Foreword

The public need to know whether psychological professionals are appropriately qualified and competent to do their job. This guidance helps by defining clear registration requirements for the use of each of the psychological professions titles within the NHS in England.

The guidance has been developed in consultation with psychological professions registering and professional bodies, the Health and Care Professions Council (HCPC), the Professional Standards Authority (PSA) and the Department of Health and Social Care (DHSC).

In the words of one of our lived experience advisors:

“There are so many titles in the NHS, so it is very confusing and difficult for service users to understand the qualifications and skills of their practitioner. It gives me confidence if I can look up a practitioner on a register…. This is particularly important in the psychological professions because many of the titles are not legally protected, so without further guidance could be used by people with no formal training at all.”

Dr Adrian Whittington, National Clinical Lead for Psychological Professions, NHS England

Introduction

Purpose

The guidance outlines the registration requirements needed to use specific psychological professions titles in the NHS in England. It should be consistently adopted across all sectors of NHS commissioned healthcare in England by 31 March 2027.

Consistent use of psychological profession titles is important for public protection and clarity in NHS services. Inconsistent or unrecognised titles make it difficult for service users and employers to determine whether practitioners have the appropriate qualifications and registration. National guidance on permitted titles creates transparency, improves public trust, and ensures titles accurately reflect practitioners’ credentials.

This approach enhances public protection by requiring certain professions in NHS commissioned services to hold recognised registration—either with a professional healthcare regulator or on a register accredited by the Professional Standards Authority (PSA).

This is especially important as only a minority of the psychological professions workforce is required by law to be registered with a professional healthcare regulator.

Who should implement this guidance?

This guidance is primarily for NHS employers and workforce planners.

It supports leaders in NHS commissioned services, including chief psychological professions officers, to define and align nationally the registration requirements in their services.

Employers are asked to implement the requirements into person specifications for jobs and to support those who have not achieved a recognised registration required for their role to do so urgently. This should be addressed in accordance with the employer’s local change management policy, with proper regard to employment law and in consultation with the employee and recognised trade unions locally.

Alignment with established guidance and standards

This guidance should be used alongside the NHS Employers ‘Professional registration and qualification checks standard’ guidance and the relevant implementation guidance and manuals for individual service pathways, which provide more detailed information on their practice requirements. This guidance does not supersede or replace NHS service pathway implementation guidance.

Some pathways have additional specific requirements in addition to those in this guidance, for example, the NHS Talking Therapies manual, Implementation guidance for psychological therapies for severe mental health problems, Implementation guidance for psychological therapies in perinatal mental health, and the Mental health support team manual.

The case for change

“Trust is so important to me when entering into a therapeutic alliance with any psychological professional, including reassurance that the person is qualified to support me in managing my mental health.” – Lived experience advisor

The psychological professions workforce is diverse and influential, working across a range of settings and populations, including mental health and physical health pathways. Within this context, there is a need for greater clarity and consistency of professional registration requirements to use psychological professions titles in the NHS.

NHS Employers sets out the requirement for employers to verify that suitable professional registration is in place for the specific role at recruitment.

There are clear conventions for registration or accreditation of most of the psychological professions in the NHS. However, there are some areas of ambiguity, which can result in lack of clarity for individuals seeking employment in the NHS and those seeking to recruit into the workforce.

To add to the complexity, some NHS services and pathways have specific requirements for additional competencies, registration, and accreditation for the delivery of certain psychological interventions and therapies.

Overview of register types

Statutory registers

Professionals in certain occupations are legally required to be on these registers, which are managed by professional healthcare regulators. For example, doctors of medicine are required by law to register with the General Medical Council (GMC), registered nurses with the Nursing and Midwifery Council (NMC) and occupational therapists with the Health and Care Professions Council (HCPC). These statutory registers ensure that the professionals on their registers are properly educated and qualified and maintain proficiency against the regulator’s standards. The PSA scrutinises and oversees the work of all 10 health and care regulators, including the HCPC.

Very few activities in the NHS are limited by law to regulated professionals, including prescribing, acting as an approved clinician within the Mental Health Act or leading a Care Quality Commission regulated service. Some employers also restrict other roles or activities to regulated professionals. Statutory registration may be conflated with the term “core profession,” but there is no universal definition of “core profession,” which is used differently in different contexts.

The HCPC regulates 15 health and care professions, including some psychological professions (practitioner psychologists and arts therapists). The professions regulated by the HCPC have one or more protected titles. Professionals must be registered with HCPC in a particular category to use them.

Accredited registers

An accredited register is a non-statutory register that is accredited by the PSA. PSA accreditation ensures that the register protects the public and meets the Standards for accredited registers.

The Accredited Registers offer employers a way to ensure that practitioners who are not regulated by law still meet high standards in education, skills and behaviour. A full list of Accredited Registers can be found on the PSA website via ‘Find a Register’.

Practitioners on accredited registers typically work in health and social care occupations that do not have to be regulated by law.

Where practitioners are registered on a PSA accredited register according to the requirements of this guidance, employers may be assured that this affords them an alternate path to transparency and public protection in relation to the psychological professions that do not have a professional healthcare regulator. Accredited registration can give employers the confidence and protection to open some roles and activities to this wider group of employees who are not on a statutory register.

Voluntary registers

These voluntary registers may or may not be accredited by the PSA, and there is no legal requirement to be on one. Voluntary registers without PSA accreditation do not have PSA oversight to ensure they are fit for the purpose of public protection.

NHS psychological professions taxonomy

The psychological professions are a diverse group whose work is informed by the disciplines of psychology and psychological therapy. There are 3 main professional groupings in the NHS in England: psychologists (including associate and assistant roles), psychological therapists, and psychological practitioners.

Psychologists:

• clinical psychologists
• counselling psychologists
• forensic psychologists
• health psychologists

Associate and assistant roles:

• clinical associate in psychology
• assistant psychologists

Psychological therapists:

• cognitive behavioural therapists
• counsellors
• child and adolescent psychotherapists
• adult psychotherapists
• family and systemic psychotherapists
• psychological therapists (other)
• art, drama, and music therapists (with allied health professional leadership)
• medical psychotherapists (with medical professional leadership)

Psychological practitioners:

• psychological wellbeing practitioner
• education mental health practitioner
• children’s wellbeing practitioner
• mental health and wellbeing practitioner
• youth intensive psychological wellbeing practitioner

Art, drama, and music therapists are allied health professionals and medical psychotherapists are psychiatrists, each formally represented by their own professional leadership group within NHS England. They are also included in the psychological professions taxonomy as professions that are part of the wider psychological professions workforce.

Registration requirements for use of psychological professions titles in NHS commissioned healthcare in England

Employers should ensure all relevant staff meet the following requirements for using specific psychological profession titles. These requirements apply to all 21 occupations in the current NHS psychological professions taxonomy for practice across all sectors of NHS commissioned healthcare in England.

Employers are responsible for managing the governance arrangements for these occupations and any others not included in this guidance. This guidance only applies the minimum registration requirements across settings to practice under the stated title. Additional training, registration, or accreditation may also be required to work in specific pathways or to deliver specific modalities of therapy.

It is important to ensure the registration requirements align with NHS service and pathway implementation guidance requirements (see the useful links section) for additional competencies, registration, or accreditation for the delivery of certain psychological interventions and therapies.

If further clarity is required, please consult the chief psychological professions officer or psychological professions lead within your provider organisation.

Psychologist grouping

Table 1. Required registration for a qualified psychological professional within the psychologist grouping of the taxonomy to use titles in the NHS in England

Table 2. Other titles associated with the psychologist group

Associates and assistants

Table 3. Required registration for a qualified psychological professional within the psychologist – associate and assistant grouping of the taxonomy [link] to use titles in the NHS in England

Table 4. Other titles associated with the psychologist – associate and assistant group

Psychological therapist grouping

Table 5. Required registration for a qualified psychological professional within the psychological therapist grouping of the taxonomy to use titles in the NHS in England

* A dedicated framework for counsellors, psychotherapists, and psychoanalysts working with children and young people would be beneficial; further work is required to support this development.

Table 6. Other titles associated with the psychological therapist grouping

* A dedicated framework for counsellors, psychotherapists, and psychoanalysts working with children and young people would be beneficial; further work is required to support this development.

Psychological practitioner grouping

Table 7. Required registration for a qualified psychological professional within the psychological practitioner grouping of the taxonomy to use titles in the NHS in England.

Table 8. Other occupations and titles associated with the psychological practitioner grouping

Supporting individuals to achieve recognised registration within NHS commissioned healthcare

Further work is required across the system, particularly by employers delivering NHS commissioned healthcare, to enable the consistent adoption of this guidance.

Where this means a change to contracts of employment or terms and conditions of service, appropriate consultation must be included to allow fair, transparent and timely implementation.

Transitional arrangements for staff without the recognised registration

Where staff lack the required registration for a title or role, the psychological professions professional lead for the service must establish transitional arrangements to ensure patient safety and transparency.

A robust, urgent plan should be developed with staff, in conjunction with advice from local human resources teams and staff representatives, to support required training or registration without delay.

For patient safety, it may be necessary to stop practitioners from practising alone, in a particular role or under a particular title until they are enrolled as trainees or have their full registration in place. This should be implemented unless advised that other transitional arrangements are safe by the chief psychological professions officer in the provider organisation.

Where new registers are launched, it is best practice for practitioners to apply for registration on the new register within 12 months.

Embedding requirements into job descriptions

Employers should develop their job descriptions, in consultation with staff and their representatives, to build alignment to this guidance, so that the full range of recognised registrations for specific roles and titles is embedded within these.

Appropriate recruitment processes should be put in place to check the registration of successful applicants.

Existing Agenda for Change National job profiles are not directly affected by this guidance and usual process should be followed for job matching and job evaluation. Panels should be mindful however that the changes in job descriptions caused by implementation of the guidance in this document may mean that national profiles need updating. In future, national job profiles may be developed that align more closely to this guidance.

Aligning registration to workforce data recording

The Electronic Staff Record (ESR) (or the equivalent record for NHS commissioned services that do not use ESR) allows for specific registrations to be added as requirements for roles, with notifications to managers if registration lapses.

The NHS has published National Workforce Data Set (NWD) guidance documents, which include the Psychological Professions Coding Manual and NHS Talking Therapies for anxiety and depression (formerly known as IAPT) Workforce Coding Manual. Systems and providers should accurately code psychological professions staff in line with the NWD coding guidance and record professional registrations accordingly.

Recording dual registrations

Where dual registration is required for a specific role, the primary professional registration and the second role-specific registration should be recorded on ESR.

Implementation

The implementation of this guidance will require collaborative action across systems, NHS commissioned employers, workforce planners, chief psychological professions officers, psychological professions professional leads and line managers. Support should also be provided by local human resources teams and staff representatives.

This guidance must be implemented in a manner that fully complies with the Equality Act 2010, ensuring that all actions, decisions, and processes are fair, inclusive, and do not result in discrimination on the basis of protected characteristics. Employers should actively consider equality and diversity throughout the application of this guidance and take steps to identify and mitigate any potential adverse impacts on individuals or groups. Reasonable adjustments or extensions to implementation timelines should be applied as necessary to support individuals who may be disadvantaged as a result of protected characteristics.

Please note, this document is guidance and does not place additional legal obligation for compliance on employers. Implementation should occur in accordance with the employer’s local change management policy, with proper regard to employment law, and in consultation with the employee and recognised trade unions locally.

The above actions should be undertaken by 31 March 2027. 

Useful links

Service pathway specific guidance

• Psychological therapies for severe mental health problems implementation guidance
  • Annex – Training implementation guidance, supporting guidance
• The NHS Talking Therapies for anxiety and depression manual
• Psychological Therapies for Perinatal Mental Health: Implementation guidance – Futures collaboration platform (log in required) National Perinatal Mental Health Workspace
• Mental Health Support Team Operating Manual – Futures collaboration platform Mental Health Support Teams (MHST) Community of Practice Workspace

Specific clinical governance guidance

• EMDR clinical governance guidance – Futures collaboration platform, NHS England National Adult and Older Adult Mental Health Programme

Electronic staff records guidance documents

• National Workforce Data Set (NWD) guidance documents
• Psychological professions coding manual
• NHS Talking Therapies for anxiety and depression (formerly known as IAPT) workforce coding manual

Other relevant links

• NHS Employers professional registration and qualification checks standard guidance
• NHS England workforce, training and education psychological professions
• Health careers psychological professions
• Psychological professions network

Annex A – NHS recognised registers for counsellors, psychotherapists and psychoanalysts, with alignment of registered titles to the SCoPEd Framework

Annex A should be used in conjunction with table 5 and table 6 of the NHS registration requirements for use of psychological professions titles.

Please ensure that reference is made to specific NHS services and pathway implementation guidance (where available) to identify the relevant level of competencies required for the role and alignment with the registered title. Pathway implementation guidance supersedes the generic guidance below.

The Scope of Practice and Education (SCoPEd) framework is a shared standards framework, developed by 6 Professional Standards Authority (PSA) accredited bodies that make up the Partnership of Counselling and Psychotherapy Bodies (PCPB), and represent approximately 75,000 counsellors and psychotherapists. Each professional body within the PCPB has a number of PSA registered titles, under which registered individuals may use additional titles recognised by the professional body. For example, psychodynamic psychotherapist, psychodynamic counsellor, child psychotherapist. Please visit the professional body websites for more information.

Table 1. NHS recognised registers for counsellors, psychotherapists and psychoanalysts and alignment of registered titles to SCoPEd framework.

Publication reference: PRN01856