England has fewer empty psychiatry posts, but over a quarter are still vacant or held by locums
- The Royal College of Psychiatrists census counted non-trainee psychiatrist posts in 40 of 48 NHS mental health trusts in England (83%) as at 31 March 2025. Of 5,193 consultant posts, 4,445 (86%) were filled.
- The consultant vacancy rate fell from 15.9% (821 posts) in 2023 to 14.4% (748 posts) in 2025. It was 10% in both 2019 and 2021; the College press release adds 6% in 2015.
- Locums filled 13% of consultant posts (669), the same proportion as in 2023. Counting vacant and locum-held posts together, the true vacancy rate was 27%, down from 29% in 2023 and above 21% in 2019 and 24% in 2021.
- Eating disorders psychiatry had the highest vacancy rate (20%) and true vacancy rate (37%), followed by general adult psychiatry (17% and 34%). Medical psychotherapy had the lowest true vacancy rate, 9%. By region, the North West had the highest true vacancy rate, 33%.
Every two years the Royal College of Psychiatrists counts the senior psychiatric workforce of English NHS trusts. The 2025 census, a snapshot on 31 March 2025 published in March 2026, shows a slightly lower consultant vacancy rate than the 2023 count.
Posts, not people
Forty of 48 mental health trusts returned data, against 39 of 52 in 2023. The census counts posts. Of 5,193 consultant posts, 4,445 were filled: 3,776 by substantive consultants and 669 by locums. Locum data were collected only for consultants.
Two rates for the same posts
Vacant posts dropped from 15.9% to 14.4%. In 2019 and 2021 the figure stood at 10%. The College's second measure adds locum-held posts to the vacant ones and gets 27%, which the press release puts at 1,417 posts. That number moved by two points in two years.
The spread by specialty is wide. In eating disorders, 37% of consultant posts are vacant or held by a non-substantive psychiatrist; in general adult psychiatry, 34%; in medical psychotherapy, 9%.
The cost lands on continuity
My reading is that the falling vacancy rate tracks how many posts have a doctor attached on census day. A locum fills the clinic list, and a locum contract is temporary by design. In eating disorders and general adult psychiatry, more than a third of consultant posts are held this way or empty, so a change of psychiatrist is a predictable event in the client's treatment.
For a psychologist working beside such a team, I would check at referral whether the consultant post is substantive, keep the formulation and medication history current in the shared record, and prepare the client for a handover before it happens.
A vacancy rate counts whether a post has a doctor on census day, and in eating disorders and general adult psychiatry more than a third of consultant posts have no permanent one.
The census counts posts and covers 40 of 48 trusts. Locum data were collected only for consultant posts. The 1,417 figure and the 2015 rate come from the College press release.