Now is the time to add Child and Adolescent Psychiatrists to the National Shortage Occupation List, says Royal College of Psychiatrists

Press release
08 March 2018
  • The number of NHS Child and Adolescent Psychiatrists has fallen 6.3% since November 2013
  • In Kent, Surrey and Sussex there are just 3.75 Child and Adolescent Psychiatrists per 100,000 children
  • The Government’s recent Children and Young People’s Mental Health Green Paper outlined plans for a four-week waiting time target – but this will not be possible without increasing the psychiatry workforce

8 March: The Royal College of Psychiatrists has urged the Government to add NHS Child and Adolescent Psychiatrists to the shortage occupation list, as new figures analysed by the RCPsych show numbers have fallen by 6.3% in the last four years.

The number of NHS child and adolescent psychiatrists at all grades declined by 6.3% between November 2013 and November 2017.

For consultants alone the decrease was 6.9% over the same period.[i]

Across England, the number of NHS Child and Adolescent Psychiatrists per 100,000 children is:[ii]

  1. Kent Surrey and Sussex – 3.75
  2. East of England – 4.87
  3. Yorkshire and Humber – 5.40
  4. South West[iii] – 5.74
  5. East Midlands – 5.76
  6. Wessex – 6.38
  7. West Midlands – 6.89
  8. North West – 7.92
  9. Thames Valley – 9.29
  10. North West London – 13.42
  11. North East – 14.29
  12. South London – 17.15
  13. North Central and East London – 17.32

Ongoing work with Health Education England has highlighted an urgent need to address the shortage – especially in light of the Government’s Children and Young People’s Mental Health Green Paper which predicted a short-term rise in referrals to NHS mental health services.

In its consultation response to the Green Paper, the RCPsych said recruiting from overseas was crucial to achieve the proposed four-week waiting time against rising demand.

Dr Bernadka Dubicka, Chair of the Royal College of Psychiatrists’ Child and Adolescent Faculty said: “Earlier this year an Indian child and adolescent psychiatrist had their visa application rejected because the quota for Tier 2 visas had been reached and they did not qualify as a priority on the shortage specialty list.

“Shortstaffing 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.”

The HEE mental health workforce plan committed to an extra 100 consultant CAMHS psychiatrists by 2021, but these new roles will not be in community CAMHS teams.

The Home Office shortage occupation list gives specific professions priority for Tier 2 visas to employ non EEA staff because they are struggling to recruit at home. Core psychiatry trainees and old age psychiatrists are on the shortage speciality list, but child and adolescent psychiatrists are not.

Applicants who do not qualify on the shortage specialty list may be rejected for a visa even if they are desperately needed by the service that is trying to employ them.


Notes to editors

  • NHS workforce data for each Health Education England (HEE) region is published on a quarterly basis by NHS Digital and draws upon the NHS Electronic Staff Record for each trust and clinical commissioning group (CCG). This analysis was based on the most recent data for September 2017, published on 21 December 2017.
  • NHS workforce data records how many psychiatrists are employed by a particular Trust based within each Health Education England region.
  • A Trust may have a contract to provide services, and therefore employees, in a different location outside its own Health Education England region. These contracts are subject to regular tendering.
  • Population data is primarily based on the mid-2016 population estimates for the CCGs in the corresponding HEE regions in the NHS Digital data, as published by the Office for National Statistics.
  • “Children” in this press release are defined as people aged 0-17 years.
  • NHS Child and Adolescent Mental Health Services are provided in Devon by Virgin Care and therefore for this analysis, the 0-17 year old population for the two CCGs in Devon (Northern, Eastern and Western Devon and South Devon and Torbay) was excluded from the standardised calculations. The 0-17 population for Torbay was then added into the total, to reflect that CAMHS services are provided by an NHS trust in that area (Torbay and South Devon NHS Foundation Trust). This figure was reported by the Office for National Statistics in its Middle Super Output Area Mid-Year Population Estimates.
  • The 0-17 year old population increased by 0.92% between mid-2015 and mid-2016, so this increase was applied uniformly to each region to take some account of population growth by the middle of 2017.
  • Read the RCPsych’s response to the Health and Education joint Select Committee inquiry into the Green Paper and watch the oral evidence.

About the Royal College of Psychiatrists

  1. We are the professional medical body responsible for supporting over 18,000 psychiatrists in the UK and internationally.
  2. We set standards and promote excellence in psychiatry and mental healthcare.
  3. We lead, represent and support psychiatrists nationally and internationally to governments and other agencies.
  4. We aim to improve the outcomes of people with mental illness, and the mental health of individuals, their families and communities. We do this by working with patients, carers and other organisations interested in delivering high quality mental health services.

For further information, please contact: