‘We’ve got vacancies, and we’re missing out on the right people’

The British Psychological Society has produced new guidance on Best Practice in Psychology Recruitment. The document – aimed at anyone involved in the recruitment of applied psychology posts primarily within health and social care – rests on the assumption that fair and sensible recruitment will only happen with access to the widest pool of the candidates.

In recent years there has been a welcome expansion of posts for psychologists, reflecting the wider range of areas where specialist psychological skills are valued and posts funded. These new roles may not fit the limited range of post titles used historically: a careful analysis of the necessary skills could increase the number of people who might best meet the requirements of the post.

This is particularly relevant given that one in seven posts in the NHS are not filled. Psychologists were recently added to the shortage occupation list by the Migration Advisory Committee, indicating that there is a national shortage of psychologists, despite being one of the most popular subjects at undergraduate level. As well as reducing the access for service users to qualified practitioners, unfilled vacancies can also lead to posts being de-established or downgraded and the money taken out of psychology and used elsewhere, such as psychology sessions for a diabetes service being used instead for a specialist nurse.

The problem

A 2018 audit of psychology job adverts conducted for the BPS showed that 66 per cent of jobs in the NHS were advertised for clinical psychologists. Only 13 per cent of jobs were advertised so that psychologists of any domain could apply. In almost a third of advertisements, the job title did not match the essential criteria on the person specification: for example, the title and job description indicated that an applied psychologist was needed, but only those with a DClinPsych qualification were eligible to apply, or the title was clinical psychologist but in the essential criteria the role was actually open to other HCPC-registered practitioner psychologists. In over 90 per cent of cases, job titles did not include contexts of practice or an indication of the role other than 'psychologist'.

In addition, the Society's 2019 member survey highlighted that 10.7 per cent of psychologists cite inappropriate recruitment practices as a barrier to entering the profession, and the Society has received numerous complaints regarding issues where psychologists are unable to apply for jobs due to the advertised title of the role.

Why is recruitment of psychologists complex?

Recruitment in any field should be based on a competency framework reflected in the person specification and job description, and this should be followed through in advertising, shortlisting, interviewing and selection. For psychologists there are a number of reasons why this is more complex.

Practitioner Psychology is a relatively new profession. Professionals working in health and social care were initially almost always clinical psychologists and the majority of registered psychologists are clinical. However, as the profession has evolved, its base has expanded leading to a broader range of professional training and areas of focus. The wider range of titles have been established for over 25 years and this was consolidated when the Health and Care Professions Council (HCPC) took over regulation in 2009.

The HCPC approves postgraduate training programmes, completion of which confers eligibility to register with the HCPC and use one of the protected titles. NHS England historically recorded all psychologists as clinical psychologists, but from 2020 all practitioner psychologists are recorded under the Occupational Code 'Applied Psychologist' and under Job Role as one of the particular types of practitioner psychologists (e.g. health, counselling, clinical etc.).

On their career pathways and in the years post qualification, many psychologists develop skills beyond their core training which fit them for a wider range of posts than may be assumed. This is recognised by HCPC in that registrants are not expected to maintain competence across all areas of initial training, but as required by their role – where they may have developed significant further competencies. Using one protected title in an advertisement may therefore directly limit the range of competent professionals able to apply for the post. Similarly, psychologists' career pathways prior to qualification can be varied and may include experience relevant to particular roles.

Another issue is diversity. Psychologists working in health and social care show limited diversity in areas that have been reliably measured – and specifically in ethnicity. Research is clear that a mis-match between staff and users of the service reduces the efficacy of the interventions. Those more recent areas of registered psychology do show a wider range of ethnic diversity and would be able to contribute to a more diverse workforce. This premise applies equally to other differences such as gender, sexuality or any other protected characteristic and beyond to any group who may be socially excluded.

Recommendations

The BPS and those in recruitment within its subsystems should work towards a long-term systemic solution to enable access to as wide a range of potential candidates as possible. This includes recommendations that:

• Advertisements for psychologists use the appropriate title(s), based on the competences required to deliver the duties of the post. This will normally be an inclusive title such as applied psychologist/practitioner psychologist/registered psychologist.

• The advertised job specifies the context of the role (e.g. Child Mental Health, Diabetes Service, etc.).

• The recruitment process includes a review of the essential and desirable criteria in Person Specifications to ensure they do not inadvertently exclude psychologists whose skills, knowledge and training would be appropriate.

The guidance goes on to specify three options for the wording of advertisements:

• an inclusive title as the default option, particularly where a service employs a range of psychologists and is able to accommodate a diversity of additional staff, where the post might be shaped around the skills and expertise of a range of psychologists, or where recruitment has been difficult and it is felt that training can support applicants from a range of backgrounds.

• using multiple titles may be considered where there are obvious registered professions likely to be appointable, for example in mental health where posts are normally advertised as for clinical/counselling Psychologists, or in specialist services such as Children and Young People's Development Disorders Assessment services where clinical or educational psychologists might be thought to be relevant professional groups. However, this may still exclude highly skilled candidates.

• single titles, in the very few cases where only one title would apply. Neuropsychology is (for now) perhaps a special case as only specific titles can gain a qualification in this area, though this is expanding. This could be managed in the advert by specifying a qualification and/or experience in neuropsychology.

Following the recommended advertising practices above will, in many cases, open applications to a wider pool of candidates. Including the context, appropriate knowledge, and experience, alongside the title will allow potential candidates to easily and rapidly select appropriate posts. This could match and complement the NHS England Coding structure – applied psychology posts would be advertised by the Occupational Code and/or Job Role followed by the area of work, for example 'Applied Psychologist – weight management (Child Diabetes Service) Band 7'.

People who recruit psychologists will demonstrate best practice by working to a competency framework and using inclusive job titles along with the context of the role within job advertisements. This will enable the most effective means of filling psychology posts with the best candidates.

- Read the Guidelines.  

'…the most efficient and effective way'

We heard more from Catherine and Hannah…

What do you think tends to happen when recruiters in health and social care settings advertise a job?
Most of the time you just get out a, standard person spec and you're only allowed to tweak certain things. Psychology Managers are overworked, busy, and don't have time to think it through. But what we're talking about in the guidance is the most efficient and effective way of recruiting. We've got vacancies, and we're missing out on the right people for them.

Are different areas of Psychology really equivalent when it comes to working in health and social care?
There's a lot of prejudice around this issue, but there's validity to some of it. Take clinical psychology: you know roughly what a clinical psychologist is. You know their training, placement, quality control, so they're generally a consistent and reliable product. In some of the newer areas, it can be more variable. Some candidates may not have had a clinical placement in an NHS core service, and so may they may not have been exposed to the full range of clinical applications. This can create assumptions about the competence of different domains and there may be some gaps in relation to the full set of skills. But we need honesty around that issue, which we can then work on. There are now many options for addressing this with the expansion of online training and CPD.

Aren't we swimming against the tide though – in terms of the whole structure of the BPS itself, the discipline, training, protected titles? Are we even going to be able to practice what we preach ourselves?
Having 'Divisions' and protected titles doesn't go against the guidance, because that's not what the guidance is. There's a difference between saying that all the protected titles, the 'domains', are the same, and saying that some of them have overlapping competencies and therefore, individual psychologists may be suitable for a particular job, which is what the guidance is. We're not trying to push people out… in fact, we're trying to be inclusive, to make sure that psychologists with unusual career paths and the like are not inadvertently excluded, and that posts are filled. The only way we can practice what we preach is by sending the guidance to the place(s) where we advertise for psychology roles. It's about long-term, systemic change. It's about good recruitment.

What are next steps?
We are not going to sort this out immediately, and the Workforce Planning Advisors Standing Committee under the Practice Board is being used to oversee implementation. Membership is from the main domains of psychology and the devolved nations. Once that group is moving, we can be realistic about what we're going to be doing – a dialogue to deal with the underlying issues. On a practical level, we'd look to write to recruiters, just to say 'have you thought that by doing it another way you might open the role up to a wider pool of decent candidates?' We could also develop a library of model job descriptions to assist recruiters. 

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