Dr. Melody Smith, Clinical Psychologist
When you picture yourself on a DClinPsy programme or working as a clinical psychologist, you might first think about core skills: assessment, formulation, therapy, research. Frameworks like SCRIPTED FLAG help to organise this thinking and give you a structure for reflecting on your readiness.
Alongside this, there is another framework that will shape almost everything you do in the NHS: the NHS Constitution (Department of Health and Social Care, 2023). It sets out the principles, values, rights and responsibilities that apply to patients, the public and staff. Understanding it is part of growing into the role of a future NHS clinician.
This blog explores what the NHS Constitution says, why it matters for aspiring clinical psychologists, and how it sits alongside the SCRIPTED FLAG competencies you are already working with.
A quick guide to the NHS Constitution
The NHS Constitution describes what the NHS is here to do: improve health and wellbeing, support people to stay as well as possible, and provide care at times of greatest need with compassion and respect. It is built on seven guiding principles, including providing a comprehensive service, being free at the point of use, aspiring to the highest standards of excellence, putting patients at the heart of care, working across organisational boundaries, using resources responsibly, and being accountable to the public.
It also sets out core NHS values, such as working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives and making sure everyone counts. These values are meant to influence decisions at every level, from national policy to day-to-day interactions on a ward or in a clinic.
Alongside values and principles, the Constitution sets out three other areas. First, the rights of patients, the public and staff, for example to safe care, confidentiality, access to information, involvement in decisions, and the ability to make complaints. Second, pledges, which go beyond legal rights and describe what the NHS is committed to providing, such as clear communication, smooth transitions between services and learning from feedback. Third, responsibilities for patients, the public and staff, such as using services appropriately, treating others with respect, following agreed care plans and raising concerns about safety.
For aspiring clinical psychologists, this is the backdrop to almost every piece of work you do, whether that is in an Assistant Psychologist post, a support worker role or a research setting linked to the NHS.
Why the NHS Constitution matters for aspiring clinical psychologists
The DClinPsy is not just training you to deliver psychological interventions. It is preparing you to work as a senior clinician within a complex public system that is value-driven and accountable. The NHS Constitution helps you understand what that system expects of you.
For example, the principle of providing a comprehensive service, available to all, links directly to questions of access, equity and inclusion. In practice, that might mean noticing who is missing from a service, thinking about barriers to accessing care, or reflecting on how your own assumptions could influence who you feel most comfortable working with.
The value “everyone counts” supports thinking about finite resources and the need to make fair decisions. This is highly relevant when you are involved in triage, risk decisions or waiting list discussions. It invites you to think about how to balance individual needs with the needs of the wider community.
The rights relating to dignity, respect, informed consent and confidentiality sit at the heart of therapeutic work. They remind you that even when someone is distressed, detained or struggling to engage, their human rights remain central. This can guide how you speak to people, how you involve families and how you respond when care falls short of the standards you would hope for.
Finally, the responsibilities of staff – including maintaining professionalism, raising concerns, following governance processes and contributing to service improvement – map closely onto the identity of a clinical psychologist as a reflective leader and scientist-practitioner.
Comparing the NHS Constitution with SCRIPTED FLAG Competencies
It can be helpful to think about the NHS Constitution and SCRIPTED FLAG as two different, but connected, lenses.
The NHS Constitution gives a system-level lens. It describes what the NHS is for, how it should behave, what people can expect from it and how staff should act. It is grounded in law, national policy and public accountability. It applies to all staff groups, not only psychologists.
SCRIPTED FLAG gives an individual professional lens. It focuses on twelve specific competencies that are important for DClinPsy selection and training: Supervision, Communication, Research, Interventions, Personal and Professional Development, Therapeutic Alliance, Evaluation, Diversity and Inclusion, Formulation, Leadership, Assessment and Governance. It is a way of thinking about how you develop and evidence your readiness to train.
There are clear overlaps. For example, the NHS value “everyone counts” aligns with Diversity and Inclusion, and the emphasis on quality of care and safety links directly with Governance, Assessment, Evaluation and Research. Working together for patients reflects Communication, Therapeutic Alliance and Leadership. The focus on improving lives and learning from feedback sits alongside Personal and Professional Development and Evaluation.
There are also differences. The Constitution does not break down skills into detailed competencies, and it is not designed as a reflective tool for individual development. SCRIPTED FLAG, by contrast, helps you track your growth, spot gaps and generate concrete examples for applications and interviews. The two frameworks complement each other: one sets the ethical and organisational context, the other helps you describe how you are operating within it.
As an aspiring clinical psychologist, you might find it useful to ask: for each SCRIPTED FLAG competency, which NHS principles or values are most relevant here, and how does my example show that?
Using both frameworks in your applications and interviews
When you are preparing personal statements, applications and interviews, you are often encouraged to ground your examples in SCRIPTED FLAG. Adding the NHS Constitution into that picture can deepen your reflections.
You might describe an example of Assessment where you worked with a young person and their family. SCRIPTED FLAG prompts you to explain what you did, how you gathered information, how you used supervision and how you reflected on the work. The NHS Constitution invites further questions. How did you uphold their rights to dignity, informed choice and confidentiality? How did you make sure everyone felt heard? Were there any inequities in access or support that you noticed and raised?
In a Leadership example, you might describe co-ordinating a small project to improve communication on a ward. SCRIPTED FLAG helps you show initiative, collaboration and evaluation. The Constitution adds another layer: how did this project support “working together for patients”, “commitment to quality of care” or “everyone counts”?
This approach can also help you respond to ethical or governance questions. Rather than seeing these as abstract, you can connect them to specific rights and responsibilities in the Constitution and to the Governance, Diversity and Inclusion and Leadership elements of SCRIPTED FLAG.
Final Thoughts
Stepping into the NHS as an aspiring clinical psychologist means stepping into a values-driven system. The NHS Constitution offers a shared language for what patients, the public and staff can expect, while SCRIPTED FLAG helps you describe how you are growing into the role of a future clinician within that system. Holding both together can steady you when services feel stretched and when the application process feels uncertain.
You do not need to have everything perfected. A thoughtful, reflective stance that shows awareness of both the wider NHS context and your own developing competencies can be very powerful. If you would like guided support with this, including application prep, interview practice and structured reflection, you are welcome to join the ACPsych Pathfinder Membership, where we explore these frameworks in depth through workshops, resources and community discussion.
References
Department of Health and Social Care. (2023). The NHS Constitution for England. Updated 17 August 2023. GOV.UK. https://www.gov.uk/government/publications/the-nhs-constitution-for-england
