This is an Official Statistics Publication

As of 1st October 2019, NHS Education for Scotland (NES) has taken responsibility for some national workforce data, statistical & intelligence functions.

NHS Education for Scotland (NES) is NHSScotland’s education and training body. It is the authoritative source of information on the people who work for NHSScotland. NES became an accredited provider of Official Statistics in December 2019 and as such this release is produced in accordance with the UK Statistics Authority’s Code of Practice for Statistics. NES voluntarily applied the Code of Practice for the publication released on 3 December 2019.

1 Introduction

This publication summarises national data on the workforce providing Psychology Services in NHSScotland, following the latest census at 31 March 2023. When describing the size of a particular staff group, figures are presented either as headcount (actual number of staff) or whole time equivalent (WTE), which adjusts the headcount to take account of part-time working.

This report summarises key aspects of the data including:

The data are collected directly from Psychology services and held within the National Services Scotland (NSS) National Psychology Workforce Information Database. The data are verified by Psychology Heads of Service, who work closely with NES to ensure a high level of accuracy. The information collected and presented is used routinely by NES, the Scottish Government and NHS Boards to support local, regional and national workforce planning, and to support educational training and planning.

In recent years, NHSScotland has seen a steadily increasing demand for access to Applied Psychologists and Psychological Therapies due to the growing evidence base, recognised in Scottish Intercollegiate Guidelines Network (SIGN) and National Institute for Health and Clinical Excellence (NICE) guidelines, for the effectiveness of psychological interventions in delivering positive health change for people with a wide range of clinical conditions. The term ‘Psychological Therapies’ refers to a range of interventions based on psychological concepts and theory, which are designed to help people understand and make changes to their thinking, behaviour and relationships in order to relieve distress and to improve functioning. The skills and competences required to deliver these interventions effectively are acquired through training and maintained through clinical supervision and practice.

The NHS Education for Scotland- Scottish Government Report The Matrix: A Guide to Delivering Evidence-Based Psychological Therapies in Scotland summarises and describes the most up-to-date evidence-based psychological therapies. The Matrix report also provides information and advice for NHS Boards on the delivery of effective and efficient therapies and the levels of training and supervision necessary for staff to deliver these safely and effectively.

In conjunction with this report, comprehensive workforce data as at 31 March 2023 are shared across the following outputs:

1.1 Dashboards

  • The psychology dashboards present quarterly data on staff in post in NHSScotland psychology services, vacant posts and staff in training.
  • The dashboards present a breadth of data, including staff WTE and headcount; WTE per 100,000 population; age band; target age and area of work; gender and contract type; Agenda for Change (AfC) band; contract length; ethnicity and disability; turnover; vacant posts; staff in training; and the retention of trainees in the workforce.

1.2 Data Tables

The psychology background tables include:

  • Supplementary long-term trend data for staff in post, vacancies and trainees.
  • Quarterly updates to staff in post tables.
  • Biannual updates on Clinical Psychology training courses
  • Annual updates on:
    • Staff ethnicity and disability status
    • Staff turnover

Due to varying sources and frequency of data collection, not all published tables are updated at this time of year.

2 Main Points

As at 31 March 2023:

  • There were a total of 1538.4 WTE (1844 headcount) clinical staff in post. This is 7.5% (107.3 WTE) higher than reported 12 months previously. Since the last quarterly census, the WTE of staff in post has increased by 1.8% (26.9) WTE.

  • There were a total of 953.3 WTE (1186 headcount) Applied Psychologists in post: an increase of 1.7% (16.3 WTE) from 31 March 2022 and 0.2% (2.4 WTE) from 31 December 2022. The biggest increase was in Clinical Associate in Applied Psychology (CAAP) roles. As at 31 March 2023, 211.2 WTE (239 headcount) Clinical Associates were in post in NHSScotland. This is an increase of 8.8% (17 WTE) from 31 March 2022 and 7.3% (14.3 WTE) from 31 December 2022.

  • There were 157.3 WTE advertised vacancies, which is -40.6% (-107.6 WTE) lower than 31 March 2022 and -23.1% (-47.2 WTE) lower than 31 December 2022. Of these vacancies, 52% (81.8 WTE) had been advertised for less than three months, 25.9% (40.8 WTE) for three to six months and 22.1% (34.7 WTE) for longer than six months. The vacancy rate was 9.3%, compared to 11.9% at 31 December 2022 and 15.6% at 31 March 2022.

  • In early 2023, 43 students graduated from the MSc in Psychological Therapy in Primary care, and 34 graduated from the MSc in Applied Psychology for Children and Young People. This compares with an average yearly graduation figure of 25 for the MSCPTPC and 20 for the MSCAPCYP. The probabilities of completing these courses within two years of starting are 0.96 and 0.97 respectively.

3 Staff in Post

At 31 March 2023, there were a total of 1538.4 WTE (1844 headcount) clinical staff in post within Psychology Services across NHSScotland. Bespoke data collection for this workforce began with an initial pilot collection in 2001, with more complete data collection commencing in 2002.

Figure 1 shows the increase in this workforce since March 2011, overall and split by All Applied Psychologists and Other Clinical Staff. Since 2011, the overall workforce has increased by 78.6% (677.2 WTE). In the past 12 months there has been an overall increase of 7.5% (107.2 WTE), and since the last quarterly census, there has been an increase of 1.8% (26.9 WTE).

Figure 1: WTE of all Clinical Staff in NHSScotland Psychology Services

Figure 1: Line graph showing the increase in the psychology services workforce from September 2006 to March 2023, split by All Professional Groups, All Applied Psychologists and Other Clinical Staff.

Notes

Quarterly data collection began from March 2011. Prior to this there was only an annual census at 30 September.

Clinical and Other Applied Psychologists are also referred to as all Applied Psychologists. Further information can be found in the Glossary and Summary of Professional Groups.

As at 31 March 2023 there were 62.3 WTE (4.1%) staff on maternity/paternity leave and 13.9 WTE (0.9%) on long term sick leave.

Figure 2 illustrates the WTE of staff on maternity/long-term sick leave, quarterly since March 2015. Numbers under 5.0 WTE have been suppressed.

Figure 2. WTE of Staff in NHSScotland Psychology Services on Maternity and Long-term Sickness Absence, Quarterly from March 2015 to 31 March 2023.

Figure 2. WTE of Staff in NHSScotland Psychology Services on Maternity and Long-term Sickness Absence, Quarterly from March 2015 to March 2023.

3.1 Whole Time Equivalent (WTE) per 100,000 population

Figure 3 shows the Whole Time Equivalent (WTE) of all clinical staff employed in NHSScotland Psychology Services per 100,000 population as at 31 March 2023.

NHS Borders and NHS Dumfries and Galloway currently have the largest WTE per 100,000 population, with 35.3 and 33.4 respectively, compared to the overall NHSScotland rate of 28.1.

The higher rates in some boards are partly due to the provision of regional services including referrals from other boards. In some instances, this may also involve specialist inpatient care, where staffing requirements are higher. Health boards with higher levels of deprivation will have a greater demand for services.

Figure 3: Whole Time Equivalent (WTE) of All Clinical Staff per 100,000 population as at 31 March 2023

Figure 3. A horizontal bar chart showing the Whole Time Equivalent (WTE) of all clinical staff employed in NHSScotland Psychology Services per 100,000 population, by NHS Board, as at 31 March 2023.

Figure 4 compares the Whole Time Equivalent of all Applied Psychologists employed per 100,000 population in NHS boards at 31 March 2011 and 31 March 2023. NHS Borders currently has the highest number of Applied Psychologists employed per 100,000 population (20.8 WTE).

Figure 4: Whole Time Equivalent per 100,000 population of Applied Psychologists in NHSScotland Psychology Services as at 31 March 2011 and 31 March 2023

Figure 4. A a bar chart that shows the Whole Time Equivalent of all Applied Psychologists employed per 100,000 population in NHS Boards as at 31 March 2023.

3.2 Staff by Professional Group

At 31 March 2023, All Applied Psychologists comprised 62% of the workforce (953.3 WTE) and Other Clinical Staff 38% (585.1 WTE).

Figure 5 shows the WTE of different Professional Groups in NHSScotland. Clinical Psychologists were the largest staff group, comprising 55.9% (859.4 WTE) of the workforce. This is 1.5% (12.5 WTE) higher than at 31 March 2022 and 0.4% (3.4 WTE) higher than the previous quarter. The WTE of Counselling Psychologists increased from the previous year by 4.2% (3.3 WTE), the WTE of Health Psychologists increased by 6.6% (0.5 WTE), and the WTE of Forensic Psychologists did not change.

The WTE of all Other Clinical Staff groups also increased between 31 March 2022 and 31 March 2023, particularly Psychology Assistants, which rose by 38.1%, (46.5 WTE) over that year. The WTE of the Other staff category increased by 21.6%, (19.5 WTE), Clinical Associates by 8.8% (17 WTE), Cognitive Behavioural Therapists by 10.9%, (5.6 WTE) and Counsellors by 5.6%, (0.9 WTE).

Figure 5: WTE of Professional Groups in NHSScotland Psychology Services as at 31 March 2022 and 31 March 2023

Figure 5. A bar chart that shows the WTE of different Professional Groups in NHSScotland as at March 2022 and March 2023. Clinical psychologists are by far the largest group.

Notes

Other includes: Mental Health Clinicians, Self Help Workers, Peer Support Workers, Primary Mental Health Workers, Mental Health Nurses, Psychological Therapists and Child and Adolescent Therapists.

The professional group Clinical Associate in Applied Psychology (CAAP) has been recorded since 31 December 2017. Previously, these staff would have been included in either the Graduate of the MSc Psychological Therapy in Primary Care or Graduate of the MSc Applied Psychology for Children and Young People professional groups, which have now been removed. While data quality checks and updates are ongoing, some CAAPs are still being recorded in the Other professional group. Increasingly NHS Boards are employing graduates of the MSc PTPC under roles other than CAAP. These individuals are recorded under ‘CBT Therapist’, ‘Other Therapist’ and ‘Other’.

3.3 Staff by Target Age and Area of Work

This section provides further information on the specialty areas and patient groups cared for by the psychology workforce. For more detailed information please refer to the background tables.

Within each professional group, individual staff members may work across several different Target Ages and Areas of Work. Target Age refers to the age group of patients being cared for. For Psychology Services, the distinct age groups are generally Child & Adolescent (0-18 years), Adult (19-64 years), or Older Adult (65+ years).

Area of Work refers to the broad specialty area that the clinician works in. For definitions of each Area of Work please refer to the Glossary.

3.3.1 Target Age

Figure 6 displays the quarterly WTE of staff working across each Target Age, between September 2006 and 31 March 2023. The largest Target Age group continues to be Adult, which accounts for 60.1% (924 WTE) of the Psychology workforce at 31 March 2023. The Child and Adolescent Target Age accounts for 25.7% (395.9 WTE) of the workforce, Older Adults 5.7% (87.2 WTE) and Age Non-Specific 8.5% (131.3 WTE).

The Adult Target Age category has seen the largest growth of WTE since March 2011, an increase of 64.5% (362.2 WTE). The largest percentage increases were seen in the Age Non-Specific and Older Adult categories, with increases of 166.6% (82.1 WTE) and 124.1% (48.3 WTE) respectively. The increase within the Older Adult Target Age may partly be due to the introduction of trainees on the Doctorate in Clinical Psychology course having specific alignment to Older People’s Services. The MSc Psychological Therapy in Primary Care course covers both adults and older adults. This has enabled graduates to work in the Older Adult Target Age on completion, an age group for which historically there have been fewer staff assigned.

The WTE of staff working within the Child and Adolescent Target Age has increased by 87.4% (184.6 WTE) over this time period, although the proportion of staff has remained similar, accounting for around a quarter of the total staff WTE.

Figure 6: Whole Time Equivalent of All Clinical Staff in Psychology Services by Target Age between 31 December 2011 and 31 March 2023

Figure 6. A line chart that displays the trend in the WTE of staff working across each Target Age (Adult, Child and Adolescent, Older Adults, Age Non-Specific), between 30 September 2006 and March 2023.

Notes

There is a differing age range of service provision across the boards in child services. For more details, please see the Age of Service Provision table within the CAMHS publication, available here.

3.3.2 Area of Work

Area of Work refers to the broad specialty area of the services that a clinician provides - the areas being Mental Health, Learning Disabilities, Physical Health, Neuropsychology, Forensic, Alcohol & Substance Misuse and Other specialty services.

Figure 7 shows the WTE for the Mental Health Area of Work, broken down into sub-specialties (General, Mild to Moderate, Severe and Enduring, Eating Disorders, and Early Intervention) at 31 March 2011, 31 March 2022 and 31 March 2023. Different specialty areas have different staffing requirements. For example, the subcategory Severe and Enduring Mental Health requires a more intensive level of staffing than Mild to Moderate services. For definitions of each Area of Work, including the subcategories for Mental Health, please see the Glossary.

By far the largest area of work is General Mental Health, which accounted for 47.7% (734.5 WTE) of the workforce at 31 March 2023. Mild to Moderate Mental Health accounted for 9.1% (139.5 WTE) of the workforce, Early Intervention for 2.8% (43.3 WTE), Severe and Enduring Mental Health for 2.4% (36.5 WTE), and Eating Disorders for 1% (15.8 WTE).

Figure 7: WTE of Staff in Post in the Mental Health Area of Work, Overall and by Subcategory, as at 31 March 2011, 31 March 2022 and 31 March 2023

Figure 7. A combo chart with bar and line graphs that show the WTE for the Mental Health Area of Work, overall and broken down into sub-specialties (General, Mild to Moderate, Severe and Enduring, Eating Disorders, and Early Intervention), at March 2011, March 2022 and March 2023.

The WTE of the majority of Mental Health subcategories has increased since March 2022; General Mental Health by 11.1% (73.3 WTE), Mild to Moderate Mental Health by 14.8% (18 WTE), Severe and Enduring Mental Health by 3.5% (1.2 WTE), and Eating Disorders by 49.1% (5.2 WTE). Conversely, the WTE of the Early Intervention subcategory decreased by -8.3% (-3.9 WTE)

Figure 8 shows the WTE of non-Mental Health areas of work. The largest of these is Physical Health, accounting for 10.5%, (161.1 WTE). The second largest is the Other category (9.8%, 150.8 WTE), which incorporates sub-categories such as Healthcare for the Elderly and Dementia, Academic, Teaching and Management, Trauma Services, Autistic Spectrum Disorders, Self-help Workers, Prison Services and Gender-based Violence. This is followed by Learning Disabilities (6.1%, 93.3 WTE), Forensic (4.7%, 72.4 WTE), Neuropsychology (3.4%, 52.6 WTE), and Alcohol and Substance Misuse (2.5%, 38.7 WTE).

Figure 8: WTE/Percentage of Staff in Post in the Non-Mental Health Areas of Work, as at 31 March 2023

Figure 8. A pie chart that shows the WTE and percentage of staff employed in non-mental health areas of work as at 31 March 2023: Other, Physical Health, Learning Disabilities, Forensic, Neuropsychology, and Alcohol and Substance Misuse.

4 Characteristics of the Workforce

4.1 Gender and Contracted Hours

Since March 2011, the majority of the increase seen in WTE can be accounted for by the rise in female staff working within Psychology Services, from a total of 809 headcount in March 2011 to 1573 headcount at the current census date (+764 headcount, a 94.4% increase). The number of male staff has remained relatively stable: 271 headcount as at the current census, increasing from 194 (+77 headcount, 39.7%).

Over the past 12 months, the headcount of female staff has increased by 107 (7.3%). Female staff currently contribute 1294.3 WTE (84.1%) of the total 1538.4 WTE within NHSScotland Psychology Services.

Overall, 50.7% of posts were part-time at the latest census compared to 37.3% at 31 March 2011. The majority of this increase can be attributed to the increase in part-time female staff, with 54% of contracts for female staff being part-time at the current census date compared to 40.2% in March 2011.

The trend for contract type and gender is illustrated in Figure 9. For more detailed information on contract type and gender by professional group, please refer to Table 6.1 within the background tables.

Figure 9: Trend of Contract Type and Gender for Psychology Staff within NHSScotland from 31 March 2011 to 31 March 2023

Figure 9. A line chart that illustrates the headcount of Male and Female staff working in Whole time and Part time posts since March 2011.

4.2 Contract Term

At 31 March 2023, 82.1% (1262.3 WTE) of staff in NHSScotland Psychology Services were employed on a permanent contract, 14.6% (225.2 WTE) were employed on a fixed term contract of less than two years’ duration and 3.3% (50.8 WTE) were employed on a fixed term contract of longer than two years’ duration.

Figure 10 shows the WTE of staff employed on a permanent contract as at 31 March 2023. While 90% (857.8 WTE) of All Applied Psychologists held a permanent contract, this number was lower for Other Clinical Staff (69.1%, 404.5 WTE). The percentage of Applied Psychologists on permanent contracts has declined from 92.7% (585 WTE) at March 2011, while the percentage of Other Clinical Staff holding permanent contracts has increased from 57.6% (132.5 WTE).

Figure 10: WTE of Applied Psychologists and Other Clinical Staff on Permanent and Fixed Term Contracts, as at 31 March 2023

Figure 10. A bar chart that shows the WTE of applied psychologists and other clinical staff holding permanent and fixed term contracts as at 31 March 2023.

4.3 Age Profile of Staff

Figure 11 shows the age distribution of male and female staff as at 31 March 2023, and Figure 12 shows the mean WTE of male and female staff by age category. These two charts show that, while the largest group of staff by age category is female staff aged 35-39 (320 headcount), the average wte of this group is 0.8, compared to 0.89 for male staff.

Figure 11: Age distribution of female and male staff as at 31 March 2023

Figure 11. A bar chart that shows the headcount of male and female staff by age category.

Figure 12: Mean WTE of female and male staff by age band, as at 31 March 2023