• Child and adolescent psychiatrists down 6.3 per cent over four years
  • Royal college calls for role to be added to shortage occupation list
  • Stark variation in the number of child and adolescent psychiatrists across England

Mental health leaders have urged the government to add child and adolescent psychiatrists to its shortage occupation list to make it easier to hire them from overseas, HSJ can reveal.

The call from the Royal College of Psychiatrists follows a significant drop in the number of specialist psychiatrists in the last four years.

Psychologist / psychiatrist / mental health

Source: Alamy

The number of NHS child and adolescent psychiatrists fell below 1,000 last year

The number of NHS child and adolescent psychiatrists fell faster than other types of medic.

Analysis by the college, shared with HSJ, said the number of NHS child and adolescent psychiatrists fell from 1,027 to 962 between November 2013 and November 2017 – a 6.3 per cent drop.

It also found the number of NHS child and adolescent consultants fell by 6.9 per cent, from 667 to 621.

This compares to a 4 per cent fall in the number of psychiatrists between 2014 and 2017.

As a result, the college wants child and adolescent psychiatrists to be added to the Home Office’s shortage occupation list so trusts can hire staff from abroad more easily.

This change would give the sector priority for tier two visas, which are given to workers who have a skilled job offer and are not from the European Economic Area.

Child and adolescent faculty chair Bernadka Dubicka said a child and adolescent psychiatrist from India had their visa application rejected because the quota for tier two visas had been reached.

She added: “Short staffing in child and adolescent mental health services is no secret. We are already struggling, and the government’s own green paper impact assessment predicts a rise in referrals.

“We are now calling for the child and adolescent psychiatrists to be added to the shortage occupation list.

“Recruiting from overseas is key to quickly employing more qualified doctors specialising in children’s mental health and will ensure the profession is seen as a priority by the Home Office.”

Core psychiatry trainees and old age psychiatrists are already on the list but child and adolescent psychiatrists are not.

Health and social care secretary Jeremy Hunt said in 2016 that CAMHS were the “biggest single area of weakness in NHS provision” and pledged to make it a top priority.

The college’s analysis also found a stark variation in the number of child and adolescent psychiatrists across the country (see table).

North central and east London had the most psychiatrists per 100,000 children at 17.32, while the fewest were in Kent, Surrey and Sussex at 3.75 per 100,000.

The analysis was drawn from NHS Digital workforce data with population figures based on mid-2016 estimates for clinical commissioning groups published by the Office for National Statistics. NHS Digital data is recorded by location of the employer trust not the location worked, so a psychiatrist employed by a trust in London could actually be providing a service in Kent, for example.

NHS child and adolescent psychiatrists per 100,000 children in each region

RegionNumber of psychiatrists per 100,000 children
Kent, Surrey and Sussex 3.75
East of England 4.97
Yorkshire and the Humber 5.40
South West 5.74
East Midlands 5.76
Wessex 6.38
West Midlands 6.89
North West 7.92
Thames Valley 9.29
North west London 13.42
North East 14.29
South London 17.15
North central and east London 17.32

The royal college said it fears there will not be enough CAMHS psychiatrists to meet the predicted rise in referrals outlined in the green paper.

In its response to the green paper, the college said recruiting from overseas was “crucial” to achieve the proposed four week waiting time target for children and young people.

Health Education England’s mental health workforce plan, published last year, promised 2,000 additional nurse, consultant and therapist posts in CAMHS.

However, none of the 100 new consultant roles promised by 2020-21 will be in community teams with half assigned to children and young people’s crisis care.