully acknowledges the contribution of the following people: Scott Heald Head of Costs and Workforce, ISD, Gyle Square, 1 South Gyle Crescent, Edinburgh David Allan, IT Department, ISD, Gyle Square, 1 South Gyle Crescent, David Greig, Edinburgh EH12 9EB. Simon Payne & Benji Larbi. For further information on the NES-ISD Psychology Workforce Project, please contact Dr Liz Jamieson: Information Services (ISD), Healthcare Information Group, Gyle Square, 1 South Gyle Crescent Edinburgh EH12 9EB Tel: Fax: elizabeth.jamieson@isd.csa.scot.nhs.uk