Changes to how we deliver health and care at a neighbourhood, organisation or system level requires input from all professions, service users and other stakeholders. Yet despite clear guidance in the Psychological Professions Vision for England, and the Health Education England Psychological Professions Workforce Plan, there remain significant gaps in psychological professional leadership in provider organisations and the Integrated Care Boards. Unless this is addressed, the aims of the Integrated Care Systems and provider organisations in improving outcomes, tackling inequalities, enhancing productivity, and supporting social and economic development will not be fully realised.
We are strongly recommending to every NHS organisation that they should have a senior lead psychological professional in a system-wide leadership role within their organisational structure. In most instances, this will be a senior consultant level psychological professional, able to act as a Chief Psychological Professions Officer (CPPO) for the organisation, with appropriate support, infrastructure and opportunity to deliver professional leadership for, and on behalf of the psychological professions.
Additionally, there should be a role in each Integrated Care System for a senior psychological professional (usually a CPPO), as noted in recent guidance (B0664-ics-clinical-and-care-professional-leadership.pdf (england.nhs.uk). This role should be included as core to strategic decision-making structures in order to maximise the contribution that psychological professions can make to population level health, innovations in workforce and delivery of high quality care, and to providing comprehensive services accessible and affective for all.
Why does this matter?
We recognise that with the development of place-based structures and Integrated Care Boards, there has been welcome acknowledgment of the value of multi-professional clinical leadership. The embedding of senior clinical roles in decision-making structures is taking place at variable rates across the country. However, multi-professional leadership remains a work in progress, with survey evidence indicating a continued reliance on mandated roles of medicine and nursing. While there is widespread recognition that the expertise of these professions is necessary in system leadership forums, it will not be sufficient for the provision of expanded and innovative health and care services in the future.
There is increasing demand by the public for psychological approaches and psychologically-informed services. The psychological impact of Covid on both the public and on NHS and care staff is now resulting in the anticipated increased rates of referral to services and indications of emotional fatigue and risk of burnout amongst staff. Consequently, it has never been more important that organisational and system level decision-making in response to these needs is as well informed and supported by the skill-set of psychological professionals as possible.
Collectively the Psychological Professions account for over 12% of the workforce in NHS mental Health Trusts and are employed in increasing numbers across physical health and social care sectors. In most mental health trusts, Psychological Professions are already the largest professional grouping other than Nurses.
The NHS Long Term Plan identifies the need for significant further expansion in the psychological professions to increase access to evidence-based services for people of all ages across a wide range of settings, from Improving Access to Psychological Therapies (IAPT services) to secondary and specialist mental health care for children, young people and adults of all ages. This expansion requires an increase of over 10,500 psychological professionals by 2024.
While progress is being made in many areas (for example, increases in training places and the introduction of new roles to support service delivery), these developments highlight the importance and the challenge of ensuring that the growing workforce is appropriately supported, and that the contribution of the psychological professions is understood and fully included in organisation and system level planning and delivery. With the contribution of the Psychological Professions alongside multi-professional colleagues and leaders, we can maximise the effectiveness of local systems in developing and delivering high quality health and social care to meet local population needs.