This eighth annual census undertaken by the Royal College of Psychiatrists relates to psychiatric staffing in England, Scotland, Wales and Northern Ireland as at 30 September 1999. For the first time the assumptions made in producing the census are clearly given.

The College has confidence that the census provides the most accurate picture we have of psychiatric staffing in the UK. This is vital information as we work towards producing an effective response to the National Service Framework for Mental Health and the NHS National Plan, and their respective workforce expansion requirements. The data collected in the census have a direct bearing on the College negotiations with the NHS Executive with respect to the number of national training numbers that remain within the speciality, or are added or withdrawn from its pool.

Comment

There has been an overall increase in consultant posts with growth rates varying from 4.6%, England, 7.4%, Scotland, under 1% in Wales and a slight reduction in Northern Ireland by 5%. There is considerable regional variation. The North West and Mersey have over 20% vacant posts, compared with 17% in Yorkshire, but under 8% in East Anglia, Oxford, Wessex and all of Scotland except the West. Compared with last year, the vacancy rate generally is coming down despite the creation of new posts. There is also variation between specialities. In child and adolescent psychiatry recruitment is improving in most areas except Scotland. The same is true of forensic psychiatry where 16% of posts in Scotland are vacant, but empty posts are reducing everywhere else. Learning disability posts are fully recruited to in Wales, but vacancy rates are running at 15% elsewhere.

Recruiting into old age psychiatry is getting better in England and Scotland. In psychotherapy the very low vacancy rate is likely to be a reflection of the lack of growth of new posts. General adult psychiatry remains problematic. Vacancy figures overall are down, for example, to 12% in England. However, sub-specialities of liaison, rehabilitation and substance misuse, which for the purposes of the NHS Executive's Specialist Workforce Advisory Group negotiations are considered part of general adult, all have higher vacancy rates. As numerically this is the largest group of consultants, recruiting to these empty posts without a substantial increase in senior house officer and specialist registrar posts is going to be very difficult and a challenge for the next few years. The continuing increase in staff grade numbers this year may be one way trusts are seeking to make up the shortfall, as the supply of appropriately qualified locums is insufficient to meet service needs.