Raising standards through sharing excellence
HEE – CYP MH Workforce collection
NHS Providers
July 2019
Report for: West Yorkshire and Harrogate (Health & Care Partnership) STP
Contents
Executive summary 3
Introduction and background 4
Timescales 5
Engagement 6
Workforce overview 9
Demographic profiling 11
Service provision 24
Community 28
• General community team 28
• Eating disorder community team 40
• Forensic community team 52
Inpatient 61
• General adolescent beds 73
• Eating disorder beds 78
• Forensic beds 81
Conclusion 86
Appendix: Skills and training 87
Executive Summary
This bespoke report outlines the findings from a national stocktake of NHS providers of Children and Young
People’s Mental Health (CYP MH) workforce across England. The project was commissioned by Health
Education England (HEE) and undertaken by the NHS Benchmarking Network (NHSBN). This project
builds on the previous iteration undertaken by NHSBN in 2016.
CYP MH is a multi-agency service that involves many organisations in providing services across England.
The project recognised the multi-agency nature of CYP MH delivery and therefore aimed to collect data
across a wide range of organisations that included;
• NHS providers
• Local Authorities
• Independent sector providers
• Voluntary sector providers
• Youth Justice services
NHSBN conducted a data collection exercise inviting all NHS providers to quantify and describe the shape
and nature of their CYP MH workforce. The data collection took place between February and April 2019
and used data relating to 2018 calendar year.
The headline figures for NHS providers are as follows;
• A total of 13,431 staff are employed in CYP MH services, delivering a total of 11,036 WTE.
• The CYP MH workforce has shown growth in recent years with the workforce increasing by 23% in WTE
since 2016.
• Workforce demographics suggest a largely female (84%) workforce.
• Majority of staff members (77%) in CYP MH have worked in their current post for 5 years or less.
• 1110 WTE of vacancies were reported, of which 41% were designated as nursing vacancies.
Introduction and Background
This report outlines details of the second comprehensive national stocktake of NHS Trust providers of CYP MH
services, which builds on a previous data collection performed by NHS Benchmarking Network in 2016. Children
and Young People’s Mental Health services are a high profile service area that has been identified for investment
and development in a number of recent national strategies including the NHS Five Year Forward View (2014) and
The NHS London Term Plan (2019).
The previous national data collection was completed in 2016 and used 2015 as the baseline year for profiling the
workforce. This project used the same CYP MH sectors analysed in the 2016 data collection. The 2019 project
analyses data from the calendar year 2018 for the following sectors;
• NHS providers
• Local Authorities
• Independent sector providers
• Voluntary sector
• Youth Justice (Youth Offending Teams)
The project aimed to provide a comprehensive profile of the CYP MH workforce across the NHS including:
• Size of workforce (headcount and WTE)
• Demographic profiling
• Discipline mix and skill mix
• Training / competencies
• Service models
• Activity and productivity metrics
Timescales
The project’s data collection period began on 8th February 2019, with an initial submission date of 1st April
2019. This was slightly extended to allow some providers to maximise data collection completeness.
Data supplied by providers was subject to a validation process in April and May to ensure the accuracy of
the project’s findings.
EngagementAn active process of engagement was undertaken to ensure that the project’s content was appropriate to
provide a robust commentary on the CYP MH workforce. The following groups supported the scoping and
design of this report.
• National Policy
• Discussions were held with national policy teams in both Health Education England and
NHS England.
• NHS
• The NHSBN Mental Health Benchmarking reference group provided advice and
commentary on data definitions and project scope.
• Independent Sector
• NHS England Specialised Commissioning provided input to help promote the project
across all independent sector providers commissioned by NHS England.
• Local Authorities
• The Association of Directors of Children’s Services helped promote the project across
the Local Authority sector.
• Voluntary Sector
• The Association of Mental Health Providers helped share the project’s goals and
encourage involvement by the voluntary sector.
• Youth Justice
• The Youth Justice Board promoted the project across Youth Offending Teams in
England.
Data completeness • The chart below illustrates the degree of completeness
achieved in data submissions across the various CYP MH
sectors. Completeness has been assessed using a definition of
known numbers of providers which are drawn from recognised
national positions for providers in the NHS, Local Authorities,
Independent sector and Youth Offending Services.
• NHS – All NHS Trust providers of CYP MH services
responded to the project’s request for data
• Independent sector – 70% of the independent sector
providers commissioned by NHS England Specialised
Commissioning contributed to the data collection
• A total of 83% of Local Authorities responded to the
survey with CYP MH data or statements that CYP MH
services are not provided
• YOTs – 52% of YOTs responded with details of their
involvement in wider CYP MH activities. It should be
noted that Youth Offending Services do not generally
employ dedicated CYP MH workers but include CYP MH
activities as part of wider youth justice activities.
• The Voluntary sector is perhaps the most difficult to scope due
to the complex commissioning arrangements via a range of
agencies and subsequent complexity of provider models. A
total of 35 data submissions were received although it is not
possible to estimate a degree of completeness based on this
position.
• It should though be noted that more data was received from all
sectors than was achieved in the 2016 project.
▪ Across the four core workstreams with
dedicated CYP MH posts, 14,065 WTE
staff were reported as working within CYP
MH services. Of these, 80% (11,036 WTE)
were employed by NHS Trusts.
▪ Comparisons with the 2016 project (which
used 2015 calendar year data) are shown
in the table opposite, which also
summarises changes that have taken place
over the last 3 years.
▪ Please note that YOT staff are not
dedicated CYP MH workers but staff
members who have CYP MH
responsibilities as part of wider roles.
Headline workforce summary
0
2000
4000
6000
8000
10000
12000
NHS IndependentSector
LocalAuthorities
VoluntarySector
Total WTE working in CYP MH
Sector 2015
WTE
2018
WTE
Change
%
Number of
providers
(2015)
Number of
providers
(2018)
NHS 8,976 11,036 23% 65 63*
Local
Authority
865 1,065 23% 37 57**
Independent 1,688 1,643 -3% 2 7***
Voluntary 158 321 103% 13 35**
Core CYP MH 11,687 14,065 20%
YOT 996 792 -20% 84 72****
Total 12,683 14,857 17%
*The position of 63 NHS providers in 2018 has reduced from the 65 NHS providers reported in
2015 due to Trust mergers, a 100% provider participation rate is evident for both years.
** The position of Local Authorities and Voluntary sector is influenced by an enhanced sample
size in 2018
*** The position of Independent sector providers represents a different sample mix in 2018.
**** The position of YOTs is influenced by a reduced number of contributors in 2018, although it
should be noted that staff reported by YOTs do not exclusively work on CYP MH
NHS workforce overview
Workforce
11,036 WTE working
in CYP MH
Disability
7% of staff have a
disability
Ethnicity
82% of staff are White
British
Time in post
77% of staff have
been in post 5 years
or less
Contract type
89% of staff are on
permanent contracts
Age
32% of staff are aged
over 50
Full/part time
60% of staff work 0.8
– 1 WTE
Gender
84% of WTE are female
Vacancies
1110 WTE posts are
vacant
Workforce size by Trust
On average, each Trust has 150
staff members for Children and
Young People’s Mental Health.
The NHS has a wide range in
staffing numbers from 851 to 3
per team.
Some Trusts provided multiple
submissions for each site, which
accounts for the lower number
of staffing for some
submissions.
100
200
300
400
500
600
700
800
900
HE
E_0
67
HE
E_0
17
HE
E_0
15
HE
E_0
82
HE
E_0
77
HE
E_0
46
HE
E_0
65
HE
E_0
05
HE
E_0
28
HE
E_0
36
HE
E_0
52
HE
E_0
24
HE
E_0
11
HE
E_0
12
HE
E_0
06
HE
E_0
80
HE
E_0
16
HE
E_0
33
HE
E_0
21
HE
E_0
27
HE
E_0
25
HE
E_0
79
HE
E_0
78
HE
E_0
13
HE
E_0
18
HE
E_0
19
HE
E_0
34
HE
E_0
83
HE
E_0
47
HE
E_0
68
HE
E_0
51
HE
E_0
01
HE
E_0
20
HE
E_0
10
HE
E_0
14
HE
E_0
76
HE
E_0
55
HE
E_0
81
HE
E_0
74
HE
E_0
66
HE
E_0
02
HE
E_0
32
HE
E_0
64
HE
E_0
04
HE
E_0
29
HE
E_0
30
HE
E_0
07
HE
E_0
53
HE
E_0
70
HE
E_0
03
HE
E_0
75
HE
E_0
41
HE
E_0
40
HE
E_0
42
HE
E_0
71
HE
E_0
73
HE
E_0
26
HE
E_0
72
HE
E_0
08
HE
E_0
35
HE
E_0
54
HE
E_0
50
HE
E_0
23
HE
E_0
45
HE
E_0
44
HE
E_0
43
HE
E_0
22
HE
E_0
31
HE
E_0
59
HE
E_0
62
HE
E_0
37
HE
E_0
60
HE
E_0
58
HE
E_0
56
HE
E_0
39
HE
E_0
57
HE
E_0
61
HE
E_0
09
HE
E_0
49
HE
E_0
48
HE
E_0
38
HE
E_0
69
HE
E_0
63
Total CYP MH staffing - headcount
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 150 Median = 112
Raising standards through sharing excellence
Demographic Profiling
Demographic - Age
The NHS CYP MH workforce is reasonably well distributed across different age bands.
Almost a third of staff (32%) are aged 50 or older. This is slightly below the figure reported in the 2016
stocktake (36%) and may reflect a range of new roles which have developed and been filled by more junior
staff.
0%
3%10%
14%
14%
13%
14%
13%
11%
6%
2%
Age of staff in postUnder 20
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 +
Age of staff in postNational average STP
Under 20 0.0% 0.0%
20 - 24 3.1% 2.8%
25 - 29 10.5% 9.7%
30 - 34 14.3% 15.6%
35 - 39 14.0% 14.4%
40 - 44 12.9% 13.0%
45 - 49 13.6% 13.4%
50 - 54 13.0% 13.8%
55 - 59 11.0% 10.3%
60 - 64 5.6% 4.7%
65 + 2.0% 2.3%
Demographic - Ethnicity
Trusts reported that 82% of staff in CYP mental health services were White and 5% of the workforce was
reported as Asian British. When compared to the general population of England, this represents an under-
representation in Asian/Asian British people who account for 7.5% of the resident population.
Ethnicity
National
averageSTP
White / White British /
White Other82.1% 94.0%
Asian / Asian British 5.6% 3.2%
Black / Black British 5.2% 1.3%
Mixed race 2.3% 1.0%
Other ethnicity 1.4% 0.3%
Unknown / not stated 3.4% 0.2%
Demographic - Gender
The workforce data continues to show a largely female workforce, at 84% nationally in the NHS. The
proportion of female to male has increased even further from the 2016 collection, where 82% of the workforce
were female.
16%
84%
Gender of staff in post
Male Female Gender of staff
in post
National
averageSTP
Male 16% 15%
Female 84% 85%
There are differences in the
hours worked by male and
female staff, with female staff
more likely to work part time
hours.
57% of female staff work full
time (0.8 WTE or more)
compared to 71% of male
staff.
Additional Gender Profiling
Contracted hours per week
Analysis of staffing by WTE shows that just under two thirds (60%) of staff work full time or nearly full
time hours (0.8 – 1 WTE).
4%
7%
15%
14%60%
Contracted hours per week
0 - 0.2 WTE
0.2 - 0.4 WTE
0.4 - 0.6 WTE
0.6 - 0.8 WTE
0.8 - 1 WTE
Contracted hours per
week
National
averageSTP
0 - 0.2 WTE 4.3% 2.5%
0.2 - 0.4 WTE 7.4% 6.2%
0.4 - 0.6 WTE 15.3% 10.9%
0.6 - 0.8 WTE 13.5% 13.5%
0.8 - 1 WTE 59.5% 66.9%
Contract type
The majority of the workforce are on permanent contracts (89%), with a tenth (10%) on fixed term/
temporary contracts. This is very similar to 2016 where 87% of staff were on permanent contracts, and is a
reassuring finding, indicating stability of employment for the majority of the workforce.
89%
10%
1%
0%
Type of contractPermanent
Fixed Term /
Temporary
(including
training posts)
Agency
Honorary
Type of Contract
National
averageSTP
Permanent 89.0% 92.5%
Fixed Term / Temporary
(including training
posts)
9.8% 7.4%
Agency 0.7% 0.0%
Honorary 0.5% 0.1%
Job roles
The most common job role reported in CYP MH services is registered nursing (29% of the workforce). 26% of
these registered nurses work in the inpatient setting and 74% in community. There is also a strong psychology
offer, at 15% of the workforce.
The newer role of CYP Psychological Wellbeing Practitioner was not widely reported, with just 1.1% of the
workforce (118 WTE) categorised in this way. This is expected to rise in coming years.
Job Roles
National
averageSTP
Admin/ Management 15.4% 19.4%
CYP Education MH practitioner 0.1% 0.0%
CYP Psychological wellbeing practitioner 1.1% 2.1%
Nursing 28.9% 15.8%
Support worker 10.4% 13.0%
Medical 2.8% 1.5%
OT 2.2% 1.8%
Psychology 14.5% 12.3%
Psychotherapy 4.8% 1.0%
Family Therapist 0.4% 0.0%
Therapist/AHP 6.6% 4.2%
Counsellor 0.5% 0.0%
Social worker 3.3% 3.2%
Student 0.3% 0.0%
Other 8.6% 25.7%
Time in post
The time in post data shows that over three quarters of staff members (77%) have been in their current
post for 5 years or less. This may be due to staff being promoted to new roles, turnover of staff or
expansion of the workforce.
31%
46%
13%
10%
Time in post (years)
Under 1
1 -5
6- 10
Over 11
Time in post
(years)
National
averageSTP
Under 1 year 30.9% 30.9%
1 -5 years 46.4% 56.0%
6- 10 years 12.5% 9.8%
Over 11 years 10.1% 3.4%
Staff retention
Staff retention measures the
number of staff members still
in post on 31st December
2018 that were working in the
same post on 1st January
2018.
The data shows that 82% of
staff members were still in
post at the end of the
calendar year.
The range varies across the
NHS with some Trusts
retaining all 100% of staff
members, to other Trusts
which retained less than 30%.%
20%
40%
60%
80%
100%
120%
HE
E_0
03
HE
E_0
63
HE
E_0
14
HE
E_0
29
HE
E_0
35
HE
E_0
08
HE
E_0
76
HE
E_0
30
HE
E_0
15
HE
E_0
68
HE
E_0
72
HE
E_0
05
HE
E_0
33
HE
E_0
34
HE
E_0
48
HE
E_0
10
HE
E_0
06
HE
E_0
07
HE
E_0
60
HE
E_0
32
HE
E_0
01
HE
E_0
71
HE
E_0
67
HE
E_0
50
HE
E_0
16
HE
E_0
23
HE
E_0
19
HE
E_0
24
HE
E_0
74
HE
E_0
04
HE
E_0
55
HE
E_0
80
HE
E_0
75
HE
E_0
49
HE
E_0
69
HE
E_0
82
HE
E_0
73
HE
E_0
81
HE
E_0
26
HE
E_0
37
HE
E_0
38
HE
E_0
39
HE
E_0
40
HE
E_0
41
HE
E_0
42
HE
E_0
43
HE
E_0
44
HE
E_0
45
HE
E_0
17
HE
E_0
65
HE
E_0
11
HE
E_0
57
HE
E_0
13
HE
E_0
53
HE
E_0
52
HE
E_0
02
HE
E_0
58
HE
E_0
62
HE
E_0
54
HE
E_0
66
HE
E_0
51
HE
E_0
25
HE
E_0
70
HE
E_0
36
HE
E_0
18
HE
E_0
64
HE
E_0
27
HE
E_0
79
HE
E_0
12
HE
E_0
31
HE
E_0
20
HE
E_0
21
HE
E_0
46
HE
E_0
09
HE
E_0
77
HE
E_0
59
HE
E_0
28
HE
E_0
56
HE
E_0
61
HE
E_0
83
Proportion of staff in post at 1st January still in post at 31st December
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 82% Median = 83%
Time allocation
Where available, organisations reported
the time allocation of their staff into the
following categories:
• Patient facing time
• Patient non-face to face time
• Indirect patient specific activity
• Non-patient specific activity
• Travel
The time allocation data shows that on
average 43% of available staff time is
allocated to patient facing time.
A further 18% of time is spent on non-
face to face patient time.
Disability
Where disability status was recorded by participants, the average rate of staff reporting a disability was 7%, with
93% reporting no disability.
This figure is similar to the 2016 figure of 5% of staff reporting a disability and 95% reporting no disability.
Vacancies
• 1110 WTE of
vacancies were
reported. These
included:
• Nursing = 450 WTE
• Psychologists = 116
WTE
• Administration and
management = 97
WTE
• Support workers = 111
WTE
Raising standards through sharing excellence
Service Provision
NHS Service Summary
NHS providers reported the types
of services they provided from
the broad categories of
community teams, inpatient beds
and day units, which were then
subcategorised by general,
eating disorder specific, and
forensic specific.
The most commonly provided
service was a general community
team for CYP MH, followed by an
eating disorder specific
community team.
The following page shows how
the workforce is distributed
between these service types.
NHS Workforce Distribution
Just over three quarters (79%) of the NHS workforce in CYP MH is employed in community teams, with general
community teams employing most of these staff (74%).
Although inpatient unit numbers are relatively small, the 24/7 nature of these services means higher staffing levels
are required. 21% of NHS staff in CYP MH work in an inpatient setting.
74%
4%
1%
18%
3%
Workforce distribution by WTE
General community
CYP mental health
team
Eating disorder
community CYP
mental health team
Forensic CYP mental
health community
team
Inpatient unit without
day service attached
Inpatient unit with
attached day service
Workforce distribution by WTE
National
averageSTP
General community CYP mental health team 73.7% 72.7%Eating disorder community CYP mental
health team 4.2% 5.0%
Forensic CYP mental health community team 1.0% 3.1%
Inpatient unit without day service attached 17.7% 19.2%
Inpatient unit with attached day service 3.4% 0.0%
Age range of community CYP MH
servicesIn all three services, General, Eating disorder and Forensics, the most frequently used age range is 0-17, with 45%, 45%
and 85% of organisations using this age range respectively.
In General and Eating disorder services, there are a wide variety of different age ranges across the NHS including services
which stop at age 16, 17, 18, 19, 24 or 25, and which are from birth from age 5 or from age 8. However, for Forensic
services, the age range for services is either 0-17 or 0-18 year olds.
The percentage of services that offer the age range of 0-25 is expected to rise with the implementation of the Long Term
Plan which aims to support the transition of patients into adult mental health services.
Raising standards through sharing excellence
Community
1. General community teams
Service Model (1)General community team
Organisations were asked to identify the type of functions provided by their general CYP MH community teams.
74 organisations provided answers for this question, with the following two tables showing the percentage of
organisations that answered yes for each element.
Service model Percentage responding YesNational
averageMental Health Promotion in the community, schools, within primary
care 89%
Evidence based parenting programmes 67%
Early Intervention Psychosis Teams 44%
CYP MH Primary Care Mental Health Team (Dedicated CYP MH
delivery) 64%
Ante- & post-natal specific support 29%
Early years support for infants / toddlers 39%
Training & Education to staff working in primary care/universal
services (schools, GPs) 90%
Paediatric Liaison Service 56%
100%0%
Service Model (2)General community team
Service model Percentage responding YesNational
average
Outreach work 68%
Specific support to BME groups within the community 15%
Joint working/family therapy/group work 97%
24/7 crisis response 47%
Provision of services to Schools or Colleges 79%
Assertive Outreach Teams 32%
Support to Youth Offending Teams 86%
Liaison and diversion for Police custody 31%
Support to Drug & Alcohol Services 35%Specific services for children in and leaving care, adopted children
and foster carers 78%
Support to LA behaviour support & inclusion services 40%Treatment and support for CYP with a Learning Disability and a mental
health need 93%
Treatment and support for CYP with ASD 68%
Treatment and support for CYP with ADHD 92%
Sensory Impairment Services 14%
100%0%
100%0%
Job rolesGeneral community team
The largest single staff category in general
community teams for CYP MH is registered
nursing (23% of the workforce).
3% of the workforce is comprised of support
workers, giving a ratio of 8:1 qualified to
unqualified nurses.
There is typically a strong specialist therapy
presence in these teams, with psychologists
representing 18% of the workforce.
0%
5%
10%
15%
20%
25%
30%
Admin/ Management
CYP Education MH practitioner
CYP Psychological wellbeingpractitioner
Nursing
Support worker
Medical
OT
PsychologyPsychotherapy
Family Therapist
Therapist/AHP
Counsellor
Social worker
Student
Other
General Community Job roles
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Job Roles
National
averageSTP
Admin/ Management 16.7% 19.1%
CYP Education MH practitioner 0.1% 0.0%
CYP Psychological wellbeing practitioner 1.4% 2.4%
Nursing 23.3% 12.9%
Support worker 3.2% 7.2%
Medical 5.1% 4.9%
OT 2.2% 1.7%
Psychology 18.2% 14.5%
Psychotherapy 6.5% 1.5%
Family Therapist 0.4% 0.0%
Therapist/AHP 7.6% 4.0%
Counsellor 0.7% 0.1%
Social worker 3.8% 4.0%
Student 0.4% 0.0%
Other 10.1% 27.6%
Registered nurses
Newly qualified band 5 nurses are rarely
seen in general community teams. Half of
the nurses employed are band 6, with a
further 34% at band 7.
General community team
0%
10%
20%
30%
40%
50%
60%
70%
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Band 8d
Band 9
General Community Registered nurses (Band 5-9)
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Nursing bands
National
averageSTP
Band 5 8.8% 24.7%
Band 6 50.7% 61.7%
Band 7 33.5% 13.6%
Band 8a 6.4% 0.0%
Band 8b 0.5% 0.0%
Band 8c 0.2% 0.0%
Band 8d 0.1% 0.0%
Band 9 0.0% 0.0%
Skills and trainingGeneral community team
Organisations were asked what interventions and competencies they had staff members trained to deliver in the
general community team. Organisations could choose from a prepopulated list of 37 different interventions and had
the option to submit other interventions not listed, which have been collated in the Skills and Training Appendix.
Overall, 53 organisations answered this question and the following two pages show the percentage of those
organisations that provided the interventions and competency training to their staff.
Skills and trainingGeneral community team
Skills and training Percentage responding YesNational
averageAttachment informed interventions e.g. Dyadic Developmental
Psychotherapy or Video Feedback to Promote Positive Parenting 85%
ASD assessment approaches (e.g. ADOS/ADI or DISCO) 92%
Cognitive Behavioural Therapy (CBT) for young people with
depression and anxiety 96%
CBT for Eating Disorders 40%
CBT for Psychosis 47%
Cognitive Analytic Therapy (CAT) 43%
Counselling children and young people with mild anxiety and
depression 75%
Combination - prescribing and psychological therapy 70%
Dialectical Behaviour Therapy (DBT) 91%
Dietary counselling for eating disorders 25%
Enhanced Evidence Based Practitioners (EEBP) 32%
Eye Movement Desensitisation Reprogramming (EMDR) 87%
Family Therapy (FT) 91%
Family Focused Therapy 57%
Anorexia-nervosa-focused family therapy for children and young
people (FT-AN) (single or multiple-family) 40%
Bulimia-nervosa-focused family therapy (FT-BN) 23%
Systemic Family Practice (SFP) for eating disorders 40%
SFP for over 10s with conduct problems, or depression and self-
harm 51%
100%0%
Skills and trainingGeneral community team
Skills and training Percentage responding YesNational
averageFormal instruction in bio-psycho-social mental health
assessment including risk assessment 74%
Formal instruction (including CYP-IAPT) in ‘developing a
formulation 72%
Inpatient CAMHS whole team training 21%
Mentalisation Approaches (e.g. AMBIT) 42%
Interpersonal Psychotherapy for adolescents (IPT-A) with
moderate to severe depression 70%
Adolescent-focused psychotherapy for anorexia nervosa (AFP-
AN). 11%
Focal psychodynamic therapy (FPT) 8%
Psychodynamic psychotherapy 72%
Psycho-education / guided self-help 74%
Parenting for children (under 10 years) with conduct and
behavioural problems (e.g. The Incredible Years, Positive 77%
Children and young people with learning disabilities or autistic
spectrum disorder training (via CYP IAPT) 45%
Supervision (diploma level) 72%
Outreach enhanced supervision (for supervisors not attending
full diploma course) 40%
Service Transformational Leadership 49%
Non-medical prescribing 62%
Approved clinician (non-medical) 19%
Social prescribing 26%
Systems training for emotional predictability and problem
solving (STEPPS) 11%
Working with 0-5s training via CYP IAPT 23%
100%0%
Contacts per clinical WTE
On average, 404 contacts are
delivered per clinical WTE per
year.
This equates to approximately
1.8 contacts per WTE per day,
assuming a 44 week year
(allowing for annual leave,
training days and sickness
absence).
There is quite a noticeable
range which spans from over
900 to fewer than 150.
This figure does not reflect the
content and duration of
contacts which may differ
between organisations.
General community team
100
200
300
400
500
600
700
800
900
1000
HE
E_
03
4
HE
E_
06
1
HE
E_
07
8
HE
E_
05
6
HE
E_
06
5
HE
E_
04
0
HE
E_
02
3
HE
E_
07
6
HE
E_
06
7
HE
E_
04
4
HE
E_
00
1
HE
E_
03
5
HE
E_
01
3
HE
E_
07
1
HE
E_
01
2
HE
E_
01
8
HE
E_
07
0
HE
E_
03
7
HE
E_
01
0
HE
E_
05
8
HE
E_
08
1
HE
E_
03
6
HE
E_
03
1
HE
E_
05
7
HE
E_
01
7
HE
E_
01
1
HE
E_
04
5
HE
E_
03
3
HE
E_
04
3
HE
E_
04
2
HE
E_
07
9
HE
E_
02
6
HE
E_
01
9
HE
E_
07
2
HE
E_
03
2
HE
E_
00
7
HE
E_
05
9
HE
E_
07
5
HE
E_
06
6
HE
E_
00
2
HE
E_
04
7
HE
E_
06
2
HE
E_
04
6
HE
E_
02
8
HE
E_
02
9
HE
E_
05
2
HE
E_
01
5
HE
E_
02
0
HE
E_
05
3
HE
E_
06
8
HE
E_
02
1
HE
E_
07
7
HE
E_
05
5
HE
E_
00
8
HE
E_
02
5
HE
E_
02
7
HE
E_
02
4
HE
E_
00
3
HE
E_
00
5
HE
E_
00
4
HE
E_
01
6
HE
E_
06
3
HE
E_
00
6
HE
E_
08
3
HE
E_
08
2
HE
E_
06
0
Total contacts per clinical WTE (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 426 Median = 404
Patients on caseload per clinical WTE
Caseloads are a snapshot of
open cases i.e. CYP receiving
treatment at a point in time.
On 31st December 2018, there
was on average 39 patients on
a caseload per clinical WTE.
The data shows notable
variation on this metric, with the
top two providers supporting
over 100 patients and the
bottom two providers supporting
fewer than 10 patients per
clinical WTE.
General community team
20
40
60
80
100
120
HE
E_
01
2
HE
E_
07
5
HE
E_
06
1
HE
E_
00
4
HE
E_
03
5
HE
E_
07
6
HE
E_
05
9
HE
E_
04
2
HE
E_
05
6
HE
E_
05
7
HE
E_
05
8
HE
E_
04
5
HE
E_
02
5
HE
E_
03
4
HE
E_
03
7
HE
E_
00
2
HE
E_
04
0
HE
E_
04
4
HE
E_
03
3
HE
E_
01
7
HE
E_
03
1
HE
E_
06
7
HE
E_
08
1
HE
E_
06
2
HE
E_
04
3
HE
E_
05
2
HE
E_
07
8
HE
E_
06
5
HE
E_
01
3
HE
E_
02
9
HE
E_
00
1
HE
E_
01
5
HE
E_
07
9
HE
E_
08
0
HE
E_
02
0
HE
E_
01
9
HE
E_
02
3
HE
E_
02
7
HE
E_
02
1
HE
E_
01
1
HE
E_
00
5
HE
E_
06
8
HE
E_
04
6
HE
E_
02
6
HE
E_
00
3
HE
E_
03
6
HE
E_
01
6
HE
E_
08
3
HE
E_
00
8
HE
E_
02
8
HE
E_
01
8
HE
E_
05
5
HE
E_
00
6
HE
E_
07
7
HE
E_
06
6
HE
E_
01
0
HE
E_
02
4
HE
E_
04
7
HE
E_
05
3
HE
E_
00
7
HE
E_
03
2
HE
E_
08
2
HE
E_
06
3
HE
E_
06
0
Patients on caseload per clinical WTE (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 39 Median = 34
Sickness absence
The average sickness
absence rate in general
community teams for
CYP MH services is
4%, which is the same
as the national NHS
average.
General community team
%
2%
4%
6%
8%
10%
12%
14%
16%
HE
E_
04
8
HE
E_
00
2
HE
E_0
56
HE
E_
07
5
HE
E_
04
3
HE
E_0
26
HE
E_
02
8
HE
E_
01
6
HE
E_0
80
HE
E_
05
3
HE
E_
03
6
HE
E_0
60
HE
E_
03
2
HE
E_
04
4
HE
E_0
59
HE
E_
00
4
HE
E_
01
3
HE
E_0
74
HE
E_
03
1
HE
E_
01
5
HE
E_0
45
HE
E_
04
9
HE
E_
06
7
HE
E_0
42
HE
E_
00
6
HE
E_
03
7
HE
E_
01
2
HE
E_0
68
HE
E_
01
9
HE
E_
07
2
HE
E_0
23
HE
E_
08
1
HE
E_
08
2
HE
E_0
70
HE
E_
05
0
HE
E_
06
2
HE
E_0
24
HE
E_
01
1
HE
E_
07
6
HE
E_0
61
HE
E_
02
0
HE
E_
05
8
HE
E_0
10
HE
E_
01
7
HE
E_
00
7
HE
E_0
05
HE
E_
02
5
HE
E_
02
9
HE
E_0
77
HE
E_
01
8
HE
E_
05
2
HE
E_
03
4
HE
E_
03
3
HE
E_
05
5
HE
E_
03
5
HE
E_0
14
HE
E_
06
4
HE
E_
04
6
HE
E_0
79
HE
E_
06
5
HE
E_
00
1
HE
E_0
27
HE
E_
05
7
HE
E_
02
1
HE
E_0
66
HE
E_
08
3
HE
E_
04
0
HE
E_0
08
HE
E_
06
3
HE
E_
07
1
Sickness absence (%) (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 4% Median = 4%
Staff turnover
The average staff
turnover in general
community teams is 17%.
This is quite high and
could explain the reason
why most staff members
have been in their post for
less than 5 years (page
17).
The range in staff
turnover is high, with two
organisations reporting a
staff turnover of 50% or
above.
General community team
%
10%
20%
30%
40%
50%
60%
HE
E_0
28
HE
E_
06
1
HE
E_0
56
HE
E_
02
1
HE
E_0
59
HE
E_
02
6
HE
E_0
31
HE
E_
02
0
HE
E_0
46
HE
E_
04
9
HE
E_0
79
HE
E_
01
4
HE
E_0
12
HE
E_
04
3
HE
E_0
83
HE
E_
07
7
HE
E_
05
8
HE
E_
00
8
HE
E_
02
5
HE
E_
06
4
HE
E_
05
2
HE
E_
01
8
HE
E_
07
0
HE
E_
06
6
HE
E_
00
2
HE
E_
03
6
HE
E_
01
3
HE
E_
04
0
HE
E_
05
3
HE
E_0
81
HE
E_
05
7
HE
E_0
80
HE
E_
07
5
HE
E_0
11
HE
E_
00
6
HE
E_0
65
HE
E_
04
4
HE
E_0
17
HE
E_
08
2
HE
E_0
55
HE
E_
02
4
HE
E_0
71
HE
E_
02
3
HE
E_0
04
HE
E_
06
2
HE
E_0
32
HE
E_
00
7
HE
E_0
74
HE
E_
01
9
HE
E_
00
5
HE
E_
03
3
HE
E_
01
0
HE
E_
01
6
HE
E_
04
5
HE
E_
04
2
HE
E_
02
9
HE
E_
02
7
HE
E_
03
7
HE
E_
06
0
HE
E_
07
2
HE
E_0
15
HE
E_
06
8
HE
E_0
76
HE
E_
03
5
HE
E_0
01
HE
E_
06
7
HE
E_0
50
HE
E_
03
4
HE
E_0
48
Staff turnover (%) (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 17% Median = 15%
Raising standards through sharing excellence
Community
2. Eating disorder community teams
Service Model (1)Eating disorder
48 organisations provided answers for which service functions their eating disorder community teams provided.
The following two charts show the breakdown of the percentage of organisations that said they had these service
models.
Service model Percentage responding YesNational
averageMental Health Promotion in the community, schools, within primary
care 77%
Evidence based parenting programmes 51%
Early Intervention Psychosis Teams 9%
CYP MH Primary Care Mental Health Team (Dedicated CYP MH
delivery) 42%
Ante- & post-natal specific support 4%
Early years support for infants / toddlers 6%
Training & Education to staff working in primary care/universal
services (schools, GPs) 79%
Paediatric Liaison Service 53%
100%0% 100%0%
Service Model (2)Eating disorder
Service model Percentage responding YesNational
average
Outreach work 54%
Specific support to BME groups within the community 2%
Joint working/family therapy/group work 90%
24/7 crisis response 46%
Provision of services to Schools or Colleges 56%
Assertive Outreach Teams 13%
Support to Youth Offending Teams 40%
Liaison and diversion for Police custody 6%
Support to Drug & Alcohol Services 17%Specific services for children in and leaving care, adopted children
and foster carers 42%
Support to LA behaviour support & inclusion services 17%Treatment and support for CYP with a Learning Disability and a mental
health need 66%
Treatment and support for CYP with ASD 45%
Treatment and support for CYP with ADHD 64%
Sensory Impairment Services 9%
100%0% 100%
100%0%
Job roles
There is a higher percentage of nursing
staff in eating disorders than general
community teams, with 33% of the ED
workforce nurses, compared to 23% of
the general workforce.
17% of staff are psychologists and 14%
are Therapists/ AHPs.
Eating disorder
0%
5%
10%
15%
20%
25%
30%
35%
Admin/ Management
CYP Education MH practitioner
CYP Psychological wellbeingpractitioner
Nursing
Support worker
Medical
OT
PsychologyPsychotherapy
Family Therapist
Therapist/AHP
Counsellor
Social worker
Student
Other
Eating Disorders Community Job roles
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Job Roles
National
averageSTP
Admin/ Management 11.2% 10.4%
CYP Education MH practitioner 0.2% 0.0%
CYP Psychological wellbeing practitioner 0.2% 0.0%
Nursing 33.1% 12.5%
Support worker 2.8% 2.1%
Medical 3.4% 4.2%
OT 1.2% 2.1%
Psychology 16.6% 12.5%
Psychotherapy 7.5% 0.0%
Family Therapist 1.2% 0.0%
Therapist/AHP 14.0% 22.9%
Counsellor 0.0% 0.0%
Social worker 0.6% 0.0%
Student 0.0% 0.0%
Other 8.1% 33.3%
Registered nurses
The skill mix of registered nurses in
eating disorder community teams is
similar to general community teams,
with 58% at band 6 and 34% working
at band 7.
Eating disorder
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Band 8d
Band 9
Eating Disorders Community Registered nurses (Band 5-9)
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Nursing bands
National
averageSTP
Band 5 3.0% 0.0%
Band 6 57.8% 100.0%
Band 7 34.1% 0.0%
Band 8a 5.2% 0.0%
Band 8b 0.0% 0.0%
Band 8c 0.0% 0.0%
Band 8d 0.0% 0.0%
Band 9 0.0% 0.0%
Skills and trainingEating disorder
27 organisations answered what interventions and competencies their eating disorder community teams had
undertaken.
The following two pages detail the percentage of organisations that responded yes to having staff members
trained in the relevant skills.
Skills and trainingEating disorder
Skills and training Percentage responding YesNational
averageAttachment informed interventions e.g. Dyadic Developmental
Psychotherapy or Video Feedback to Promote Positive Parenting 18%
ASD assessment approaches (e.g. ADOS/ADI or DISCO) 32%
Cognitive Behavioural Therapy (CBT) for young people with
depression and anxiety 61%
CBT for Eating Disorders 79%
CBT for Psychosis 21%
Cognitive Analytic Therapy (CAT) 14%
Counselling children and young people with mild anxiety and
depression 43%
Combination - prescribing and psychological therapy 43%
Dialectical Behaviour Therapy (DBT) 43%
Dietary counselling for eating disorders 57%
Enhanced Evidence Based Practitioners (EEBP) 7%
Eye Movement Desensitisation Reprogramming (EMDR) 29%
Family Therapy (FT) 82%
Family Focused Therapy 39%
Anorexia-nervosa-focused family therapy for children and young
people (FT-AN) (single or multiple-family) 71%
Bulimia-nervosa-focused family therapy (FT-BN) 50%
Systemic Family Practice (SFP) for eating disorders 54%
SFP for over 10s with conduct problems, or depression and self-
harm 21%
100%0%
Skills and trainingEating disorder
Skills and training Percentage responding YesNational
averageFormal instruction in bio-psycho-social mental health
assessment including risk assessment 43%
Formal instruction (including CYP-IAPT) in ‘developing a
formulation 54%
Inpatient CAMHS whole team training 7%
Mentalisation Approaches (e.g. AMBIT) 29%
Interpersonal Psychotherapy for adolescents (IPT-A) with
moderate to severe depression 29%
Adolescent-focused psychotherapy for anorexia nervosa (AFP-
AN). 21%
Focal psychodynamic therapy (FPT) 7%
Psychodynamic psychotherapy 29%
Psycho-education / guided self-help 50%
Parenting for children (under 10 years) with conduct and
behavioural problems (e.g. The Incredible Years, Positive 29%
Children and young people with learning disabilities or autistic
spectrum disorder training (via CYP IAPT) 14%
Supervision (diploma level) 57%
Outreach enhanced supervision (for supervisors not attending
full diploma course) 18%
Service Transformational Leadership 14%
Non-medical prescribing 11%
Approved clinician (non-medical) 7%
Social prescribing 7%
Systems training for emotional predictability and problem
solving (STEPPS) 4%
Working with 0-5s training via CYP IAPT 4%
100%0%
Contacts per clinical WTE
On average, 392 contacts
are delivered per clinical
WTE in eating disorder
teams.
This is similar to the
number of contacts
delivered by general
community teams, 404
(page 36).
Eating disorder
200
400
600
800
1000
1200
1400
Total contacts per clinical WTE (Eating disorder)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 403 Median = 392
Patients on caseload per clinical
WTE
Clinical staff in eating
disorder teams have an
average of 13 patients
on caseload per clinical
WTE.
The number of patients
on caseload per clinical
WTE across eating
disorder services ranges
from 4 to 34.
Eating disorder
5
10
15
20
25
30
35
40
Patients on caseload per clinical WTE (Eating disorder)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 13 Median = 12
Sickness absence
The average sickness
absence for eating
disorder community
teams is 4%. This is the
same percentage of
sickness absence shown
in general community
teams.
Eating disorder
%
1%
2%
3%
4%
5%
6%
7%
8%
9%
10%
Sickness absence (%) (Eating disorder)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 4% Median = 3%
Staff turnover
The staff turnover
for ED community
teams shows that
just under 1 in 5
staff members
leave per year
(19%).
Eating disorder
%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Staff turnover (%) (Eating disorder)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 19% Median = 20%
Raising standards through sharing excellence
Community
3. Forensic community teams
Service Model (1)Forensic
Organisations were asked about their forensic community teams service models. This question received responses
from 21 organisations. The next two tables show the percentage of these 21 organisations that responded yes to
providing certain service models.
Service model Percentage responding YesNational
averageMental Health Promotion in the community, schools, within primary
care 10%
Evidence based parenting programmes 0%
Early Intervention Psychosis Teams 0%
CYP MH Primary Care Mental Health Team (Dedicated CYP MH
delivery) 10%
Ante- & post-natal specific support 0%
Early years support for infants / toddlers 0%
Training & Education to staff working in primary care/universal
services (schools, GPs) 52%
Paediatric Liaison Service 0%
100%0% 100%0%
Service Model (2)Forensic
Service model Percentage responding YesNational
average
Outreach work 81%
Specific support to BME groups within the community 0%
Joint working/family therapy/group work 21%
24/7 crisis response 10%
Provision of services to Schools or Colleges 52%
Assertive Outreach Teams 0%
Support to Youth Offending Teams 95%
Liaison and diversion for Police custody 19%
Support to Drug & Alcohol Services 24%Specific services for children in and leaving care, adopted children
and foster carers 57%
Support to LA behaviour support & inclusion services 19%Treatment and support for CYP with a Learning Disability and a mental
health need 80%
Treatment and support for CYP with ASD 35%
Treatment and support for CYP with ADHD 80%
Sensory Impairment Services 0%
100%0% 100%
100%0%
Job roles
Forensic community teams are mainly
staffed with registered nurses (35% of
the workforce) and support workers,
8%. This gives a ratio of 4:1 qualified to
unqualified nurses.
Other notable job roles are
psychologists who make up 13% of the
workforce.
Forensic
0%
10%
20%
30%
40%
50%
60%
Admin/ Management
CYP Education MH practitioner
CYP Psychological wellbeingpractitioner
Nursing
Support worker
Medical
OT
PsychologyPsychotherapy
Family Therapist
Therapist/AHP
Counsellor
Social worker
Student
Other
Forensic Community Job roles
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Job Roles
National
averageSTP
Admin/ Management 8.0% 16.7%
CYP Education MH practitioner 0.0% 0.0%
CYP Psychological wellbeing practitioner 0.0% 0.0%
Nursing 35.4% 10.0%
Support worker 8.0% 3.3%
Medical 3.5% 3.3%
OT 4.4% 0.0%
Psychology 13.3% 6.7%
Psychotherapy 0.0% 0.0%
Family Therapist 0.0% 0.0%
Therapist/AHP 1.8% 0.0%
Counsellor 0.0% 0.0%
Social worker 0.0% 0.0%
Student 0.0% 0.0%
Other 25.7% 60.0%
Registered nurses
Most registered nurses are band 7 in
forensic community teams (47%)
unlike in general and eating disorder
community teams where band 6
nurses are most prevalent.
Forensic
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Band 8d
Band 9
Forensic Community Registered nurses (Band 5-9)
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Nursing bands
National
averageSTP
Band 5 25.0% -
Band 6 15.6% -
Band 7 46.9% -
Band 8a 9.4% -
Band 8b 3.1% -
Band 8c 0.0% -
Band 8d 0.0% -
Band 9 0.0% -
Contacts per clinical WTEForensic
The average number of
contacts per clinical WTE in
forensic community teams is
106. This is much lower than
general and eating disorder
which are around 400 contacts
per clinical WTE.
50
100
150
200
250
300
350
400
HEE_017 HEE_015 HEE_067 HEE_036 HEE_021 HEE_078 HEE_047 HEE_027
Total contacts per clinical WTE (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 106 Median = 55
Patients on caseload per clinical
WTEForensic
There is an average of 12
patients on caseload per
clinical WTE in forensic
community teams.
This has some wide variation
with the data ranging from 25
patients on caseloads per
clinical WTE to 1.
5
10
15
20
25
30
HEE_036 HEE_017 HEE_078 HEE_027 HEE_047 HEE_015 HEE_067
Patients on caseload per clinical WTE (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 12 Median = 11
Sickness absenceForensic
The sickness absence
in forensic community
teams is consistent
with the general and
eating disorder
community teams,
with an average of 4%
of staff members with
a sickness absence.
%
1%
2%
3%
4%
5%
6%
7%
HEE_015 HEE_078 HEE_021 HEE_036 HEE_067 HEE_001
Sickness absence (%) (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 4% Median = 5%
Staff turnoverForensic
The data shows
that staff turnover
in forensic
community teams
is just over a fifth
(21%).
%
5%
10%
15%
20%
25%
30%
35%
HEE_027 HEE_036 HEE_021 HEE_078 HEE_001
Staff turnover (%) (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 21% Median = 19%
Raising standards through sharing excellence
Inpatient
Services ProvidedGeneral CYP
Most general CYP MH services do not provide inpatient beds (54%), and only a sixth (15%) provide day units.
Over a quarter (29%) of general CYP MH services provide intensive home treatment as an alternative to inpatient care.
46%
54%
Do you provide general CYP inpatient beds?
Yes No
15%
85%
Do you provide a general CYP day unit?
Yes No
29%
71%
Do you provide general CYP intensive home treatment (as an alternative to
inpatient care)?
Yes No
Services ProvidedEating disorder
In eating disorder CYP MH services, less than a fifth (19%) provide inpatient beds and only 6% provide a day unit.
16% of services said they provided eating disorder intensive home treatment.
19%
81%
Do you provide eating disorder inpatient beds?
Yes No
6%
94%
Do you provide an eating disorder day unit?
Yes No
16%
84%
Do you provide eating disorder intensive home treatment (as an
alternative to inpatient care)?
Yes No
Services ProvidedForensic
A tenth of forensic services provide inpatient beds (10%). Day units and intensive home treatment models
are not seen within forensic services for young people.
10%
90%
Do you provide forensic inpatient beds?
Yes No
Job roles
Over a third of staff (37%) in inpatient units
with attached day services are registered
nurses, and 33% are support workers. This
gives a near 1:1 ratio of qualified to
unqualified nurses.
Inpatient unit with attached day services
0%
5%
10%
15%
20%
25%
30%
35%
40%
Admin/ Management
CYP Education MH practitioner
CYP Psychological wellbeingpractitioner
Nursing
Support worker
Medical
OT
PsychologyPsychotherapy
Family Therapist
Therapist/AHP
Counsellor
Social worker
Student
Other
Inpatient with day unit Job roles
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Job Roles
National
averageSTP
Admin/ Management 5.3% -
CYP Education MH practitioner 0.0% -
CYP Psychological wellbeing practitioner 0.0% -
Nursing 36.9% -
Support worker 32.7% -
Medical 2.3% -
OT 3.3% -
Psychology 5.5% -
Psychotherapy 2.3% -
Family Therapist 0.0% -
Therapist/AHP 3.5% -
Counsellor 0.0% -
Social worker 1.0% -
Student 1.0% -
Other 6.3% -
Registered nurses
The majority of registered nurses in inpatient
units with attached day services are band 5
(60%). 27% are band 6 and just over 8% are
band 7. This confirms a more junior nursing
profile than is seen in CYP MH community
services.
Inpatient unit with attached day services
0%
10%
20%
30%
40%
50%
60%
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Band 8d
Band 9
Inpatient with day unit Registered nurses (Band 5-9)
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Nursing bands
National
averageSTP
Band 5 59.7% -
Band 6 27.1% -
Band 7 8.3% -
Band 8a 3.5% -
Band 8b 0.7% -
Band 8c 0.7% -
Band 8d 0.0% -
Band 9 0.0% -
Job roles
The majority of staff in inpatient units
without day services attached are either
qualified nurses (33%) or support
workers (35%).
The proportion of qualified to unqualified
nurses shows slightly more unqualified
nurses.
Inpatient unit without attached day services
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
Admin/ Management
CYP Education MH practitioner
CYP Psychological wellbeingpractitioner
Nursing
Support worker
Medical
OT
PsychologyPsychotherapy
Family Therapist
Therapist/AHP
Counsellor
Social worker
Student
Other
Inpatient without day unit Job roles
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Job Roles
National
averageSTP
Admin/ Management 8.3% 18.1%
CYP Education MH practitioner 0.0% 0.0%
CYP Psychological wellbeing practitioner 0.0% 0.0%
Nursing 32.7% 22.5%
Support worker 34.8% 41.9%
Medical 3.6% 6.3%
OT 2.9% 2.5%
Psychology 4.5% 3.1%
Psychotherapy 1.0% 0.0%
Family Therapist 0.3% 0.0%
Therapist/AHP 2.4% 1.9%
Counsellor 0.1% 0.0%
Social worker 0.9% 0.0%
Student 0.3% 0.0%
Other 8.3% 3.8%
Registered nurses
Most registered nurses are band 5 (60%)
while 29% are band 6.
Inpatient unit without attached day services
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Band 5
Band 6
Band 7
Band 8a
Band 8b
Band 8c
Band 8d
Band 9
Inpatient without day unit Registered nurses (Band 5-9)
Average West Yorkshire and Harrogate (Health & Care Partnership) STP
Nursing bands
National
averageSTP
Band 5 59.1% 94.4%
Band 6 28.3% 2.8%
Band 7 8.7% 2.8%
Band 8a 3.1% 0.0%
Band 8b 0.7% 0.0%
Band 8c 0.0% 0.0%
Band 8d 0.0% 0.0%
Band 9 0.0% 0.0%
Skills and trainingInpatient
22 organisations detailed the skills and training accessed by staff members in their inpatient units.
The following two pages give a national breakdown of the percentage of organisations that reported the
relevant skills and training.
Skills and trainingInpatient
Skills and training Percentage responding YesNational
averageAttachment informed interventions e.g. Dyadic Developmental
Psychotherapy or Video Feedback to Promote Positive Parenting 45%
ASD assessment approaches (e.g. ADOS/ADI or DISCO) 82%
Cognitive Behavioural Therapy (CBT) for young people with
depression and anxiety 86%
CBT for Eating Disorders 64%
CBT for Psychosis 68%
Cognitive Analytic Therapy (CAT) 41%
Counselling children and young people with mild anxiety and
depression 68%
Combination - prescribing and psychological therapy 64%
Dialectical Behaviour Therapy (DBT) 91%
Dietary counselling for eating disorders 45%
Enhanced Evidence Based Practitioners (EEBP) 18%
Eye Movement Desensitisation Reprogramming (EMDR) 50%
Family Therapy (FT) 91%
Family Focused Therapy 77%
Anorexia-nervosa-focused family therapy for children and young
people (FT-AN) (single or multiple-family) 50%
Bulimia-nervosa-focused family therapy (FT-BN) 41%
Systemic Family Practice (SFP) for eating disorders 41%
SFP for over 10s with conduct problems, or depression and self-
harm 41%
100%0%
Skills and trainingInpatient
Skills and training Percentage responding YesNational
averageFormal instruction in bio-psycho-social mental health
assessment including risk assessment 68%
Formal instruction (including CYP-IAPT) in ‘developing a
formulation 77%
Inpatient CAMHS whole team training 77%
Mentalisation Approaches (e.g. AMBIT) 64%
Interpersonal Psychotherapy for adolescents (IPT-A) with
moderate to severe depression 36%
Adolescent-focused psychotherapy for anorexia nervosa (AFP-
AN). 23%
Focal psychodynamic therapy (FPT) 18%
Psychodynamic psychotherapy 50%
Psycho-education / guided self-help 77%
Parenting for children (under 10 years) with conduct and
behavioural problems (e.g. The Incredible Years, Positive 36%
Children and young people with learning disabilities or autistic
spectrum disorder training (via CYP IAPT) 50%
Supervision (diploma level) 45%
Outreach enhanced supervision (for supervisors not attending
full diploma course) 18%
Service Transformational Leadership 55%
Non-medical prescribing 14%
Approved clinician (non-medical) 5%
Social prescribing 5%
Systems training for emotional predictability and problem
solving (STEPPS) 9%
Working with 0-5s training via CYP IAPT 0%
100%0%
Clinical WTE per 10 bedsInpatient
On average, there are
29 clinical WTEs per
10 beds.
The data shows a
range spanning from
55 to 5 clinical WTE
per 10 beds.
10
20
30
40
50
60
Clinical WTE per 10 beds - Total
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 29 Median = 30
Raising standards through sharing excellence
Inpatient
1.General adolescent beds
Bed occupancy (excluding leave)General adolescent
The average bed
occupancy in general
adolescent inpatient
beds, excluding leave, is
69%.
%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Bed occupancy (excluding leave) General
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 69% Median = 68%
Admissions per bedGeneral adolescent
On average, there are 5
admissions per bed per
year in general inpatient
services.
1
2
3
4
5
6
7
8
9
10
Admissions per bed (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 5 Median = 5
Sickness absenceGeneral adolescent
The workforce sickness
absence in general
inpatient services is 5%.
This is slightly higher than
general community
services (4%).
The range in inpatient
services is also higher,
with Trusts reporting from
as high as 15% sickness
absence to below 1%.
%
2%
4%
6%
8%
10%
12%
14%
16%
18%
Sickness absence (%) (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 5% Median = 5%
Staff turnoverGeneral adolescent
The staff turnover in general
inpatient services averages
17%, with some Trusts
reporting as high as 43%
staff turnover.
%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Staff turnover (%) (General)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 17% Median = 16%
Raising standards through sharing excellence
Inpatient
2. Eating disorders beds
Bed occupancy (excluding leave)Eating disorder
The data shows that
bed occupancy in
eating disorder services
is three quarters
occupied (75%), and
consistent across all
NHS Trusts.
%
10%
20%
30%
40%
50%
60%
70%
80%
90%
HEE_065 HEE_067 HEE_036 HEE_027
Bed occupancy (excluding leave) Eating disorder
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 75% Median = 78%
Admissions per bedEating disorder
In eating disorder
services, there is an
average of just over 1
admission per bed per
year.
.
.2
.4
.6
.8
1.
1.2
1.4
1.6
1.8
2.
HEE_036 HEE_065 HEE_067 HEE_027
Admissions per bed (Eating disorder)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 1.27 Median = 1.32
Raising standards through sharing excellence
Inpatient
3. Forensic beds
Bed occupancy (excluding leave)Forensic
Bed occupancy in
forensic services
(excluding leave) is 65%.
%
10%
20%
30%
40%
50%
60%
70%
80%
90%
HEE_030 HEE_067 HEE_001 HEE_078 HEE_051 HEE_015 HEE_021
Bed occupancy (excluding leave) Forensic
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 65% Median = 64%
Admissions per bedForensic
Forensic inpatient
services have on
average just over 1
admission per bed per
year.
.
.5
1.
1.5
2.
2.5
3.
3.5
4.
HEE_030 HEE_001 HEE_067 HEE_021 HEE_078 HEE_015 HEE_051
Admissions per bed (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 1.09 Median = .8
Sickness absenceForensic
Workforce sickness
absence in forensic
inpatient services is
5%. This is consistent
across all three
inpatient bed types.
%
2%
4%
6%
8%
10%
12%
14%
HEE_078 HEE_051 HEE_015 HEE_036 HEE_001 HEE_067 HEE_030
Sickness absence (%) (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 5% Median = 5%
Staff turnoverForensic
The staff turnover in
forensic inpatient
services shows under 1
in 10 staff members left
(8%) during the year.
This is much lower than
general and eating
disorder services,
which are 17% and
16% respectively.
%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
HEE_051 HEE_078 HEE_036 HEE_001 HEE_067 HEE_015
Staff turnover (%) (Forensic)
All Orgs West Yorkshire and Harrogate (Health & Care Partnership) STP Mean = 8% Median = 4%
▪ We would like to thank all NHS organisations who took part in the Health Education England CYP MH
services workforce data collection, and we hope you find this analysis useful in comparing your local
position against the national average. In addition to the NHS data returns, data has been submitted by
independent organisations, local authorities, youth offending teams and voluntary organisations. This
stocktake is a key part of implementing the targets in the recently published NHS Long Term Plan which
aims to significantly expand capacity in children and young people’s mental health services.
▪ CYP MH is a multi-agency service with contributions to service delivery provided by organisations in a
range of sectors. Data submissions were received from the independent sector, local authorities, voluntary
sector and youth justice services, although this report focuses on NHS organisations.
▪ Contributions from the various sectors are not based on 100% like for like comparisons with the 2016
project due to differences in the contributor sample size. However, data from participants does confirm
evidence of growth and momentum in CYP MH services. The number of contributions from independent
sector, local authorities and voluntary sector have all increased in the last 3 years. Growth in workforce
size in voluntary sector providers may be taking place at pace but it should be noted that this si still the
smallest of the CYP MH sectors.
▪ A summary report is available which provides detailed evidence of workforce size and shape across all
CYP MH provider sectors. This includes profiling of workforce demographic characteristics, skills and
competencies. Workforce data has been aligned with service delivery data to describe how CYP MH
services are delivered across the NHS and other sectors. Almost all of the metrics analysed by the project
describe an expansion of the CYP MH service offer across England.
▪ If you have any queries about the report, please contact Alexander Ng ([email protected]) or Zoë Morris
Conclusion
Raising standards through sharing excellence
Appendix: Skills and training
The following qualifications / training courses were reported by services, in addition to the list provided.
Additional skills and training
• ACT (Acceptance and Commitment Therapy)
• ADOS-2 Training (Positive about autism)
• AMHP training
• Approved Clinician for MHA (Medical)
• Art Psychotherapy
• Art Therapy
• Attachment and psychotherapy - Dynamic
• Behavioural Family Therapy BFT
• Behaviour activation graded exposure
• Behaviour Management /PBS
• BTEC plus advanced certificate in health management
• CBT informed intervention - Group & Individual (Parent
only, Parent and young person & Young person only)
• Certificate in Education (Further education) post 16
• Child and Family Development
• Cognitive Assessments (WISC.WASI,WAIS)
• Compassion - focused therapy
• CYP IAPT for Learning Disabilities and working with 0-5s
- courses not attended, but skills in the workforce.
• DBT skills training
• DDP
• DNA-V
• Drama therapy
• Edward Jenner Programme
• EMDR practitioner partially trained
• ENB 603 - Child and Adolescent Psychiatric Nursing plus
certificate in the understanding and treatment of
disturbed behaviour in childhood and adolescence.
• Evidence-based Diploma in Parenting Interventions for
Children and Young People
• Family Based Treatment-
• Family Intervention for Psychosis
• Family therapy & Systemic Practice
• Filial Therapy
• FRIENDS
• Functional analysis of children with learning disabilities
• Guided Self Help
• Hearing Voices Work
Additional skills and training• IAPT 6 day supervision training
• Imaginal Exposure Therapy
• Incredible Years Peer Coaching/Video Interaction
Guidance Supervision
• International School for Infancy and Early Years
• Master of science in applied social learning theory and
counselling - provided CBT qualification
• Maudsley model • Mental Health and intellectual disability - assessment
liaison and care coordination. Psychotropic
management
• Mentalization and CBT
• MET
• Mindfulness
• Motivational Interviewing
• Music therapy (group)
• Music therapy (individual)
• Narrative Therapy
• National CAMHS eating Disorders training programme• National community Children’s Eating Disorders
training• Neuropsychological assessment, formulation &
treatment
• NG Insertion / Feeding
• Non violence resistance training
• Occupational Therapy
• Parent Child Game• Person Centred Expressive Therapy• Play Therapy• Positive Behaviour Support• Psychodrama• Psychology trainees on a rotating basis• Psychosocial Interventions for Psychosis.• QB training• Radically Open Dialectical Behaviour Therapy
(RO-DBT)• Rewind treatment for PTSD and Phobias• Risk Assessment Training• Risk management and care planning • RNLD• SFBT• Short term Psychoanalytical Psychotherapy • Solution Focused • Specialist group work • Specialist sensory assessments • System practice IAPT• Systemic Practitioner• Theraplay• Therapuetic Assessment and Intervention for
Sexually Harmful Behaviour• Trauma
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