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Glossary

Advanced nurse practitioners (ANP)

An ANP is an experienced and highly educated Registered Nurse who manages the complete clinical care for their patient, not solely any specific condition. Advanced practice is a level of practice, rather than a type or speciality of practice.

ANPs are educated at Masters Level in advanced practice and are assessed as competent in this level of practice. As a clinical leader they have the freedom and authority to act and accept the responsibility and accountability for those actions. This level of practice is characterised by high level autonomous decision making, including assessment, diagnosis, treatment including prescribing, of patients with complex multi-dimensional problems. Decisions are made using high level expert, knowledge and skills. This includes the authority to refer, admit and discharge within appropriate clinical areas.

Working as part of the multidisciplinary team ANPs can work in or across all clinical settings, dependant on their area of expertise.

Agenda for change (AfC)

The national NHS pay system which introduced new pay bands and harmonised terms and conditions for NHS workforce. It came into effect, across the UK, on 1st December 2004 and replaced the previous Whitley council system. It applies to all staff groups except Medical and Dental. 

Allied health professions (AHPs)

The Allied Health Professions are a distinct group of healthcare professionals who apply their expertise to diagnose, treat and rehabilitate people of all ages and all specialties. AHPs are distinct from medicine, pharmacy and nursing and include professions such as physiotherapy, dietetics, speech and language therapy, occupational therapy, podiatry.

Applied psychologists 

Professional Groups within the Clinical Psychology Services workforce data base. These include: Clinical Psychologists, Counselling Psychologists, Health Psychologists, Forensic Psychologists, Neuropsychologists.

Area of work

The specialty area that a clinician works in. These are relevant for the CAMHS and Psychology workforce publications and are defined in downloadable spreadsheets: CAMHS and Psychology definitions. 

Census date

Date at which a snapshot of data represent. For example, the number of staff employed at 31 March 2020 census.

Child & adolescent mental health services (CAMHS)

Delivered by multidisciplinary teams including psychiatrists, psychologists, nurses, social workers, allied health professionals and others. The main function of CAMHS is to develop and deliver services for those children and young people (and their parents/carers) who are experiencing the most serious mental health problems. They also have an important role in supporting the mental health capability of the wider network of children’s services.

Children and young people

The people served by child and adolescent mental health services. Some areas provide services for all those under 18, while others offer services to those over 16 only if they are in full time education.

Clinical fellowships

Specialty training posts which allow the post holder to spend 25% of their time on academic training as well as 75% in clinical training, and prepare for an application for a training fellowship for a higher degree.

Community nurse

Term used to describe staff involved in providing nursing care to patients in a community setting, for example in their own home. They aim to enable patients to remain at home where possible and to assist individuals to improve, maintain or recover from their health condition and to provide support and care to those with life limiting illnesses.

Consultants

Doctors who have had a minimum of six years training in their specialty (these consultants are listed on the GMC’s specialist register) and directors of public health (see The Association of Directors of Public Health for more information). 

Dental officer and senior dental officer

Dentists paid by their employing NHS board. These are dentists working in hospitals and community health services provide dental care for people who have either been referred for further treatment or could not get care through the GDS (for example for patients who are residents of long-stay care). 

Doctor in training

Doctors who have completed the Foundation Programme but are still receiving training (normally in a specialty). The British Medical Association website explains the medical training pathway. The medical workforce is reported by grade in the NHSScotland Workforce publication.

Electronic employee support system (e:ESS)

e:EES is a single national HR system for all boards in NHSScotland. It is used to manage employment information for all staff employed by NHS Scotland’s health boards.

Establishment

Term used in calculating NHSScotland vacancy information to describe total filled and vacant posts by occupation. Establishment is calculated by adding the number of staff employed to the number of vacant posts.

Extract date

Date at which a snap shot of data is extracted from a system. For example, the number of staff employed at 31 March 2021 census were extracted from the system on 13 April 2021. 

Foundation year 1 and 2

Doctors who are on an integrated two-year Foundation Programme (FY). Completion of FY1 allows junior doctors to gain full registration with the GMC and completion of FY2 allows them to apply for further study and training in a specialised area of medicine. The medical workforce is reported by grade in the NHSScotland Workforce publication.

General medical services (GMS)

General Medical Services (GMS) is the term used to describe the range of healthcare that is provided by General Practitioners (GPs or family doctors) as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. Today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments.

General dental service (GDS)

NHS general dental services are provided by general dental practitioners, under a national contract between themselves and the NHS Boards. General dental practitioners are independent contractors. They are free to choose whether to join a NHS Board's dental list and whether to provide NHS dental treatment to each individual patient.

General medical council (GMC)

A public body that maintains the official register of medical practitioners within the United Kingdom.

General Practice Designations

In line with legislation that came into effect on 1 April 2004, GPs are collectively termed ‘Performers’. These can be broken down into further sub-categories or designations as follows:

  • Performer: a GP who has entered into a contract to provide services to patients and is effectively self-employed; usually a practice partner.

  • Performer salaried: A GP who is employed by the practice or NHS Board on a salaried basis.

  • Performer retainee: A GP, typically part-time, who can be utilised by a practice as required.

  • Performer Registrar/Specialist Trainee: A medical practitioner in a GP training program. 

Hard to recruit

Term used in workforce vacancy collection. Posts which remain vacant after a minimum of 6 months, where a reasonable effort has been made to fill these vacancies.

Headcount

The number of individuals employed which adjusts the figures to take account of part time working. The Scotland figure eliminates any double counting that may exist as a result of an employee holding more than one post.

Healthcare science staff

Staff group which play a vital role in the prevention, diagnosis and treatment of a huge number of medical conditions, as well as in rehabilitation.

Health improvement, efficiency, access or treatment (HEAT)

These have been replaced by the Local Delivery Plan (LDP) Standards.

Health and care professions council (HCPC)

This is a register for health and care professionals within the UK who are required to meet certain standards of practice. For many professions, including several types of Psychologists, it is a legal requirement to be registered in order to practice in their field.

Hospital, community, and public health services (HCHS)

Includes all medical and dental staff directly employed by the boards, does not include general practitioners or the general dental service.

Information services division (ISD)

A division of National Services Scotland, part of NHSScotland. ISD provided health information, health intelligence, statistical services and advice that support the NHS in progressing quality improvement in health and care and facilitates robust planning and decision making. ISD became part of Public Health Scotland (PHS) from 1 April 2020.

From 1 October 2019, responsibility for some national workforce data, statistical & intelligence function transferred from ISD to NHS Education for Scotland (NES). Workforce publications prior to 3 December 2019 can be accessed via the Public Health Scotland (previously ISD Scotland) workforce publication page.

Inflow

The number of people who are employed at a census but not in the previous census. We normally analyse this over a financial year: the number of employees who are employed at 31 March year n+1 and were not employed at 31 March year n. Also called 'joiners' and part of the measures investigating workforce turnover.

Job plan

A consultant job plan is a prospective agreement that sets out a consultant's duties, responsibilities and objectives for the coming year. The job plan is divided into programmed activities (PAs). The contract is based on a full-time work commitment of 10 PAs per week, each having a timetabled value of four hours. These PA's are divided into four categories, Direct Clinical Care, Supporting Professional Activities, Additional responsibilities and external duties and Extra Programmed Activities. These data were collected by a survey which is currently on hold. 

Job family

A high-level occupational grouping of the workforce employed by NHSScotland. This is used interchangeably with 'staff group'. The Variables Guide describes how data is mapped for job families and staff groups used in NHSScotland Workforce publications.

Joiners

The number of people who are employed at a census but not in the previous census. We normally analyse this over a financial year: the number of employees who are employed at 31 March year n+1 and were not employed at 31 March year n. Also called 'inflow' and part of the measures investigating workforce turnover.

Local authority contract (LAC)

A contract between a NHS Board and local authority to provide a service. 

Leavers

The number of people who are employed at a census but not in the next census. We normally analyse this over a financial year: the number of employees who are employed at 31 March year n and were not employed at 31 March year n+1. Also called 'outflow' and used to calculate the turnover rate.

Locum appointment in service (LAS)

A locum (temporary) post for which the post-holder (doctor) provides only service. LAS posts do not provide training that is recognised by a deanery or Royal College as counting as towards the Certificate of Completion of Training.

Locum appointment in training (LAT)

A locum (temporary) post for which the post-holder (doctor) is assigned both a clinical supervisor and an educational supervisor. LAT posts are approved training posts recognised by a deanery or Royal College which can contribute towards the Certificate of Completion of Training.

Management information and dental accounting system (MIDAS)

The general dental service data are held in MIDAS owned by Public Health Scotland. Data are extracted annually on 30th September and are released as part of the NHSScotland Workforce publication.

Medical and dental staff

The medical and dental staff group includes consultants, staff and associate specialist grades, doctors in training & other trained grades

Medical grade

Position a person is working at in the medical profession. The British Medical Association produces guidance on the medical training pathway. The medical workforce is reported by grade in the NHSScotland Workforce publication and grades are defined in the Variables Guide (downloadable spreadsheet).

Medical specialty

An area of training with curricula and assessments approved by the General Medical Council. The medical workforce is reported by specialty in the NHSScotland Workforce publication and specialties are defined in the Variables Guide (downloadable spreadsheet).

NHS board

NHSScotland consists of

  • 14 regional NHS Boards which are responsible for the protection and the improvement of their population’s health and for the delivery of frontline healthcare services, and
  • 7 Special NHS Boards and 1 public health body who support the regional NHS Boards by providing a range of important specialist and national services. 

Non-salaried dentist

A dentist which is typically a self-employed contractor who is paid according to the work they have completed.

National Primary Care Clinician Database (NPCCD)

The Primary Care Clinicians Database is a centralised database of primary care clinicians and general practice details, held at NHS NSS but with data maintained by NHS boards.

Nursing and midwifery council (NMC)

The regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to practise within the UK.

Outflow

The number of people who are employed at a census but not in the next census. We normally analyse this over a financial year: the number of employees who are employed at 31 March year n and were not employed at 31 March year n+1. Also called 'leavers' and used to calculate the turnover rate.

Professional Group

The staff grouping for the workforce delivering Psychology Services and Child and Adolescent Mental Health Services (CAMHS). Professional groups used in CAMHS and Psychology workforce publications are defined in downloadable spreadsheets: CAMHS and Psychology definitions.

Public dental service (PDS)

Introduced in January 2014 and brings together the previously separate salaried and community dentists. Salaried dentists are directly employed by NHS boards and provided an alternative service to independent dentists where this is considered the best solution to meet local needs. People can also register with salaried dentists. Historically, the Community Dental Service (CDS) provided a 'safety net' dental service for people who were unable to obtain care from independent dentists (through the General Dental Service (GDS)), such as patients with special care needs or patients living in areas where there were few NHS dentists providing GDS.

Salaried dentists

A dentist which is employed within or by an NHS organisation, and mainly works in a primary care or community setting. These provide an alternative service to the contracted General Dental Practitioners, in order to meet the needs of the local population. From January 2014 salaried dentists became part of the Public Dental Service.

Scottish workforce information services system (SWISS)

The main source of NHSScotland workforce statistics is SWISS. Workforce information was first captured through SWISS in 2007 for the data at 30 September 2007.

Sex

Self-defined sex is used to report on the sex of the NHS Scotland workforce. This is sourced from SWISS and is defined as whether a person considers themselves to be male or female.

Specialty doctor

Doctors who have gained some experience within their specialty such as associate specialist, clinical medical officer and hospital practitioner. There is a difference between a specialist and specialty doctor as explained by the British Medical Authority.

Staff group

A high-level occupational grouping of the workforce employed by NHSScotland. This is used interchangeably with 'job family'. The Variables Guide describes how data is mapped for job families and staff groups used in NHSScotland Workforce publications.

Staff in post

The number of people, measured using Headcount or the Whole Time Equivalent, who are currently employed. This differs from establishment which includes vacant posts.

Sub job family

A sub-grouping for job family / staff group of the NHSScotland workforce. The Variables Guide describes how data is mapped for sub job families used in NHSScotland Workforce publications.

Target age

The age group of patients seen by a clinician. For example, some practitioners may work primarily with early years (0 – 4 year olds) whereas others may work in a service that mainly supports adolescents. While some practitioners specialise in working with a specific target age, others work across a range of ages.

In the CAMHS workforce publication, target age groups are: 0-4, 5-11, 12-15, 16-17, and 18+

In the Psychology services workforce publication, target age groups are: child & adolescent (0-18/19 years), adult (20-64 years), and older adult (65+ years). Age non-specific refers to those clinicians who see patients from across the lifespan and can also include non-clinical work such as teaching.

Tiers of service provision

In Scotland, child and adolescent services are generally delivered through a tiered model of service organisation:  

Tier Definition
Tier 1 Child and adolescent mental health services at this level are provided by practitioners working in universal services who are not mental health specialists. This includes: GPs, health visitors, school nurses, teachers, social workers, youth justice and voluntary agencies. Tier 1 practitioners are able to offer general advice and treatment for less severe problems. They contribute towards mental health promotion, identify problems early in the child or young person’s development and refer to more specialist services.
Tier 2 Mental Health Practitioners at this level tend to be CAMHS specialists working in community and primary care settings, in multi-disciplinary teams (although many will also work as part of tier 3 services). They can include mental health professionals employed to deliver primary mental health work, psychologists and counsellors working in GP practices, paediatric clinics, schools and youth services. Practitioners offer consultation to families and other practitioners outreach to identify severe or complex needs requiring specialist intervention.
Tier 3 This is usually a multi-disciplinary team or service working in a community mental health clinic or child psychiatry outpatient service, providing a specialised service for children and young people with more severe, complex and persistent disorders. Team members are likely to include child and adolescent psychiatrists, social workers, clinical psychologists, community psychiatric nurses, child psychotherapists, occupational therapists and art, music and drama therapists.
Tier 4 Essential tertiary level services such as intensive outreach services, day units and inpatient units. These are generally services for the small number of patients who are deemed to be at the greatest risk (of rapidly declining mental health or serious self-injury) and/or who require a period of intensive input for the purpose of assessment and/or treatment. Team members will come from the same professional groups as listed for tier 3. The clinical responsibility for overseeing the assessment, treatment and care for each tier 4 patient is likely to lie with a consultant child and adolescent psychiatrist or clinical psychologist.

 

Turnover

The rate at which employees leave the workforce. Turnover is calculated by dividing the number of leavers (outflow) over the year by the number of staff employed at the start of the period.

Vacancy

A vacancy is a post which has been cleared for advert after being through the redeployment process (internal or external advert) and remains a vacancy until an individual starts in the post. These data are collected by survey.

Vacancy rate

The number of vacancies divided by the establishment and then multiplied by 100. 

Whitley council system

The old NHS pay system which was replaced by the Agenda for Change (AfC) on the 1 December 2004.

Whole time equivalent (WTE)

WTE is derived by dividing the number of contracted hours by the number of conditioned hours. WTE is sometimes a more useful measurement than headcount because it adjusts headcount figures to take account of part time working i.e. 1 person may work 20 hours a week so headcount could make the workforce appear inflated. Sometimes called full time equivalent (FTE). 

Whole time equivalent per 100,000

The Psychology workforce publications calculates the number of staff per 100,000 population. The CAMHS workforce publication calculates the number of staff per 100,000 population and per 100,000 child and adolescent (0-18 year old) population. Both populations calculate these measures using Mid-Year Population Estimates available from National Records for Scotland