V1.0. Mental Health Officers Report 2017 A National Statistics Publication for Scotland

Mental Health Officers Report 2017 A National Statistics Publication for Scotland Published 31 August 2018

Contents Executive summary... 4 1 Introduction... 5 1.1 2017 report... 5 2 MHO workforce overview... 6 2.1 Filled MHO posts, headcount, WTE and estimated hours worked... 6 2.2 Types of MHOs... 7 2.2.1 Exclusive MHOs... 8 2.2.2 Non-exclusive and cover MHOs... 8 2.3 MHOs in Health and Social Care Partnerships (HSCP)... 10 3 Gender, age and ethnicity of MHOs... 11 3.1 Gender of the MHO workforce... 11 3.2 Age of the MHO workforce... 11 3.3 Ethnicity of the MHO workforce... 13 4 MHO trainees, leavers, vacancies and shortfalls... 14 4.1 Trainee MHOs... 14 4.2 MHOs leaving the workforce... 15 4.3 MHO vacancies and staffing shortfalls... 16 4.3.1 Vacancies and unavailable MHOs... 16 4.3.2 MHO shortfall... 17 4.3.3 Groups of people who use services - specific MHO shortfalls... 17 5 MHOs as proportion of local authority social work workforce... 19 5.1 MHOs in the context of the social worker workforce... 19 6 MHOs in mental health and non-mental health teams... 21 6.1 Definitions... 21 6.2 Overview... 21 6.3 MHOs in mental health teams... 22 6.4 MHOs in non-mental health teams... 24 7 Conclusion... 28 Appendix A Definitions... 29 Appendix B Background notes... 31 1. National Statistics status... 31 2. Previous MHO publications... 31 3. Next MHO report... 31 2

4. UK context... 31 5. Respondent burden (cost of gathering and providing information)... 32 6. History of MHO report... 32 7. Data sources... 34 8. Data quality and use... 34 9. Survey methodology... 37 Appendix C Understanding the statistics in this report... 39 Appendix D Glossary... 40 Data appendices E to G... 41 Appendix E filled MHO posts, hours on MHO work and hours on MHO work per 10,000 population by local authority - 2017... 42 Appendix F - filled MHO posts, hours on MHO work and hours on MHO work per 10,000 population by Health Board area 2017... 43 Appendix G HSCP status of MHOs by local authority... 44 3

Executive summary This report presents data on Mental Health Officers (MHO) at the Scotland level, although some local authority level data is provided, mainly in the appendices. The tables and charts in this report are also made available for separate download from the SSSC s workforce data website (data.sssc.uk.com). More detailed data is available on request. The key points from this year s MHO report are set out below. There was a 3.2% increase in MHO posts from 722 in December 2016 to 745 in December 2017. The estimated average hours worked by MHOs on MHO duties in 2017 dropped from 17 hours per week to 16 hours. There were increases in the number of MHOs less than 40 years old and over 60, to 1 in 3 of all MHOs. The number of practising social workers (ie main grade social workers and senior social workers) working as MHOs remained the same in 2016 as 2017 at 10.4%. There was a drop in the number of vacancies for exclusive MHO posts to 6% of all such posts. There was a drop in the number of unavailable MHOs. There was an increase in the number of authorities reporting a shortfall in MHOs. There was an increase in the average estimated shortfall per authority to 67 hours per week. A drop was seen in the estimated average time spent by MHOs on MHO work in both mental health teams and non-mental health teams. Almost 96% of MHOs were based in their local Health and Social Care Partnership (HSCP) in December 2017, compared with 67% in 2016. Less than 10% of exclusive MHOs are based in non-mental health teams. As in 2016 the number of trainees who achieved the MHO Award in 2017 (60) was above the average seen in recent years (52). The number of admissions (53) in 2017 to MHOA programmes fell below the average of recent years (58). It remains difficult to comment on the ethnicity profile of the workforce due to levels of non-reporting of MHO s ethnicity. The gender profile of workforce remains constant at 69% female and 31% male. This is higher than the proportion of men (21%) practising as social workers in local authorities. Please note - the totals in some tables may not equal the sum of the individual parts due to the effects of rounding. 4

1 Introduction 1.1 2017 report This is the sixth annual report on the Mental Health Officer (MHO) workforce published by the Scottish Social Services Council (SSSC). The report is based on administrative data collected by the SSSC directly from local authorities as part of the annual local authority social work services survey (LASWS). The report gives a picture of the following. The number of qualified social workers practising as MHOs in post on 4 December 2017, excluding long term absentees (unavailable MHOs). The hours spent on MHO work by practising MHOs. MHO trainees, leavers, vacancies, unavailable MHOs and staffing shortfalls. Age, gender and ethnicity data on MHOs. Information on MHOs working in mental health teams and non-mental health teams. The number of MHOs working in Health and Social Care Partnerships (HSCPs). Some changes have been made to the report this year in terms of structure and content. The most significant changes are in the content. In last year s report we indicated that we would drop the analysis and discussion of whole time equivalent figures based on the MHO s contracted hours. This was for two reasons. The first is that contracted whole time equivalent (WTE) does not give an accurate picture of the amount of time spent on MHO duties as most MHOs are not expected to spend all their time on MHO work (for example, MHOs based in non-mental health teams). As an alternative measure of activity we agreed with MHO managers in local authorities to gather and publish data on the estimated time spent by individual MHOs on MHO duties (this was provided by MHO managers). That data appeared for the first time last year and it has been expanded this year. We also include for the first time information on MHOs working in HSCPs. For further information on the report s background, history, data sources, data quality and where to find previous copies of the reports etc. please refer to the detailed appendices on pages 29 to 44. 5

2 MHO workforce overview Throughout this report the workforce figures for December 2017 are presented alongside previously published data for the period 2013-2016. 2.1 Filled MHO posts, headcount, WTE and estimated hours worked Table 1a shows that in December 2017 there were 745 active MHO posts, an increase of 3.2% from 2016. This is the highest number of active MHO posts since records began in 2005. The contracted WTE also increased by 1.8% from 2016, although this remains below the peak seen in 2011 (687.8 WTE). However, it is important to note that the WTE figure relates to the contracted hours for each post and that in many of these posts only a proportion of the contracted time is expected to be spent on MHO work (see section 2.2 for further details). The average WTE per MHO reduced to 0.87 in 2017. This reduction in average WTE/MHO is because there is a greater proportion of MHOs in cover posts which have no contracted hours. In 2016 31 out of 96 cover MHO posts had no contracted hours compared with 36 out of 76 in 2017. Table 1a: Filled MHO posts and their contracted WTE 2013-2017 2013 2014 2015 2016 2017 Filled MHO posts 674 655 685 722 745 WTE of MHOs 632 603 602 636 648 Average WTE/MHO 0.94 0.92 0.88 0.88 0.87 Table 1b looks at the headcount of practising MHOs. This is the number of separate individuals working as MHOs. This can be different from the number of filled MHO posts as in a small number of authorities some MHOs work in more than one post as an MHO (see definition of filled MHO posts in Appendix A for further detail). Table 1b shows that the headcount increased by 3.5% between 2016 and 2017 and there has been a rise of 9.6% since the low of 2014. Table 1b: Headcount of practising MHOs 2013-2017 2013 1 2014 2015 2016 2017 Headcount N/A 649 653 687 711 1. This information was not gathered before 2014. 6

Table 1c provides information on the average estimated hours worked by MHOs per week in 2016 and 2017. This information was first requested in 2016 so no earlier data is available. Despite the increase in the overall number of MHOs the estimated hours worked per week on MHO duties dropped by 6% between December 2016 and December 2017. Table 1c: Estimated hours 1 worked on MHO duties per week and weekly average 2016-17 2016 2017 Estimated hours worked by MHOs 12,388 11,586 per week Average estimated hours per week per post 17.2 16.1 1. One authority did not provide this data in 2017. The estimated average for 2017 was calculated by discounting the MHOs from that authority. 2.2 Types of MHOs There are three kinds of qualified social workers that provide MHO services in Scotland s local authorities under the legislation set out in Appendix A. Exclusive MHOs whose main job is MHO work and who may have the job title Mental Health Officer. In 2017 these MHOs made up 32% of the total practising MHO workforce. Non-exclusive MHOs who are contracted to do both MHO work and non- MHO work (for example a statutory social work role) for their local authority. These workers are unlikely to have the job title Mental Health Officer and the amount of MHO work they do varies from week to week. In 2017 these MHOs made up 58% of the total practising MHO workforce. Cover MHOs who step in to provide services when required, for example to cover sickness absence. The normal contracted work of these workers for their local authority is not MHO work and the amount of MHO work they do per week can be very small. They are very unlikely to have the job title Mental Health Officer. In 2017 these MHOs made up 10% of the total practising MHO workforce. When considering the information in this report on contracted WTEs and the proportions of time spent by MHOs on MHO work, it is important to bear in mind that only a third of the total practising workforce is contracted exclusively to do MHO work. The rest are contracted to do varying amounts of other work alongside MHO duties. 7

2.2.1 Exclusive MHOs An exclusive MHO contract specifies that the staff member is to carry out primarily statutory MHO work, although in some local authorities their work profile includes non-mho duties such as care management. As might be expected, over 95% of exclusive MHOs work in mental health teams, with a small number in non-mental health teams. Before 2016 the team categories used to capture data on exclusive MHOs differed from those used to capture data on mental health and non-mental health team members. In 2016 the team categories for exclusive MHOs were brought into line with those used for mental health and non-mental health team members. We also introduced a new mental health team category called dedicated MHO teams in 2016. These changes mean that the team breakdown data from 2016 onwards is not wholly comparable with previous years. Table 2 shows the number of exclusive MHOs fell slightly in 2017 to 236. The majority (54%) of these MHOs work in dedicated MHO teams. The numbers of staff in non-mental health teams (NMHT) is comparable over the period and it is clear there has been a major shift away from locating exclusive MHOs in NMHTs, with only 10 posts in 2017. This means 96% of exclusive MHOs are based in specialist mental health teams (MHTs). There is further discussion of the work of MHTs and NMHTs in part 6 of this report. Table 2: Exclusive MHO positions by team category 2013-2017 2013 2014 2015 2016 2017 Dedicated MHO teams 1 - - - 119 128 Other mental health teams 142 106 140 111 98 Non-mental health teams 73 82 86 20 10 Total 215 188 226 250 236 1 Dedicated MHO teams was a new category in 2016; separate data for previous years for this category is not available. 2.2.2 Non-exclusive and cover MHOs Data on non-exclusive MHOs has not been published separately in previous MHO reports and is included for the first time in this section to provide a comprehensive overview of the MHO workforce (exclusive, non-exclusive and cover MHOs). 8

Table 3: Non-exclusive and cover MHOs by team category 2017 Nonexclusive Cover Dedicated MHO teams 0 1 Other mental health teams 190 16 Non-mental health teams 243 58 Not reported 0 1 Total 433 76 1. One authority did not provide information on the team type worked in. Table 3 shows that the majority of cover MHOs work in NMHTs, while table 4 shows a fall in the number of cover MHOs to 10.2% of all MHOs (from 13.7% in 2016). Two cover MHOs were provided by an agency in one authority. Please note that there was a change in recording methodology in 2016 whereby each individual cover MHO was positively identified by local authorities rather than the total number being obtained from other data in our survey of local authority social work services (LASWS). As a result, data for the years before 2016 is likely to understate the actual number of cover MHOs. In 2016 and 2017 ten authorities reported the use of cover MHOs. The City of Edinburgh Council has 30 cover MHOs which accounts for almost two-fifths of the total. This is because they have a considerable number of MHOs who have one or even two separately-contracted zero hours MHO posts for emergency out-of-hours cover work in addition to their basic contracted MHO post. Table 4: Cover MHOs 2014-2017 2014 2015 2016 2017 Total cover MHOs 26 38 99 76 Table 5 provides a breakdown of the number of authorities with cover MHOs and the approximate numbers in these authorities. As can be seen there has been a slight drop over time in the number of authorities using cover MHOs. 9

Table 5: Local authorities with cover MHOs by number and year No of authorities No of cover MHOs 2014 2015 2016 2017 1-3 11 10 4 4 4-6 2 0 1 1 7-9 0 1 2 3 10+ 0 1 3 2 Total 13 12 10 10 2.3 MHOs in Health and Social Care Partnerships (HSCP) We asked local authorities to tell us whether individual MHOs were based in their local HSCP. We received information from 30 of the 31 local authorities with an HSCP (note that Highland Council does not have an HSCP). 96.0% of MHOs employed by the 30 authorities were based in their local HSCP. In 22 local authorities all MHOs were within the HSCP and in the other eight councils there was a total of 16 MHOs that were not. In December 2016, there were 67% of MHOs identified as based in an HSCP. Appendix G (page 44) provides a detailed breakdown by local authority. 10

3 Gender, age and ethnicity of MHOs 3.1 Gender of the MHO workforce Table 6 sets out the number and percentage of men and women working in MHO posts during the period 2013-2017. As can be seen the gender split has remained largely constant over the five-year reporting period. Data from the local authority social work survey for December 2017 shows that 21% of those employed as social workers by Scottish local authorities are men, this was the same in 2015 and 2016. So the MHO workforce continues to have a greater proportion of men than the total social worker workforce. Table 6: Numbers and percentage (%) of males and females in MHO posts 2013-2017 2013 2014 2015 2016 2017 1 Male 207 208 219 226 233 Female 467 447 466 496 511 % male 31 32 32 31 31 % female 69 68 68 69 69 1 Age and gender data was not provided for one MHO 3.2 Age of the MHO workforce Table 7 provides a breakdown of the percentage of the MHO workforce by age categories. While there have been some relatively large changes over the period in the proportions within different age categories (for example under 40s) the overall proportion of those under 50 has remained roughly constant over time, ranging between 41% and 44%. In 2017 it was 41.7%. Two-thirds (66.9%) of MHOs are now aged between 40 and 60 which is a decrease since 2013 when it was over 75%. Increasing numbers of MHOs are either under 40 or over 60 with the proportions of each being almost identical. There are 121 MHOs over 60, 21 of whom were over 65 in December 2017. It seems likely that the vast majority of these will retire within the next five years. 11

Table 7: Percentage (%) of all MHOs by age group 2013-2017 2013 2014 2015 2016 2017 Under 40 10.8 13.4 13.9 15.4 16.8 40-44 14.4 12.5 10.2 10.4 9.1 45-49 17.4 18.3 16.6 15.9 15.7 50-54 21.7 23.4 25.7 23.0 21.5 55-59 22.3 21.8 20.7 19.7 20.6 60+ 13.5 10.5 12.8 15.7 16.3 Total 100.0 100.0 100.0 100.0 100.0 To see if there are differences in age between male and female MHOs Tables 8a and 8b provide breakdowns of MHOs by age group and gender. Table 8a: Percentage (%) of men by age group 2013-2017 2013 2014 2015 2016 2017 Under 40 7.2 10.6 10.5 13.7 13.7 40-44 13.0 10.1 6.4 6.2 6.0 45-49 18.4 21.2 16.4 11.9 15.5 50-54 23.7 23.6 28.3 29.6 24.9 55-59 24.6 23.1 26.0 21.2 23.6 60+ 13.0 11.5 12.3 17.3 16.3 Total 100.0 100.0 100.0 100.0 100.0 For men, the proportions of workers under 50 increased from 31.9% in 2016 (the lowest so far) to 35.2% in 2017 (Table 8a). The median age for male MHOs was 53. Table 8b shows that the proportion of women under 50 stayed roughly constant at 44.6%. The median age of female MHOs was 52. Male MHOs have a slighter older age profile. However, both male and female MHOs had almost identical proportions aged 60 or more. Table 8b: Percentage (%) of women by age group 2013-2017 2013 2014 2015 2016 2017 Under 40 12.4 14.8 15.5 16.1 18.2 40-44 15.0 13.6 12.0 12.3 10.6 45-49 16.9 17.0 16.7 17.7 15.9 50-54 20.8 23.3 24.5 20.0 20.0 55-59 21.2 21.3 18.2 19.0 19.2 60+ 13.7 10.1 13.1 14.9 16.2 Total 100.0 100.0 100.0 100.0 100.0 12

3.3 Ethnicity of the MHO workforce The incomplete returns on the ethnicity of MHOs mean that the figures across the years cannot be meaningfully compared. It is disappointing to note that the proportion of non-responses increased further in 2017 to 21.7%, which is the highest level of the reporting period. As a result it is difficult to comment on perceived trends in the proportions of white and ethnic minority MHOs, but we can say that the reported proportion of staff from an ethnic minority remains around 1% (see Table 9). Data from the local authority social work services survey in 2017, while having a similar level of non-response, indicates a slightly higher reported proportion (2.6%) of social workers from an ethnic minority in the local authority social work workforce as a whole. Table 9: Ethnicity of MHOs by percentage (%) 2013-2017 2013 2014 2015 2016 2017 White 88.4 81.0 79.6 77.3 77.2 Ethnic minority 0.7 1.8 1.6 1.2 1.1 Not known/not disclosed 10.8 17.2 18.8 21.5 21.7 Total 100.0 100.0 100.0 100.0 100.0 13

4 MHO trainees, leavers, vacancies and shortfalls 4.1 Trainee MHOs Currently, to practise as an MHO, social workers must successfully complete one of the three approved Mental Health Officer Award (MHOA) programmes in Scotland. These courses run at different points in the year and for differing lengths of time. They do not necessarily run every year but depend on neighbouring local authorities having sufficient staff to be trained. As a result, newly approved MHOs can and do join the workforce at various times of the year. This section provides information on trainee MHOs from the SSSC Annual Monitoring Review of MHO Award (MHOA) programmes. The higher education institutions which run MHOA programmes are Robert Gordon University, University of Edinburgh and University of Strathclyde. Admissions fell in 2012-13 because Robert Gordon University did not run a course but since 2013-14, all three institutions have run a course each year. Table 10: Admissions to and completions of MHO Award Programmes 2011-12 to 2017-18 11-12 12-13 13-14 14-15 15-16 16-17 17-18 Admissions 61 41 58 56 69 67 53 Completions 52 40 46 50 62 60 N/A Note: Years refer to academic years for example, 17-18 = September 2017 to August 2018. Figure 1 Admissions to and completions of MHO Award Programmes 2011-12 to 2017-18 14

Table 10 shows that completions in 2017 remained relatively high with 62 trainees successfully achieving the MHOA. However, the number of admissions (53) in autumn 2017 was lower than has been seen in recent years and is below the average (58) for the period 2011-18. Figure 1 shows that the rises and falls in completions generally track similar rises and falls in admissions. Given the fall in admissions seen in 2017 it seems likely that the numbers that will successfully achieve the award in 2018 will be below the average of 52 completions per year for the period 2011-17. 4.2 MHOs leaving the workforce Between December 2016 and December 2017, a total of 46 MHOs left the workforce, slightly less than the average (56 leavers) for the whole period 2013-17 (see Table 11a). Identifying MHO leavers can be problematic see the discussion in Appendix B, section 3b, Survey weaknesses. Table 11a: MHO leaver numbers by reason for leaving 2013-2017 2013 2014 2015 2016 2017 Change of post (promotion) 5 8 4 2 3 Change of post (sideways move) 6 5 6 4 2 Resigned 13 12 14 16 19 Retired 10 27 14 27 14 Other (eg career break) 24 10 15 11 8 Total 58 62 53 60 46 Table 11b sets out the proportions of MHO leavers by reason for leaving. Table 11b: MHO leaver percentages (%) by reason for leaving 2013-2017 2013 2014 2015 2016 2017 Change of post (promotion) 8.6 12.9 7.5 3.3 6.5 Change of post (sideways move) 10.3 8.1 11.3 6.7 4.3 Resigned 22.4 19.4 26.4 26.7 41.3 Retired 17.2 43.5 26.4 45.0 30.4 Other (eg career break) 41.4 16.1 28.3 18.3 17.4 Total 100.0 100.0 100.0 100.0 100.0 15

Two-fifths of all leavers in 2017 resigned, which is much higher than in recent years. The proportion retiring fell to just under a third and we know from Table 7 that the percentage of those in active MHO posts aged 60 or more increased to 16.3%. The proportion of leavers changing post for either a promotion or a sideways move remains relatively low similar to 2016. The proportion of other leavers also remains low at under a fifth. As well as career break leavers, other includes MHOs going on secondment and MHOs who s leaving reason or destination is not included in the category list or is not known. The annual survey also collects data for MHOs who move to another Scottish local authority and continue to do MHO work. Please note this data is separate in Table 11c and not included in the yearly leaver totals, because such MHOs did not actually leave the overall MHO workforce. Table 11c: MHOs moving to another local authority as an MHO 2013-2017 2013 2014 2015 2016 2017 Number of MHOs 9 3 8 8 5 4.3 MHO vacancies and staffing shortfalls 4.3.1 Vacancies and unavailable MHOs An exclusive MHO contract specifies that the staff member is appointed to primarily carry out statutory MHO work. Table 12 shows that the number of unfilled exclusive MHO vacancies fell slightly in 2017 to 14 which is the lowest over the reporting period. We also know from Table 2 that there were 236 exclusive MHOs in 2017. This means that 5.6% of all exclusive MHO posts were vacant in 2017 compared to 6.4% in 2016. An MHO is classed as unavailable when they are on maternity/paternity leave, adoption leave, a career break, long-term sick leave or compassionate leave, for a period of three months or more. Table 12 shows the number of MHOs unavailable has decreased from 24 in 2016 to 13 in 2017. Please note that unavailable MHOs are not included in the filled MHO posts or headcount data elsewhere in this report. Table 12: Unfilled MHO posts and unavailable MHOs 2013-2017 2013 2014 2015 2016 2017 Unfilled exclusive MHO vacancies 15 15 15 17 14 MHOs currently unavailable 15 15 17 24 13 16

4.3.2 MHO shortfall While the number of exclusive MHO vacancies and unavailable MHOs are at a low, Table 13 shows an increase in the reported total shortfall of MHO staff in Scotland. Each local authority was asked to report and estimate any gap between available staff time and the staff time they felt was needed in a typical week. The number of authorities reporting a shortfall increased to 22. The total additional hours per week required to address shortfalls increased by 14% from 2016 to around 1,470 hours a week in 2017. The average shortfall per authority that reported one only increased slightly however to 67 hours per week due to the increase in the number of authorities reporting a shortfall. If we assume an average full time working week is 36 hours, about 41 extra full time exclusive MHOs would be required across Scotland to fully address this reported shortfall. Table 13: MHO staffing shortfalls 2013-2017 Number of LAs reporting a staffing shortfall Total number of weekly additional hours required 2013 2014 2015 2016 2017 20 21 21 20 22 916 1,162 1,550 1,289 1,471 Approximate number of WTEs 25.4 32.3 43.0 35.8 40.9 Average LA shortfall in hours 45.8 55.3 73.8 64.4 66.9 4.3.3 Groups of people who use services - specific MHO shortfalls Since 2014, we have asked local authorities to report any shortfalls in relation to particular groups of people who use services. In 2017 18 local authorities that reported a shortfall identified groups of people specifically affected. This is higher than in previous years. Table 14 shows the number of authorities reporting shortfalls for specific groups of people who use services, including a breakdown of the other groups reported. As in all three previous years, adults with incapacity (AWI) is the most commonly reported area experiencing a shortfall which is possibly related to the levels of demand around AWI. 17

Table 14: Staffing shortfalls for specific groups of using services 2014-2017 Number of authorities reporting one or more specific shortfalls Shortfall areas: Number of local authorities 2014 2015 2016 2017 12 15 15 18 Adults with Incapacity (AWI) 7 11 11 14 Children and young people's services (<18) 6 9 8 6 Older people's services (65+) 6 8 6 8 Learning disability 4 8 9 8 Mentally disordered offenders (MDO) 1 6 8 4 Adult mental health (18-64) 4 4 5 8 Other client groups 4 5 3 3 Total shortfalls reported 32 51 50 51 18

5 MHOs as proportion of local authority social work workforce 5.1 MHOs in the context of the social worker workforce By definition, practising MHOs must be qualified social workers, this means they must also be registered with the SSSC to practise as a social worker. This section looks at MHOs as a subset of all practising social workers in individual local authorities which is the population they are mainly drawn from. Table 15: The proportion of practising social workers who are MHOs 2017 Social workers (SW) who Total number of SWs 1 % SWs that are MHOs Local authority are MHOs Aberdeen City 41 263 15.6 Aberdeenshire 9 236 3.8 Angus 8 87 9.2 Argyll and Bute 12 95 12.6 Clackmannanshire 4 61 6.6 Dumfries and Galloway 16 158 10.1 Dundee City 13 213 6.1 East Ayrshire 23 188 12.2 East Dunbartonshire 12 101 11.9 East Lothian 11 113 9.7 East Renfrewshire 11 83 13.3 Edinburgh, City of 79 628 12.6 Falkirk 13 155 8.4 Fife 41 397 10.3 Glasgow City 74 763 9.7 Highland 2 23 117 19.7 Inverclyde 11 116 9.5 Midlothian 10 93 10.8 Moray 15 137 10.9 Na h-eileanan Siar 3 17 17.6 North Ayrshire 19 181 10.5 North Lanarkshire 35 337 10.3 Orkney Islands 3 26 11.5 Perth and Kinross 12 125 9.6 Renfrewshire 18 255 7.1 Scottish Borders 16 135 11.9 Shetland Islands 6 31 19.4 19

South Ayrshire 8 116 6.9 South Lanarkshire 29 321 9.0 Stirling 8 75 10.7 West Dunbartonshire 16 129 12.4 West Lothian 20 176 11.4 Scotland 619 5928 10.4 1 From Scottish Social Service Sector: Report on 2017 Workforce Data (published 29.8.18) 2 In 2012 Highland Council s adult social workers transferred to NHS Highland. The reduced overall pool of social workers gives Highland Council a relatively high proportion of social workers who are MHOs. In the interests of comparing like with like, the proportions in Table 15 show MHOs who are social workers as a subset of the total number of local authority social workers. MHOs who are not working as social workers (for example team leaders, team managers, care managers etc) are excluded from the data in Table 15 (column 2). MHOs who hold social worker posts were identified using the post type data item in the LASWS survey data set. We know already from Table 1 that the number of filled MHO posts across Scotland increased by 3.2% between 2016 and 2017. In comparison the recently published report on the Scottish social service workforce found that the number of local authority social workers increased by 1.2% in the same period. In 2017 across Scotland 10.5% of practising social workers are MHOs, which was almost the same as 2016 (10.4%). Among the local authorities, the proportion of practising social workers who are MHOs ranged between 4% and 20% (it was 0% and 18% in 2016). 20

6 MHOs in mental health and non-mental health teams 6.1 Definitions The MHO workforce is employed in teams which specialise in various areas of mental health as well as in non-mental health teams which specialise in other areas of social work. This section of the report looks in more detail at the distribution of Scotland s MHOs among these teams. Mental health teams (MHT) provide mental health services, for example old age psychiatry or community mental health. Non-mental health teams (NMHT) provide services whose primary focus is not mental health. Although such teams are non-specialist in terms of mental health, they will specialise in other areas of social work, for example criminal justice social work or social work with children and families. 6.2 Overview Table 16 shows most active MHO posts continue to be positioned in mental health teams (59%) rather than non-mental health teams (41%). Table 1 shows there is growth in the MHO workforce for both MHTs and NMHTs. Table 16: Filled MHO posts and percentage (%) in mental and nonmental health teams 2013-2017 2013 2014 2015 2016 2017 Mental health 378 353 381 427 438 Non-mental health 296 302 306 296 306 % mental health 56.1 53.9 55.5 59.1 58.9 % non-mental health 43.9 46.1 44.5 40.9 41.1 Total 674 655 687 1 723 2 744 3 1 The sum of the members of the two team types in 2015 is 687, two more than the total of practising MHOs. This is because Aberdeen City Council had two MHOs who worked 50/50 across the team types and are included in both figures. 2 The sum of the members of the two team types in 2016 is 723, one more than the total of practising MHOs. This is because Aberdeen City Council had one MHO who worked 50/50 across a community mental health team and a forensic team and is included twice in the mental health total. 3 Information on the type of team one MHO worked in was not available. 21

6.3 MHOs in mental health teams This section focuses on MHOs working in mental health teams only. It examines the proportions of such MHOs working in different teams as well as the amount of time it is estimated that they are engaged in actual MHO work. Table 17 shows that multidisciplinary community mental health teams have the largest share of the MHT-based MHOs. However, it should be noted that their share fell by five percentage points to under 40% for the first time. Less than a third of MHOs in MHTs belonged to dedicated MHO teams (this is the same as last year) and just under a fifth in specialist social work mental health teams. Table 17: Estimated percentage (%) of filled MHO mental health team posts by team type 2013-2017 2013 2014 2015 2016 2017 Dedicated MHO teams 1 0.0 0.0 0.0 29.5 29.5 Community mental health (multidisciplinary) Specialist social work mental health teams 46.8 44.2 49.3 43.6 38.8 33.6 36.5 26.8 18.0 18.9 Old age psychiatry/dementia teams 2.1 2.0 2.4 1.2 1.8 Managerial across several teams 3.7 3.7 4.5 2.1 4.3 Other mental health teams 2 13.8 13.6 17.1 5.6 6.6 Total 100.0 100.0 100.0 100.0 100.0 1 Dedicated MHO teams were a new category in 2016; separate data for previous years for this category is not available. 2 Includes child and adolescent mental health teams and forensic teams, aggregated to hide small numbers. Table 18 provides data on the estimated average number of hours per week individual MHOs spend on MHO work in mental health teams. It is estimated they spent just under 23 hours a week, a slight fall from 24 hours in 2016. As might be expected an MHO in a dedicated MHO team was estimated on average to spend the most hours a week on MHO work (32), while an MHO managing staff across several MHTs had the lowest (just under 11 hours). 22

Table 18: Estimated average weekly hours MHOs in mental health teams spend on MHO work by team type 2016 and 2017 2016 2017 1 Dedicated MHO teams 30.9 31.7 Community mental health (multidisciplinary) 24.1 20.7 Specialist social work mental health teams 17.8 19.1 Old age psychiatry/dementia teams 8.3 15.0 Managerial across several teams 14.3 10.9 Other mental health teams 2 16.7 18.1 Overall average hours per MHO 24.2 22.8 1 One authority was unable to provide an estimate of average weekly hours. 2 Includes child and adolescent mental health teams and forensic teams to hide small numbers. Table 19 shows the percentage by team type of total hours spent on MHO work by MHOs in MHTs in 2016 and 2017. Unlike 2016, the team type which accounts for the largest proportion of total hours on MHO work in MHTs is dedicated MHO teams with a 39% share of the total. Multi-disciplinary community mental health teams saw a fall in their share of hours from 43% to 36%, which is likely related to the fall in share of MHOs these teams had (see Table 17). Old age psychiatry/ dementia teams continue to make up the smallest proportion of total hours (1%). Table 19: Estimated percentage share (%) of hours spent on MHO work by MHOs in mental health teams by team type 2016 and 2017 2016 2017 Dedicated MHO teams 37.7 39.1 Community mental health (multidisciplinary) Specialist social work mental health teams Old age psychiatry/dementia teams Managerial across several teams 43.4 36.0 13.3 16.5 0.4 1.2 1.2 1.8 Other mental health teams 3.9 5.4 Total 100.0 100.0 23

Table 20 shows the estimated proportions of total contracted hours that MHOs in mental health teams spend on MHO work. Overall, practising MHOs in mental health teams across Scotland were estimated to spend almost 70% of their contracted hours on MHO work in 2017. This is a fall in comparison with the estimate for 2016. Table 20: Estimated percentage (%) of contracted hours spent on MHO work by MHOs in mental health teams 2016 and 2017 2016 2017 Dedicated MHO teams 94.8 96.9 Community mental health (multidisciplinary) 71.0 61.2 Specialist social work mental health teams 56.8 59.6 Old age psychiatry/dementia teams 24.1 47.4 Managerial across several teams 40.4 31.3 Other mental health teams 54.7 58.5 All mental health teams 73.4 69.3 6.4 MHOs in non-mental health teams In this section we focus on those MHOs employed in non-mental health teams. These are teams whose primary concern is not mental health but other areas of social work such as children s services or criminal justice. We know from Table 16 that there are just over 300 MHOs in NMHTs and from the earlier discussion in part 2 that just 10 of them are exclusive MHOs. Table 21 shows that community care teams remain the largest settings of MHOs working in NMHTs with just under a third of the total. However, their share has fallen to its lowest level seen in the reporting period (2013-2017). There was also a further increase in the proportion of NMHT MHOs based in emergency outof-hours teams to over a quarter (26%), almost doubling since 2013. 70% of MHOs in an NMHT are based in either community care, out of hours or learning disability teams. 24

Table 21: Percentage (%) of filled MHO posts by non-mental health teams 2013-2017 2013 2014 2015 2016 2017 Generic 1.0 1.0 0.7 0.7 1.6 Community care 36.8 37.7 34.6 38.5 32.7 Learning disability 15.2 13.6 12.7 10.8 11.1 Criminal justice 7.8 8.3 8.5 8.4 8.2 Children and family 6.8 6.6 5.6 6.4 3.9 Emergency (out-of-hours) 13.9 13.9 21.2 23.0 26.1 Managerial across several teams 7.8 12.9 9.8 4.4 8.5 Other non-mental health teams 1 10.8 6.0 6.9 7.8 7.8 Total 100.0 100.0 100.0 100.0 100.0 1 Includes intake teams and physical and sensory disability teams to hide small numbers. As with those working in MHTs (table 18) there was a slight fall from 2016 in the estimated average hours spent on MHO work in NMHTs. Comparisons across the years should be made cautiously, however, as before 2016 the number of local authorities providing estimates was much lower. However, we can say in broad terms that over the reporting period a member of a learning disability team has worked the most hours per week as an MHO (9-13 hours), closely followed by a member of a community care team (8-12 hours). Those in a generic team have worked the fewest hours as an MHO per week (2-3 hours). The value of 8.7 for 2015 should be treated cautiously in view of the incompleteness of that year s data. Table 22 indicates that on average MHOs in learning disability teams spend more of their time on MHO work than MHOs in any of the other NMHTs. However, we also know from Table 21 that learning disability teams have only 11% of all MHOs working in non-mental health teams and that their share has fallen in recent years. 25

Table 22: Estimated average weekly hours each MHO spent on MHO work by type of non-mental health team 2013-2017 2013 2014 2015 2016 2017 Generic 2.0 3.2 8.7 2.3 3.0 Community care 9.4 11.6 8.4 8.5 8.0 Learning disability 10.4 12.7 11.9 9.4 9.8 Criminal justice 5.9 3.4 4.0 6.0 4.5 Children and family 2.9 2.3 7.3 5.4 5.1 Emergency (out-of-hours) 9.5 4.4 3.2 5.4 4.9 Managerial across several teams 2.7 5.3 6.8 6.2 4.1 Other non-mental health teams 2 4.2 5.1 4.7 4.4 7.3 Overall average hours per MHO 7.7 8.2 6.4 7.0 6.6 Based on figures from 24 authorities in 2012, 22 in 2013, 26 in 2014, 16 in 2015, 32 in 2016 and 31 in 2017. 1 Includes intake teams to hide small numbers. Table 23 provides us with a better indication of the share of MHO work undertaken by different types of NMHTs. It shows the percentage share by team type of the estimated total hours spent on MHO work by members of such teams. As expected, the teams spending the most time on MHO work are those with the most MHOs, namely community care, emergency (out of hours) and learning disability teams. Between them they worked 77% of the estimated hours with 70% of all MHOs in NMHTs (Table 21). The teams with the fewest MHOs, the generic teams, spent the least time on such work but data was only provided for 40% of such MHOs. Emergency out-of-hours teams accounted for one fifth, their highest proportion in the reporting period which seems to be at least partly a reflection in the growth of MHOs in such teams (Table 21). 26

Table 23: Estimated percentage share (%)of hours spent on MHO work by MHOs in non-mental health teams by team type 2013-2017 % 2013 2014 2015 2016 2017 Generic 0.3 0.4 0.7 0.2 0.3 Community care 45.7 55.6 38.4 46.9 40.9 Learning disability 20.9 20.4 23.7 14.5 16.1 Criminal justice 5.6 3.6 4.6 7.3 5.6 Children and family 2.5 2.1 6.7 4.9 3.2 Emergency (out-of-hours) 16.1 6.2 14.7 17.7 20.3 Managerial across several teams 2.2 7.9 8.5 3.6 5.0 Other non-mental health teams 6.6 3.7 2.7 4.9 8.7 Total 100.0 100.0 100.0 100.0 100.0 The proportion of total contracted hours that members of non-mental health teams spend on MHO work are set out in Table 24 below. Just over one-fifth of their contracted hours were estimated to be spent on MHO work. This is in line with what we would expect given that only 3% of such staff are exclusive MHOs and that NMHTs by definition don t specialise in mental health social work. The highest proportion is 30% for MHOs in emergency out-of-hours teams although this is down from 40% of their time in 2016 which appears to reflect the increase in MHOs in such teams (Table 21). Table 24: Estimated percentage (%) of contracted hours spent on MHO work by non-mental health teams - 2016 % 2016 2017 Generic 6.3 4.9 Community care 25.4 23.7 Learning disability 29.0 28.4 Criminal justice 16.9 12.0 Children and family 15.5 15.6 Emergency (out-of-hours) 39.8 30.0 Managerial across several teams 16.8 10.9 Other non-mental health teams 13.1 22.3 All non-mental health teams 24.0 22.0 27

7 Conclusion This year s report saw an increase in the overall number of MHO posts to the highest figure (745) since records began in 2005. This increase was reflected in similar increases in the numbers employed in mental health and non-mental health teams. There also appears to have been a shift in the employment of exclusive MHOs that reflects a refocusing of resources in those teams specialising in mental health. Improvements in retention and availability of MHOs were seen with drops in the number of vacancies for exclusive MHOs, unavailable MHOs and in the numbers leaving the workforce. There is an increase of MHOs under 40 and over 60 years old and a slight fall in trainees who successfully completed MHO training (from 62 to 60 in 2016/17). The number of local authorities reporting shortfalls in MHOs has increased, with 22 identifying a problem in 2017. There was also an increase in the average shortfall across those local authorities of an estimated 67 hours per local authority per week. This corresponds to a shortfall of approximately 41 whole time equivalent exclusive MHO posts. The number of admissions to MHO training courses in 2017 fell below the average of recent years and indicates that we can expect fewer trainees to complete successfully in 2018 than the recent average. The reasons for the increase in estimated shortfall are not immediately clear but are likely to be related at least in part to the decrease in the estimated average hours MHOs spent on MHO work. It is estimated that there was a decrease from 17 hours per week to 16 with both MHTs and NMHTs seeing reductions in estimated hours spent on MHO work of around 6%. It is also possible that the shortfall may reflect rises in demand for MHOs. 28

Appendix A Definitions An MHO is someone who: is a qualified social worker and has successfully completed an approved MHO training course and is employed by a Scottish local authority. The role of MHOs was originally set out in the Mental Health (Scotland) Act 1984. However, the most recent relevant legislation governing their role today is the: Adults with Incapacity (Scotland) Act 2000 Mental Health (Care and Treatment) (Scotland) Act 2003 Adult Support and Protection (Scotland) Act 2007. The Mental Health (Care and Treatment) (Scotland) Act 2003 sets out the requirement on local authorities to appoint a sufficient number of persons to carry out the MHO role. An MHO: can either work as part of a specialist mental health team or be integrated into a specialist team whose primary focus is not mental health (nonmental health team) is responsible for making decisions about compulsory admissions to hospital for people who are thought to pose a risk to themselves or others. A practising MHO is defined as someone who meets the three criteria identified above and who has been using mental health legislation directly in relation to working with people who use services, or potentially using this legislation directly in relation to them (for example serving on rotas), in the 12 months before the survey census date. An exclusive MHO position is defined as one where the job contract specifies that the individual is appointed to primarily carry out statutory MHO work. Filled MHO posts is a count of the contracted posts filled by qualified social workers practising as MHOs. This is in line with the LASWS data collection of which the MHO data collection forms part. In most authorities practising MHOs hold only one contracted post, so the count of filled posts is the same as the count of people. However, in two local authorities some MHOs hold two or even three separately contracted posts for MHO work, so the number of filled posts is greater than the number of people. As with previous reports, data analysis in this report uses counts of filled MHO posts, not headcount. However, differences between filled MHO posts and headcount are indicated where necessary throughout the report. 29

Whole Time Equivalent (WTE) is defined as an individual s total contracted weekly working hours expressed as a proportion of their authority s standard weekly working hours. The standard working weekly hours of the majority of local authorities fall between 35 and 37 hours per week. So a full time contract has a WTE of 1.00 and someone who works half-time has a WTE of 0.50. This calculation uses all the working hours the staff member is contracted to work for the local authority, not just those hours spent on MHO work. Hours per week spent on MHO work are the estimated hours that a practising MHO spends on average each week on duties governed by the relevant legislation. As this is estimated data which has to allow for the fluctuations that occur in MHO workloads, readers should treat it as an approximation of the resources spent on MHO work rather than a definitive measure. 30

Appendix B Background notes 1. National Statistics status The UK Statistics Authority has designated these statistics as National Statistics in accordance with the Statistics and Registration Service Act 2007 and indicates their compliance with the Code of Practice for Official Statistics. Broadly speaking this means that the statistics: meet identified user needs are well explained and readily accessible are produced according to sound methods are managed impartially and objectively in the public interest. Once statistics are designated as National Statistics, it is a statutory requirement that we continue to observe the Code of Practice. 2. Previous MHO publications The 2007-2008 survey results (produced by the Scottish Government) were published in issue 19 of the Mental Health Officers in Scotland newsletter in the winter of 2008-2009. The newsletter section containing the 2007-2008 survey results is on the SSSC s workforce data site at: http://data.sssc.uk.com/images/mho/mhoreport0708.pdf The reports from 2008-2009 to 2011-2012 (produced by the Scottish Government) are online at: http://www.gov.scot/topics/statistics/browse/health/data/mhofficers The reports from December 2012 onwards (produced by the SSSC) are on the SSSC s Workforce Data website: http://data.sssc.uk.com/mho 3. Next MHO report It is our aim to publish the next MHO report in August 2019 with data collected in December 2018. 4. UK context The remit and nature of social work services has differed significantly across the four nations of the UK since at least the 1960s. The definition and role of the MHO in Scotland was broadly equivalent to an Approved Social Worker (ASW) in England and Wales, which was created under the Mental Health Act 1983. Like MHOs, ASWs had to be qualified social workers who had undergone approved 31

training and be employees of a local authority. However, in 2007 this role was replaced in England and Wales with the Approved Mental Health Professional (AMHP). To practise as an AMHP people still have to carry out approved training but they are no longer required to be qualified social workers or employees of a local authority. We are not currently aware of any publication on the numbers of AMHPs in England and Wales. In Northern Ireland social work services and NHS health boards were combined in the early 1970s. These combined services employ ASWs who require to be qualified social workers and to have undergone approved specialist training. Workforce data on ASWs in Northern Ireland is gathered annually and is available from the Department of Health, Social Services and Public Safety. 5. Respondent burden (cost of gathering and providing information) The UK Statistics Authority requires producers of National Statistics reports to calculate the costs to organisations of gathering and providing the information that is necessary to produce the report. To calculate the overall cost of responding to this survey, we asked each local authority to provide an estimate of the time taken in hours to extract the information and complete the survey. In 2017, 29 authorities provided this figure and the median time taken was 3.0 hours. A rate of 12.43 was applied, which is the mean hourly rate for Scotland: Administrative Occupations (excluding overtime) from the Annual Survey of Hours and Earnings (ASHE) 2017 provisional results (Table 3.6a). No additional costs (apart from staff time) were reported. Using these figures in the calculation below, the total cost of responding to this survey for Scotland s local authorities in 2017 is approximately 1,081. (number of responses Cost of X any additional costs Responding ( ) = median time it takes to respond in hours + experienced by data X provider hourly rate of typical respondent) 6. History of MHO report The survey data used in this report has been collected from local authorities in the form of a snapshot census every year since 2005. Up to and including the March 2012 census the Scottish Government carried out this work but after that responsibility for collecting the data and publishing the report passed to the SSSC. The Scottish Government obtained National Statistics status from the UK 32

Statistics Authority for their 2010/11 and 2011/12 MHO reports and the SSSC has maintained this. The Scottish Social Services Workforce Data Group (SSSWDG) supports the production of the MHO report by providing advice on the reporting and publication of the sector s workforce data. The SSSWDG has representatives from Scottish Government (including the Office of the Chief Social Work Adviser), the Care Inspectorate, the Convention of Scottish Local Authorities (COSLA), Social Work Scotland and care providers from the private and voluntary sectors. The SSSC also meets at least once a year with the staff in local authorities who supply the workforce data that underpins the MHO report. The survey has developed over time with new questions added when a need for further information is identified. Below is a timeline that shows the history of additions and changes to the content or timing of the MHO report. Year Data content additions/changes 2006 Exclusive MHO positions 2007 Age and gender Vacancies 2008 Ethnicity MHOs working with mentally disordered offenders (MDO) Average hours of MHO work per week for members of non-mental health specialist teams 2009 MHO leavers and reason for leaving 2010 No changes 2011 No changes 2012 Timing of survey changed from March to December to bring it into line with the data collected on the rest of the social service workforce 2013 Data provided at individual MHO level MHO work under adults with incapacity (AWI) legislation 2014 Number of temporary/cover MHOs Team setting of MHOs work with AWI Structured categories instead of free text for presenting people who use services group specific MHO shortfall information 2015 Temporary/cover MHOs who are agency MHOs 2016 MHO type, team membership and hours per week spent on MHO work for each practising MHO Team categories for exclusive MHOs brought into line with those used for mental health and non-mental health team members Rota duty, work with Adults with Incapacity (AWI) and work with mentally disordered offenders (MDOs) dropped from data collection and report. 33

Data collection methodology changed to derive more data from flagged MHO records and reduce direct entry numerical data 2017 No changes 7. Data sources a. Local authority social work services (LASWS) survey The information about the number of qualified MHOs who are practising in Scotland comes from administrative data held by Scottish local authorities which the SSSC captures as part of its LASWS survey. As this information is used to monitor and manage services locally, it is deemed to be robust and accurate. b. National Records of Scotland (NRS) population estimates The NRS mid-year population estimates are used to calculate the estimated weekly hours spent on MHO work per 10,000 population in appendices E and F to the report (pages 42 and 43). NRS is the non-ministerial department of the Scottish Government responsible for the registration of births, marriages, civil partnerships, deaths, divorces and adoptions. The population estimates are produced using the demographic cohort component method. Full details are available from: http://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-bytheme/population/population-estimates/mid-year-population-estimates 8. Data quality and use a. Survey strengths One key strength of the data underpinning the MHO report is that it comes from a census of local authority social work staff and is not based on a sample of the workforce, so avoiding problems such as sampling errors. As stated in the definition on page 29, the focus of the survey is staff practising as MHOs in a local authority during the year before the survey census date. To complete the survey, local authorities are expected to use existing staff records (ie administrative data) to provide them with the necessary information. There are a number of reasons why the SSSC believes this administrative data can be used with confidence. The role of the MHO is one which is well understood. In addition, to practise as a qualified social worker (and as an MHO), it is legally required that the individual be registered as a social worker with the SSSC and their application must be supported by their employer. This combined with the statutory duties that only MHOs carry out means the definition of a MHO is well understood by local authorities. It is also one for which they 34

need to be able to account to both the Care Inspectorate and the Mental Welfare Commission who also make use of the published MHO workforce data. The survey is long established, having been conducted by the Scottish Government from 2005 to 2012 and involving local authority representatives (usually from authorities mental health services) who they met with once or twice a year. The SSSC continues to meet with local authority representatives. In addition, as outlined in the survey methodology section below, we developed a standardised template which provides guidance as well as logic checks. The MHO workforce is not only well-defined but is also quite compact relative to the size of other staff groups in the sector. In December 2017, numbers of MHOs per local authority ranged from five to 84 and the 745 total practising MHOs in Scotland constitute almost 13% of the total number of practising social workers in local authorities (please note this is a rough approximation because the MHO total includes workers in team leader/manager roles as well as in practising social worker roles). In response to the UK Statistics Authority s (UKSA) quality assurance of administrative data (QAAD) requirements, the SSSC carried out an investigation into the quality of the LASWS workforce data of which the MHO data forms part in 2017. Analysis of the results indicated that Scotland s local authorities have a robust and wide-ranging set of checks in place in the key quality areas of completeness and accuracy of source data and correct staff coverage by the data extracted from it for the LASWS return. Furthermore, close to 90% of responding authorities were either fully confident or very confident of their conversancy with LASWS data recording rules. These findings give us confidence in the quality of the submitted data and in the ensuing published statistics. One important issue in relation to the use of administrative data is the extent to which it may be open to misrepresentation as a result of organisations concern with evidencing key performance indicators. This is not thought to be a significant risk with the MHO statistics. There are currently few national outcome measures for mental health services and the four mental health HEAT performance targets (health improvement, efficiency, access to services and treatment) cannot be easily applied to social work services, such as the work of MHOs. There are no national key performance indicators for the provision of an MHO service or for the numbers of MHOs to be employed. For these reasons, the SSSC has confidence in the quality of the data provided by local authorities on practising MHOs. The quality assurance approach adopted by the SSSC is one which emphasises common sense and logic checks which is 35

the same approach as that used by the Scottish Government when they carried out the survey. b. Survey weaknesses While the MHO workforce is well-defined, determining the precise number of people and filled posts for workers who were practising on the census date and/or practised during the year leading up to the census date can be problematic. An authority s core MHO headcount is easy to quantify. However, because of the snapshot nature of the survey it can be a challenge for authorities to make sure they include all relevant cover workers in their annual data return. A varying number of additional cover MHOs can become eligible for inclusion in the practising workforce during the year as and when their services are required, for example to help out with heavy workloads or to cover sick leave (see section 2.2 on page 7). These additional workers should be included in the headcount and count of filled posts whether or not they were working on the census date. They should also be included in future survey data provided that: they re available to work as an MHO on the census date and they satisfy the minimum annual practice requirements set out in paragraph 5 of The Mental Health (Care and Treatment) (Scotland) Act 2003 (Requirements for continuing appointment as mental health officers) Direction 2006. The inclusion of these additional workers can have the effect of increasing the size of the MHO workforce more than can be explained by the yearly numbers of people qualifying from Scotland s MHO Award Programmes. Data on those leaving the MHO role can also be compromised by the difficulty of identifying if a cover MHO has genuinely left the MHO workforce or simply stopped providing MHO services until the next time they are required. Another issue has been in relation to the data available on the age, gender and ethnicity of the workforce. Response rates for these data items varied considerably up to December 2012, making meaningful analysis of the data problematic. From 2013, data on age and gender has been 100% complete thanks to the merging of the MHO and LASWS surveys, although unfortunately we continue to see large proportions of not known/not disclosed ethnicity data. Finally, the data on average hours per week spent on MHO work is based on estimations made by MHO service managers which have to allow for the fluctuations that occur in MHO workloads. Readers should treat this new data as an approximation of the resources spent on MHO work rather than a definitive measure. 36

9. Survey methodology a. Background In 2012 the timing of the MHO survey moved from March to early December to bring it into line with the two main workforce data gathering systems in the sector: the survey of LASWS staff the Care Inspectorate s annual returns from all registered care services. Between them these two data collections cover around 200,000 people working in the social service sector in Scotland. Conducting the MHO survey at the same time as these collections means that we can meaningfully compare the MHO data with the data on the rest of the sector. We saw the benefits of bringing the MHO survey into line with these major data gathering exercises and creating continuities with them as greater than the costs in terms of the discontinuities with previous MHO surveys. This means the MHO data from December 2012 onwards is not directly comparable with that of previous MHO reports, but it is comparable with the corresponding annual LASWS census data. b. December 2017 data collection methodology The MHO data template is part of the LASWS survey return which gathers data at an individual staff member level. A flag is used to identify MHO records in each authority s LASWS data for current staff and leavers (and MHO posts in the LASWS data for vacancies). All flagged current staff records are pulled through to a separate MHO template where the age, gender, ethnicity and unavailable MHOs sections autocomplete. Data on MHO type, team membership and hours per week spent on MHO work is entered for each MHO record and a summary table of this data autocompletes while this is done. Other data on leavers, vacancies and shortfalls is entered directly into the MHO template in numerical form. The flagged MHO records in the LASWS leavers and vacancies data form useful cross-checks with the numerical data entered into those sections of the MHO template. The template also contains a set of logic checks which highlight basic inputting errors that the data providers can then correct before submission. For the December 2017 census, local authorities were asked to return their submissions by early March 2018. The SSSC data researcher makes an initial manual check of submissions. This includes checking that the records from the LASWS templates have transferred correctly to the appropriate section of the MHO template. There are built-in checks to ensure the internal consistency of the data provided by each local authority and identify inconsistencies between responses. We also carry out contextual checks on the data including comparison with responses in previous 37

years from individual authorities and comparison between authorities of headcount numbers of MHOs. We raise problems identified in the data checking and cleaning process with individual authorities to make sure we get the correct data. Once all the local authority data has been cleaned, we import the finalised templates into a macro-enabled input file where all the graphs and charts for the report are automatically created. For the WTE rates per population, we update the mid-year population estimates annually from the National Records of Scotland website. For information, the 2017 MHO data collection template (which formed part of the 2017 LASWS survey return) is available on the SSSC s Workforce Data website at: http://data.sssc.uk.com 38

Appendix C Understanding the statistics in this report a. All staffing grades are included as long as they relate to practising MHOs. These grades include main grade social workers, senior social workers and team leaders or managers. b. Whole Time Equivalent (WTE) is the number of whole-time staff (those working a full standard working week) plus the aggregated proportions of a full standard working week worked by part time staff. All the working hours that the staff member does for the authority are included in this calculation, not just those hours spent on MHO work. The standard working weekly hours of the majority of local authorities fall between 35 and 37 hours per week. This can have the effect of WTE figures being slightly higher in local authorities which have a shorter full standard working week. For example, a person who works 15 hours a week in an authority with a full standard working week of 35 hours will have a WTE of 15 35 = 0.43, whereas a person who works the same weekly hours in an authority with a full standard working week of 37 hours will have a WTE of 15 37 = 0.41. c. Data presentation conventions: numbers of filled MHO posts and headcounts are presented as integers (whole numbers). Percentages are presented to one decimal place. Other statistics are presented to a level of detail appropriate for the item being measured. d. The rounding convention used for the data in this report is the round half up convention (for example 1.44 would be rounded down to 1.4 to one decimal place and 1.45 would be rounded up to 1.5). Some column totals in the tables in this document may not exactly equal the sum of their component parts due to the effects of rounding. For example, the percentages shown in the tables have been rounded to one decimal place, which means that they may not always add up to exactly 100%. e. Estimated hours of MHO work per 10,000 people. These statistics provide standardised measures for the estimated hours spent on MHO work in relation to the population served by those MHOs. At local authority level and Health Board level (appendices E and F, pages 42-43), comparisons can be made between authorities as the standardised population denominator creates a level playing field for that purpose. Please note that the population denominator is set at 10,000 simply to produce ratios of a magnitude suitable for analysis. 39

Appendix D Glossary Term Exclusive MHOs Unavailable MHOs Across all sectors Filled MHO posts MHO headcount Whole Time Equivalent (WTE) Hours per week spent on MHO work Meaning Exclusive MHOs are those whose contract specifies that they primarily carry out statutory MHO work. An MHO is classed as unavailable when they are on maternity leave, paternity leave, adoption leave, a career break, on long term sick leave or compassionate leave, for a period of three months or more. Involved in all aspects of MHO work and in work across all service delivery areas. The number of contracted MHO-related posts filled by practising MHOs. An MHO may have more than one contracted MHO-related post, so the count of filled MHO posts may exceed the MHO headcount. Count of people who are practising MHOs. An MHO s total contracted weekly working hours expressed as a proportion of the authority s standard weekly working hours. An estimation of the average hours that a practising MHO spends each week on duties governed by the relevant legislation. 40

Data appendices E to G These appendices provide summarised key data and local authority-level detail for some of the all Scotland data and statistics in the main body of the report. We have provided some commentary below to help readers understanding and interpretation of them. Appendix E filled MHO posts, hours on MHO work and hours on MHO work per 10,000 population by local authority 2017 As explained in Appendix C (part e), we have created a standardised measure so we can compare between authorities. The table on page 42 shows total weekly hours on MHO work for each authority (an aggregation of the estimated weekly hours spent by all the authority s MHOs). In the last column that data is converted into the standardised measure of weekly hours on MHO work per unit of population. In last year s report that was set per 100,000 people but following comments from users we have changed this to per 10,000. Appendix F filled MHO posts, hours on MHO work and hours on MHO work per 10,000 population by Health Board area 2017 This is the same as Appendix E but looks at Health Board area not local authority. Appendix G Appendix H MHOs by local authority and HSCP status This sets out the numbers of MHOs in each authority and the number and percentage based in their local HSCP. 41

Appendix E filled MHO posts, hours on MHO work and hours on MHO work per 10,000 population by local authority - 2017 Local authority Number of MHOs Weekly hours spent on MHO work Weekly hours spent on MHO work per 10,000 population Aberdeen City 44 560 24.5 Aberdeenshire 36 515 19.7 Angus 14 273 23.4 Argyll and Bute 12 285 32.8 Clackmannanshire 6 149 29.0 Dumfries and Galloway 17 557 37.4 Dundee City 18 281 18.9 East Ayrshire 25 401 32.9 East Dunbartonshire 13 224 20.7 East Lothian 12 221 21.1 East Renfrewshire 12 237 25.0 Edinburgh, City of 84 1,065 20.8 Falkirk 15 231 14.4 Fife 48 614 16.5 Glasgow City 84 1,371 22.1 Highland 26 663 28.2 Inverclyde 11 151 19.1 Midlothian 10 338 37.6 Moray 17 101 10.5 Na h-eileanan Siar 5 7 2.6 North Ayrshire 24 187 13.8 North Lanarkshire 40 615 18.1 Orkney Islands 5 55 25.0 Perth and Kinross 19 383 25.3 Renfrewshire 1 NA NK NK Scottish Borders 19 231 20.1 Shetland Islands 6 51 22.1 South Ayrshire 14 140 12.4 South Lanarkshire 37 897 28.2 Stirling 10 223 23.7 West Dunbartonshire 17 254 28.3 West Lothian 20 306 16.9 Scotland 720 11,586 21.4 Source of population data: National Records of Scotland mid-year population estimates 2017 1. Data on estimated weekly hours was not supplied. 42

Appendix F - filled MHO posts, hours on MHO work and hours on MHO work per 10,000 population by Health Board area 2017 Weekly hours spent on MHO work Weekly hours spent on MHO work per 10,000 population Number of Health Board MHOs Ayrshire and Arran 63 728 19.7 Borders 19 231 20.1 Dumfries and Galloway 17 558 37.4 Fife 48 614 16.5 Forth Valley 31 596 19.5 Grampian 97 1,175 20.0 Greater Glasgow and Clyde 137 1 2,236 22.5 2 Highland 38 948 29.4 Lanarkshire 77 1,511 23.0 Lothian 126 1,930 21.7 Orkney 5 55 25.0 Shetland 6 51 22.1 Tayside 51 936 22.5 Western Isles 5 7 2.6 Scotland 720 11,586 21.4 Source of population data: National Records of Scotland mid-year population estimates 2017 1. The 25 MHOs from Renfrewshire were excluded from this table as no data was supplied on the estimated hours worked by them. 2. This is based on the population with the Health Board except those living in Renfrewshire (see note 1 above). 43

Appendix G HSCP status of MHOs by local authority Local authority Number of MHOs Number of MHOs in HSCP Percentage of MHOs in HSCP Aberdeen City 44 44 100.0 Aberdeenshire 36 36 100.0 Angus 14 14 100.0 Argyll and Bute 12 12 100.0 Clackmannanshire 6 6 100.0 Dumfries and Galloway 17 17 100.0 Dundee City 18 17 94.4 East Ayrshire 25 25 100.0 East Dunbartonshire 13 13 100.0 East Lothian 12 12 100.0 East Renfrewshire 12 12 100.0 Edinburgh, City of 84 76 90.5 Falkirk 15 13 86.7 Fife 48 38 79.2 Glasgow City 84 84 100.0 Highland 1 NA NA NA Inverclyde 11 11 100. Midlothian 10 10 100.0% Moray 17 13 76.5 Na h-eileanan Siar 5 5 100.0 North Ayrshire 24 24 100.0 North Lanarkshire 40 40 100.0 Orkney Islands 2 5 5 100.0 Perth and Kinross 19 18 94.7 Renfrewshire 25 24 96.0 Scottish Borders 19 17 89.5 Shetland Islands 6 6 100.0 South Ayrshire 14 14 100.0 South Lanarkshire 37 37 100.0 Stirling 10 10 100.0 West Dunbartonshire 17 17 100.0 West Lothian 20 20 100.0 Scotland 719 690 96.0 1. Not applicable as the integration of Highland s local authority social work services and NHS Highland did not follow the HSCP model. 2. Not known as no data provided by Orkney on HSCP status of MHO staff. 44

This report is a National Statistics publication from the SSSC. The report and previous editions are on the SSSC Workforce Data website at: http://data.sssc.uk.com/mho If you have any enquiries about the report please contact: Zara Gall Workforce Intelligence Team Scottish Social Services Council Compass House, 11 Riverside Drive, Dundee DD1 4NY Tel: 01382 207135 Fax: 01382 207215 Email: zara.gall@sssc.uk.com If you have general enquiries about the SSSC s workforce intelligence publications please contact: Mike Docherty Workforce Intelligence Manager Scottish Social Services Council Compass House, 11 Riverside Drive, Dundee DD1 4NY Tel: 01382 207266 Fax: 01382 207215 Email: mike.docherty@sssc.uk.com All the SSSC s workforce data, information and intelligence have been brought together in one easily accessible data website which includes our workforce data publications, data by area and functionality to explore the data: http://data.sssc.uk.com If you would like to hear about new or existing statistical collections or upcoming statistical publications, please register your interest on the Scottish Government Scotstat website: http://www.gov.scot/topics/statistics/scotstat This report was published on 31 August 2018. 45

Scottish Social Services Council Compass House 11 Riverside Drive Dundee DD1 4NY Telephone: 0345 60 30 891 Fax: 01382 207215 Email: enquiries@sssc.uk.com www.sssc.uk.com If you would like to request this document in another format please contact the SSSC on 0345 60 30 891. Scottish Social Services Council 2018 46