Terminology guide for the Four Nations

The Royal College of Psychiatrists is proud to be a UK-wide professional body representing psychiatrists and supporting mental health across the four UK nations, as well as internationally. While we are one College, unified by our purpose, values, and governance, we operate in the context of four distinct health, political and workforce needs in England, Northern Ireland, Scotland and Wales.

In 2017, the College established Devolved Councils in Northern Ireland, Scotland, and Wales (although there were dedicated teams and physical presence in the nations for decades before this) recognising the divergence in health systems, structures and funding models across the UK, and in response to the need to have a presence and distinct decision-making bodies in the nations, supporting nation-specific needs and feeding back into wider College structures.  Within the UK, the College represents members through the eight Divisions in England, and via Devolved Councils in Northern Ireland, Scotland and Wales.  

The Council of the College and the Committees of Council remain the main decision-making bodies for RCPsych as a whole, but Devolved Councils in Wales, Scotland and Northern Ireland are decision-making committees for devolved matters. The Devolved Councils are led by an elected Chair, Vice-Chair and Finance Officer and a Devolved Council of elected and appointed members that meet quarterly. The Chairs of the Devolved Council are also Vice Presidents of the College and sit on Council, recognising the seniority of these postholders. Each of the eight English Divisions are led by an elected Chair, who sits on Council, and an executive committee of elected and appointed members.  

• In the UK, the National Health Service (NHS) is the umbrella term for the four health systems of England, Scotland, Wales and Northern Ireland.

• Health is a devolved matter. Responsibilities of the devolved governments include organisational control and funding of the NHS systems, family planning, provision of health services and the prevention, treatment and alleviation of disease, illness, injury, disability and mental disorder. Westminster has responsibility for these in England.

• It is important to note that the NHS has different budgets across the four nations and that NHS spending per head of population varies between the four nations.
  

• Please make sure you use the correct terminology (see full guide below), for example when referencing:
  • Healthcare systems
  • Government
  • Legislature
  • Medical Licensing Bodies
  • Main Employers of Psychiatrists        
  • Education and Training Providers (responsible bodies for education and training for the health workforce)
  • Health and Social Care Regulators
  • Public Body for Criminal Prosecutions
  • Judicial Inquiries into Circumstances Around a Death
  • Mental Health Legislation
  • Equalities Legislation 
  • National Workforce Strategies
  • Compulsory Treatment (arrangements for authorising individual practitioners)
• Ensure that any references to government are clear in regard to which part of the UK you are referring to. See terminology table below for full breakdown. If you are speaking about more than one government remember to use the plural, ‘governments’ instead of ‘government’.
  • Reserved matters (not devolved) = UK Government (or Westminster)
  • England = UK Government (or Westminster)
  • Northern Ireland = Northern Ireland Executive
  • Scotland = Scottish Government
  • Wales = Welsh Government

• Ensure that any statistics you reference are clear in regard to which part of the UK you are referring to. Please use full UK statistics if possible or make it clear that you are referring to statistics for England, Northern Ireland, Scotland or Wales (as applicable).

• If you are speaking about something that is UK-wide, consider that the applicability might be different across the nations.

• Remember, language is important. We often use ‘Trusts’ as a shorthand for describing the employers of psychiatrists – but this is alienating for those in Wales and Scotland – and even when we are describing something that is UK-wide we are inadvertently saying this is something that doesn’t apply to the whole of the UK if the word ‘Trust’ is used. If speaking generally, it’s best to use the term ‘employer’ to avoid alienating any of your audience. See table below for full terminology breakdown. 

• The Welsh Language (Wales) Measure 2011 makes Welsh an official language in Wales. This means it must be treated no less favourably than English. Due consideration must be given when communicating directly with Welsh NHS bodies, as they have specific legal obligations and duties to the language. Please consult the RCPsych in Wales team if unsure.

The NHS

The National Health Service (NHS) comprises the publicly funded healthcare systems of the UK, these are:

• NHS England
• NHS Scotland
• NHS Wales
• Health and Social Care (HSC) Northern Ireland.

The NHS was established in 1948 with the founding principles that services should be comprehensive, universal and free at the point of delivery. The NHS is primarily funded through general taxation and national insurance contributions and employs around 1.6million people across the UK.

Each of the UK health service systems operates independently and is politically accountable to the relevant government: the Scottish Government, Welsh Government, Northern Ireland Executive, and the UK Government.

The GMC

The General Medical Council (GMC) is an independent regulator for doctors in the UK. They work to protect patient safety and support medical education and practice across the UK. They do this by working with doctors, employers, educators, patients and other key stakeholders in the UK's healthcare systems.

In the UK, the National Health Service (NHS) is the umbrella term for the four health systems of England, Scotland, Wales and Northern Ireland.

Health is a devolved matter. Responsibilities of the devolved governments include organisational control and funding of the NHS systems, family planning, provision of health services and the prevention, treatment and alleviation of disease, illness, injury, disability and mental disorder. Westminster has responsibility for these in England.

Within the Royal College of Psychiatrists, the house style is as follows:

Use a capital C when writing ‘the College’ as an abbreviation of the Royal College of Psychiatrists (or other medical colleges). Don’t use capitals if you are talking about colleges in general (e.g. sixth-form colleges).

England

• In England, the eight Divisions are often collectively called ‘the Divisions’. You may wish to refer to them as the ‘English Divisions’ for clarity, for example to distinguish them from the College’s International Divisions.
  
• The names of the Divisions are:

• Eastern Division
• London Division
• North West Division
• Northern and Yorkshire  Division
• South East Division
• South West Division
• Trent Division
• West Midlands Division

• N.B. Northern & Yorkshire' (with ampersand) is not acceptable as our style guide advocates against using ampersands as these are less common/understood in some other cultures.
• The Channel Islands fall under the South West Division.
• The Isle of Man falls under the North West Division.
  

Northern Ireland

• In Northern Ireland the College is known as the Royal College of Psychiatrists in Northern Ireland or RCPsych in Northern Ireland.
• These are the preferred names, but the name may be abbreviated to RCPsychiNI but only if the full name is first used on a page or document, e.g. 'RCPsych in Northern Ireland (RCPsychiNI)'. 
• Note that the short name is less accessible and will be less understandable to non-members.  
• 'RCPsych Northern Ireland’ should never be used.
  

Scotland

• In Scotland the College is known as the Royal College of Psychiatrists in Scotland or RCPsych in Scotland.
• These are the preferred names, but the name may be abbreviated to RCPsychiS but only if the full name is first used on a page or document, e.g. 'RCPsych in Scotland (RCPsychiS)'.
• Note that the short name is less accessible and will be less understandable to non-members. 
• 'RCPsych Scotland' should never be used.
  

Wales

• In Wales the College is known as the Royal College of Psychiatrists in Wales or RCPsych in Wales.
• These are the preferred names, but the name may be abbreviated to RCPsychiW but only if the full name is first used on a page or document, e.g. 'RCPsych in Wales (RCPsychiW)'. 
• Note that the short name is less accessible and will be less understandable to non-members.  
• 'RCPsych Wales’ should never be used.
• In Welsh, the College is known as Coleg Brenhinol y Seiciatryddion.

International

• Our International Divisions represent the College in six geographical regions outside the UK.
• The names of the International Divisions are:
  • African Division
  • European Division
  • Middle Eastern Division
  • Pan-American Division
  • South Asian Division
  • Western Pacific Division

This table refers to the main public employing body and does not include private employers. 

It is important to note that the NHS has different budgets across the four nations and that NHS spending per head of population varies between the four nations.

Devolved governments receive a block grant of funding from the UK government each year. However, the figure is calculated against all UK government spend, and is not ringfenced to any particular devolved policy area (such as health) so the devolved governments can choose how to spend it. This means that increases in spending on the NHS in England do not automatically lead to similar increases in health budgets in the other nations.