Retention Charter Domain 1, action 1.4

Action 1.4: Value the identity of Psychiatrists as clinical leaders and experts in the biopsychosocial model, including them in multi-professional structures, organisational decision-making, and the design of clinical services..

Action 1.4 is part of Domain 1 of the RCPsych's Retention Charter for employers - which relates to creating a culture of belonging.

What stage is your organisation at?

Use this maturity matrix to assess what stage your organisation is at, in terms of Action 1.4. 

  • A supportive organisational culture exists where psychiatrists are empowered to lead and make decisions, ensuring that services are clinically led.
  • Structures are in place to ensure that psychiatrists can voice their views and be heard by senior leadership and management.
  • The organisation works collaboratively with medical leaders, such as medical staff advisory committees to improve working conditions for psychiatrists.
  • Leadership functions, medical management, educational roles, mentoring, quality improvement, research activity, and other important work that is not directly patient facing is formally recognised in job plans with appropriate renumeration, support, and resources to do this

  • Psychiatrists are actively encouraged and supported, through job planning, to lead quality improvement initiatives, using their clinical experience to identify problems in healthcare services and design, test, and implement solutions.
  • Team building activities are in place to develop positive team identity and culture which values everybody's contributions and makes everybody feel part of the team.
  • Psychiatrists are invited to join multiprofessional groups and collaborate with colleagues from other professions to continually review and improve clinical services.
  • Psychiatrists are supported to see and help lead multiple aspects of clinical services beyond direct clinical care such as finance, workforce, and quality.

  • Psychiatrists are actively involved in all stages of service design, at departmental, organisational, and system level, using their unique expertise from the beginning to shape clinical services.
  • Psychiatrists are given the opportunity, at all levels, to be involved in research and innovation.
  • Feedback is regularly collated and acted upon to understand the views of psychiatrists on how both the staff and patient experience can be improved. The organisation achieves high survey response rates and creates a culture where staff feel able to raise concerns and ideas without fear of negative consequences.

Advice and recommendations

  • Review the membership of committees and decision-making forums within the organisation, ensuring that there is adequate representation of psychiatrists at all levels up to board level.

  • Promote collaboration between Psychiatrists, other health professionals, and nonclinical managers in day-to-day work and build positive relationships through organised team events and team-building activities.

  • Measure psychiatrists’ sense of belonging to the organisation and wider healthcare system by using formal tools/surveys.

  • Ensure that psychiatrists have sufficient ‘supporting professional activities’ (SPA) time to attend multiprofessional groups, undertake roles in leadership/education/research, and to contribute to the planning, design, evaluation, and improvement of clinical services.

  • Promote and actively support psychiatrists in undertaking duties external to the organisation that are beneficial to the wider healthcare system, ensuring sufficient flexibility within job plans.

  • Use multiple mechanisms to gather formal and informal feedback from psychiatrists such as surveys, meetings, consultation events, and engagement with elected representatives. Track engagement with feedback mechanisms and tailor approaches used, accordingly, to maximise involvement.

Links and resources