Increased training costs

A letter concerning the Health Psychology qualification.

I was appalled to learn recently that our Society has hugely increased fees for the Health Psychology Stage 2 qualification to a flat rate of £5995. Previously completing in two years cost £2421, three years cost £3154, and four years cost £3888. As the average completion time is three years, this represents a mean increase in fees of 90 per cent at a time when inflation rates are negligible. The service provided for this fee is minimal and consists of tasks such as ratification of training plans and arranging the examination. Trainees will still need to pay additional and considerable supervision costs.

I have been offered a range of explanations. These have included the fact that trainees have been previously encouraged to complete their training quickly to avoid annual fees; that fixed fees is the fairest approach; that fee rises ensure sustainability of qualifications, and that the BPS will now facilitate access to online journals and e-books via the University of London.

I have significant concerns about the decision of the Trustees. Most importantly, I feel the likely outcome is simply that fewer psychology graduates will pursue a career in applied psychology in those areas that do not receive public funding and where career opportunities are less certain post-qualification. This is hardly an ideal outcome for a charity that aims to promote and develop our profession.

The new cost will probably prove prohibitive to individuals and to organisations keen to pay fees, as £6K means creating trainee posts will become less attractive. For example, over the course of a two-year project the cost of an Agenda for Change band 6 trainee health psychologist with only seven hours of 8A workplace and coordinating supervision per month (in reality considerably more is provided) is about £76K. For an additional £4K an organisation could employ a full-time, qualified band 8A who would arrive with greater skills and considerable lower supervisory needs.

Moreover, at an individual level, a single fee will not reflect accrued costs and penalises people who complete more quickly. Whilst some may find it beneficial to have access to University of London resources, others can access their local university or alma mater either free of charge or for a small fee of about £30 per annum, and NHS employees have access to considerable library resources.

One of the most striking aspects of my communication with our organisation about this has been the lack of openness, transparency and lack of debate about such a fundamental issue. For example, I requested details about training costs and was informed that this is confidential information. This seems odd because one way or another, the Trustees represent the membership and this is hardly commercially sensitive information.

If as an organisation we subsidise anything, then my view is that it should be our early career colleagues, but instead we seem to be using them to generate resource.
Dr Andrew Keen
Consultant Health Psychologist
NHS Grampian

Jane Smith, BPS Director of Qualifications and Standards, replies: The move to a new, single-fee structure for the Society’s suite of Stage 2 qualifications has been controversial. There are two related issues.

First, for many years our qualifications have been charged on a ‘pay-as-you-go’ basis, with candidates paying an enrolment fee, an annual maintenance fee for each subsequent year on the programme, a fee each time they submitted work for assessment and a fee for any required reassessments. This meant that candidates never knew how much it would cost them to complete a qualification, especially as fees were revised each year in line with inflation. It also encouraged candidates to complete their training as quickly as possible to avoid paying annual fees. Indeed, there were examples of people wishing to submit for assessment but being unable to do so because of the associated costs. Unlike universities, we do not have a fixed ‘course’ length and we do not differentiate between full- and part-time students, as this is impossible to do with work-based learning programmes. A single, fixed fee with an open end date therefore seems the fairest approach to take.

Second, our fees policy has always been to ensure that the qualifications cover their costs. Over the years, with changes in the structure of our qualifications and in the number of candidates on each qualification (especially as the number of alternative programmes offered by universities has increased), it was no longer the case that each qualification was sustainable in its own right. When moving to the new structure, the fee for each qualification was calculated to ensure that it covered the full costs of delivery for that qualification. This has led to a re-balancing between qualifications and, in the case of Health Psychology, does mean that new candidates are paying more than they would have done under the previous system.

The Trustees explicitly considered the policy of requiring qualifications to be self-supporting. It decided that qualifications are offered as an individual member service and as such it would not be within the Society’s charitable objective to subsidise them from other sources of income. However, for those candidates in difficult financial circumstances, the Society can – and does – offer significant discounts on its fees, taking individual circumstances into account. We have also ensured that candidates can spread the cost of the qualification over several years, to avoid the need for a large up-front payment.

The new structure is therefore designed to ensure that each qualification is sustainable and that the costs of completing a qualification are more transparent to candidates and employers at the point of enrolment. The new system will also be significantly less bureaucratic than the old, which required multiple invoices over the course of a candidate’s enrolment. Freeing up staff time will allow us to focus on further improving the service we provide to candidates. We have made strides in recent years with the introduction of supervisor and candidate workshops, online forums for candidates and, more recently, a new service enabling candidates to access academic resources through the University of London’s Senate House library, but there is much more we can and will do in the future.

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one of my concerns about the new fee structure is that it will not be of benefit, to those pursuing a career in a psychological profession applied to health, to go through stage 2 training. Since chartership in the Division of Health Psychology is not a prerequisite for practitioner psychologist registration with the HCPC, what will stop future aspiring psychologists bypassing BPS entirely? If they do so, how can we aim to further the academic, scientific and clinical excellence to which the DHP aspires?

I am glad the BPS published Dr Andy Keen's letter and I am hoping this will generate discussion.
Ms Smith states that "the costs of completing a qualification are more transparent to candidates and employers at the point of enrolment" yet this is not the case. I have just completed my enrolment documentation for my stage 2 and there is no detailed information available to candidates on what the fees will be covering.
The generic sentence "the fee for each qualification was calculated to ensure that it covered the full costs of delivery for that qualification" really does not explain what the fees will be covering.
The details of the costs of delivery are never listed. And as Dr Keen said, the service provided does feel minimal to candidates (I know of candidates who never receive acknowledgement of sent documents and only hear from the BPS when fees payments are required).
I am aware of potential stage 2 candidates which have had to renounce to their career plans because unable to afford a fee of £5995 after already spending enough on their Stage 1 training. Ms Smith states that "fees were revised each year in line with inflation", but I am yet to see a 90% inflation rate (and if there were one, a revolution not being expected).
Health Psychology is the fastest growing field of psychology in the UK (according to the BPS); therefore potential candidates should be encouraged to pursue a career in this field, not be prevented from it. The driving force behind this growth should be merit, not money.