CES BP Dclinpsy

Note: For a full explanation of Clinical Enabling Support (CES), including its definition, purpose, distinction from standard admin, and funding routes, see the accompanying document 'CES Definition and Purpose'.

Clinical Enabling Support (CES) Model – Clinical Psychologist

1. Current Baseline

- Salary: Band 7 = £43–50k/year, Band 8a = £50–57k/year (AfC 2024/25).

- Hourly cost ≈ £23–29/hour.

- Psychologists spend 25–40% of time on documentation (case notes, reports, correspondence).

- For ADHD/dyslexia clinicians, these tasks take disproportionately longer, reducing patient-facing time and increasing stress.

2. Proposed Adjustment

- Band 4 CES (junior PA-level) or Band 5 CES (senior PA-level).

- Band 4 salary ≈ £26.5–30.1k/year (~£14–15/hour).

- Band 5 salary ≈ £31–37.8k/year (~£16–19/hour).

- Allocation = 5 hrs/week CES (~0.13–0.15 FTE).

- Annual cost = ~£3,750 (Band 4) – £5,250 (Band 5).

- CES is in addition to and separate from standard admin teams; it directly addresses disability-related disadvantage.

3. Break-Even (Without Access to Work)

- 5 hrs/week freed = ~250 hrs/year.

- Equivalent to ~250 additional patient contacts annually (~5 extra contacts per week).

- Clinical psychologist time ≈ £26/hour → £6,500/year of value gained.

- CES allocation cost = £3,750–£5,250/year.

- Net gain: ~£1,250–2,750/year.

- Break-even point = 2.5–3 hrs/week freed.

4. With Access to Work Support

- NHS Trusts are large employers (>50 staff), so cost-sharing applies.

- Employer pays first £1,000, then 20% of the remainder.

Band 4 CES (£3,750/year):

- Employer pays £1,000 + £550 = £1,550.

- AtW pays £2,200.

- Trust cost reduced from £3,750 → £1,550.

- Break-even: pays for itself if it frees just 1 hr/week (~50 contacts annually).

Band 5 CES (£5,250/year):

- Employer pays £1,000 + £850 = £1,850.

- AtW pays £3,400.

- Trust cost reduced from £5,250 → £1,850.

- Break-even: pays for itself if it frees just 1.3 hrs/week (~65 contacts annually).

5. Equality Act Position

- ADHD/dyslexia = recognised disabilities under Equality Act 2010.

- CES is:

  • Separate from generic secretarial/admin support.

  • Reasonable and proportionate (low cost vs clinical time gained).

  • Practicable (Band 4–5 AfC posts widely available).

6. Secondary Outcomes

- Increased direct patient contact (therapy, assessments).

- Reduced stress and burnout.

- Improved turnaround of reports (safeguarding, SEND, legal contexts).

- Reduced risk of complaints or errors due to missed deadlines.

- Better retention of neurodivergent staff.

Model Request Wording (Clinical Psychologist)

“I am requesting approximately 5 hours per week of Band 4–5 Clinical Enabling Support (CES) as a reasonable adjustment for ADHD/dyslexia. This support would be in addition to and separate from standard administrative support within the psychology service.

My condition means I spend disproportionately longer on report writing, case notes, and documentation. CES would remove this barrier, freeing ~250 hours/year (equivalent to ~250 additional patient contacts, or ~5 contacts per week) for direct clinical care and MDT contribution.

The cost is ~£3,750–5,250/year, which pays for itself if it frees 2.5–3 hrs/week of my time. With Access to Work cost-sharing, the Trust’s net cost would fall to ~£1,550–1,850/year, which pays for itself if it frees just 1–1.3 hrs/week.

This adjustment is therefore both required under the Equality Act and a practical way to increase patient contact, reduce waiting lists, and support staff wellbeing.”