Clinical psychologists in the NHS: Understanding wellbeing and decisions to leave

The NHS faces ongoing challenges that affect the experiences and wellbeing of its staff. Clinical psychologists are widely employed by the National Health Service (NHS), though limited research exists regarding their retention.

The first paper explores existing research of NHS-employed clinical psychologists’ wellbeing. The wellbeing of clinical psychologists employed within the NHS is likely to affect care quality and intentions to leave; however, the extent of recent research is unknown. A scoping review was conducted to better understand how the wellbeing of qualified NHS-employed clinical psychologists is conceptualised and researched. Nineteen studies were located from four electronic databases. These included qualitative, quantitative, and mixed methods studies. The findings were described in relation to identified research questions. Findings were also mapped onto the NHS Health and Wellbeing Framework. The included studies were fragmented, conceptualising and researching wellbeing in different ways. This reflects the wider wellbeing literature. The findings highlight various factors affecting clinical psychologists’ wellbeing, as well as gaps in the research base.

The second paper outlines a qualitative study conducted with clinical psychologists who had either left clinical NHS employment or given notice to leave. This aimed to understand these clinical psychologists’ experiences, including their reasons for leaving and how they made sense of this decision. It was hoped that the findings could support efforts to retain clinical psychologists. Fourteen clinical psychologists participated in semi-structured interviews. Transcripts were analysed using reflexive thematic analysis and four themes were generated. Participants were affected by systemic pressures in the NHS. These challenges made it difficult to provide care that reflected their professional values, or to develop and progress in their roles. Leaving facilitated greater alignment with personal and professional priorities, though many participants shared complex responses to their decision. The findings suggest changes should be made at organisational and workforce levels to improve conditions for clinical psychologists within the NHS.