“Postcode Lottery for Psychiatric Care”

New research by the Royal College of Psychiatrists suggests there are big differences across the UK in the access that people have to consultant psychiatrists – the most senior NHS doctors working in mental health.

Data shows that Wales has the lowest rate of consultant psychiatrists per 100,000 people in the UK. For every 100,000 people who live in Wales there are just six psychiatrists offering specialist care to those with the most complex and serious mental ill health compared with 10 per 100,000 in Scotland and 8 per 100,000 in both England and Northern Ireland.

Even within Wales, there is a near three-fold variation in consultant psychiatrist numbers across Local Health Boards. People in rural areas have the poorest access to specialist mental health care with less than half the number of psychiatrists per head of population as people living in more urban areas. There were just four consultant psychiatrists for every 100,000 people in Powys Teaching Health Board compared to 11 in Cwm Taf Health Board.

Over the five years from 2011, the number of consultant psychiatrists has declined by 3.8%, while the number of consultants across all other hospital specialties increased by 10.4%. The Assembly’s Health, Social Care and Sports Committee highlighted the scale of the problem of recruitment across the range of medical professionals throughout Wales in their report on Medical Recruitment.

The research also suggests that not enough junior doctors are going into psychiatry. Recruitment into psychiatry training in Wales is at just 30% with a National fill rate (the percentage of available posts filled) of around 50%.  Although Welsh Government recently increased funding to develop services in some areas of mental health, such as liaison psychiatry and eating disorders, recruitment into the specialty is still an issue.

The number of consultant psychiatrists per 100,000 people across Wales is:-

  1. Abertawe Bro Morgannwg University Health Board – 6
  2. Aneurin Bevan Health Board – 6
  3. Betsi Cadwaladr University Health Board – 7
  4. Cardiff and Vale University Health Board – 6
  5. Cwm Taf University Health Board – 11
  6. Hywel Dda University Health Board – 4
  7. Powys Teaching Health Board – 4


The number of NHS consultant psychiatrists per 100,000 people across the UK is:-

  • Wales – 6
  • Scotland – 10
  • England – 8
  • Northern Ireland – 8

The Royal College of Psychiatrists is today launching its Choose Psychiatry campaign to encourage medical students to be part of the vital workforce needed to support people with severe mental ill health.

Despite the challenges, mental health services consistently rate highly in nationwide polls on important indicators such as staff satisfaction with the quality of work and care they are able to deliver no matter where psychiatrists are based across the country.

Professor Keith Lloyd, Vice President of the Royal College of Psychiatrists said:

“It is great that people are increasingly recognising the impact of mental health problems, but we are very concerned that people with severe mental illness are struggling to receive the right treatment from the right people in the right place at the right time due to difficulties in recruitment. This can have devastating and sometimes fatal consequences.

“Psychiatry is a great career and Wales a great place to work. I would urge anyone who is interested in a varied, stimulating career where you have time to get to truly know your patients as people to choose psychiatry.”

Alun Thomas, Chief Executive, Hafal said: 

“While all of us who work in mental health services know that recovery is dependent on a multi-agency, holistic approach, one of the key figures in the team is the consultant psychiatrist. The psychiatrist is vital, particularly in times of crisis, both in reducing the impact of that crisis and in helping prevent such issues in the future.

“Psychiatry both saves and adds years to patients’ lives.

“Within Wales we have a strong lead from Government on co-production in our health and social care services and we therefore have a particular need for Consultant Psychiatrists who want to work in a recovery-focused environment which provides continuity of support for people who need help. We do not have sufficient numbers of these specialist doctors and it is vital that we encourage and support trainees to become Consultant Psychiatrists in Wales.”

Dr Ceri Evans, the Royal College of Psychiatrists Co Lead for Recruitment and Retention in Wales said:

“The College in Wales is working hard to address the issues around recruitment and retention of psychiatrists and we have put together a robust strategy to promote the importance of this specialty and to highlight what a rewarding career it is.”

Dr Chantelle Wiseman, the Royal College of Psychiatrists Trainee Representative for Wales said:

“Providing safe and effective services with a patient centred approach is central to psychiatry training. The training programme in Wales is a well-designed scheme that focuses on developing trainees as professionals and individuals as well as the lead clinicians of the future.”

For more information, visit www.rcpsych.ac.uk/choosepsychiatry