National health and social care workforce planning: discussion document

Ministerial foreword

Our population is living longer and that's very good news for all of us. However, our longer lives bring with them a need for care that recognises multiple health and social care needs but allows us to remain connected to our communities throughout our lives and, as much as possible, to carry on living at home or in a homely setting.

This Government is taking a number of fundamental steps to implement transformational change in Scotland that will help us to deliver the care we will need in the future. The key components of change in health and social care are:

• the National Clinical Strategy;
• health and social care integration;
• public health improvement; and
• NHS governance reform.

The Delivery Plan for Health and Social Care which I launched in December set out the framework and actions needed to ensure that our health and social care services are fit to meet the challenges of our changing society. The four components set out above are neither exclusive to health, nor are they exhaustive - for example, Self-Directed support is an important aspect of social care - but taken together, they have the potential to bring about the transformation that is essential for the long-term sustainability of our services and the continuing improvement of the nation's health and wellbeing.

Making sure that we have the right people, in the right place at the right time to deliver better outcomes in future, and particularly to ensure that we can care for individuals and families appropriately in a community setting rather than in hospital, means changes in key areas, including how we make decisions about our health and social care workforce.

In future, workforce planning needs to recognise the interdependence of several key workforce sectors - the NHS, local government, the independent and third sectors and the newly created Integration Joint Boards ( IJBs). This requires staff from all backgrounds and in all professions, to work more closely with each other across boundaries, often in teams and to the top of their professional roles.

We have sound workforce planning methodologies, with good principles applying to the services which health and social care staff currently provide. But they vary considerably in how they describe roles, responsibilities and educational frameworks, and are too weighted towards the single systems in which staff have traditionally operated. We now need a more mature approach, so we can use these methodologies more flexibly, intelligently and predictively as tools to help us design jobs and roles which make sense in an integrated context, and which make the most of the world class skills our staff possess. Doing so will help ensure that these skills are combined collectively to deliver the improved services Scotland's people need. And it will reinforce confidence in the stability and sustainability of services - whether provided in hospitals or care homes - in these uncertain times.

I want all health and social care staff to feel engaged and supported to continuously improve the care and treatment they provide. The health and social care services we need can only be delivered with the full engagement and contribution of a valued and skilled workforce. At the heart of our transformation agenda is a broader, more integrated, more highly skilled, supported, and engaged workforce. That means getting our planning right in order to support individuals with the right experience and skills to deliver a service that is person-centred, and allows individuals working in any sector to feel they are making a difference.

I also want to pay tribute to those of our health and social care staff who have chosen to work in Scotland from across the EU. These committed and dedicated people continue to make a huge contribution to our nation's health and care, and we are in no doubt that free movement of labour throughout the 31 countries of the European Economic Area has helped ensure we have the skilled workforce we need. We greatly value our non- UK EU citizens and their wider contribution to our society and will do all we can to see that their rights, and their place in our nation, are protected.

This discussion document acknowledges the complexity of the system we work within but also the overriding need to collaborate in order to achieve the outcomes we need from our services in future. It sets out the background of what we have done to date to improve workforce planning, outlines some of the workforce challenges, and aims to start a conversation to support our mutual aims to transform health and social care services. It is the start of a process of improving workforce planning across health and social care and sets out the case for new thinking about how to plan the workforce.

This is a further step in the continuous process to ensure we have an effective workforce planning system in place. This will aid the hard working and dedicated staff who every day ensure Scotland has one of the best health and social care systems in the world. It builds on work already undertaken to identify the improvements required, and sets out some key early challenges that we believe can be tackled to ensure a more effective system.

I look forward to working with you to realise our ambition of a health and social care workforce fully fit for Scotland's future.

Shona Robison
Cabinet Secretary for Health and Sport