National health and social care workforce plan: part one

Foreword

Publication of this Plan marks the beginning of a process to further improve workforce planning across health and social care. Its overall aim is to support organisations which provide health and social care services to identify, develop and put in place the workforce they need to deliver safe and sustainable services to Scotland's people. It sets out new thinking about the health and social care workforce across Scotland, within a framework for wider reform of our health and care systems through the Health and Social Care Delivery Plan. Its impact will be far reaching, and directly affect everyone who uses or works in and around health and social care in Scotland.

We have worked with a wide range of partners to develop this Plan, and I want to pay tribute to our health and social care workforce and the tremendous work they do. We will continue to work as closely as we can with our staff, and the organisations which represent them, as we build our capacity to plan, deliver and develop new models of working. Their on-going involvement and input is absolutely vital.

This Plan has three distinct parts, reflecting its iterative approach. This document is Part 1 of the Plan, focussing on NHS Scotland. Part 2 of the Plan will consider ways to address the challenges facing social care workforce planning post integration and will be published jointly with COSLA in Autumn 2017. This timeframe reflects the process under way to establish new leadership within COSLA, in light of the local election results in May 2017. We will work closely with key partners on the content of this document, in particular with employers in the third and independent sector. Later this year, we will also publish Part 3 of the Plan to follow the conclusion of GMS contract negotiations which will set out our thinking on primary care. In this first year, this incremental approach will enable different systems to take stock and move together towards a second full Health and Social Care Workforce Plan in 2018. From 2018, future editions of the Plan will have greater capacity to address the size and diversity of the health and social care workforce, and its workforce planning needs.

It is no accident that we are embarking on this Plan at a time when the health and social care landscape has changed and is changing significantly. While we continue to enjoy world leading health services, with highly trained and dedicated staff, those staff must respond to changing needs and demands. NHS Scotland workforce planning must also adapt to put staff in the best position to sustain the excellent treatment and care they are renowned for. NHS Boards, Health and Social Care Partnerships and Councils are working hard to put individuals and families at the centre of planning for services. We must take the right steps to plan for and deploy our future workforce effectively against this complex, shifting background. This Plan further clarifies how that needs to be done nationally, regionally and locally.

The 79 consultation responses received have added considerably to the sum of our knowledge. Throughout the consultation period, our stakeholders showed how willing they are to engage. We are grateful for their involvement, and we will build on that going forward. Many of the organisations responding represent our staff, helping to sustain close and effective partnership. Others are more closely involved in planning the staff we need, ensuring they give of their best when and where they need to be, delivering the right treatment and care in the right way. We have listened carefully to these constructive and realistic views and they have helped us to understand the issues and arrive at solutions.

For some services, and in some areas, challenges continue and so we must improve our efforts to recruit and retain - and train and retrain - the staff we need now and for the future. That is not simply a matter of augmenting the numbers we recruit. The actions set out in this Plan will certainly improve our efforts to recruit and retain staff, but we must continue to ensure we have the right processes in place to manage workforce supply and demand. Refining these processes will help us to project our workforce needs forward more intelligently, enabling our staff to use their professional knowledge and skills to best effect in providing the high quality treatment and care for which Scotland is renowned. We also know that workforce demand and supply will change over time, so we need to link the recommendations here carefully to the arrangements to implement the Health and Social Care Delivery Plan, particularly at a regional level.

There are some specific areas where I want to see a step change in the way we work and in how we provide services, in order to ensure our health service continues to meet the changing needs of Scotland's population. Many changes are already happening. For example, General Practitioner services are moving towards a new multi-disciplinary approach, and we are introducing changes to bring about improvement in the working life of Junior Doctors, including our commitment to a maximum 48 hour working week.

But as we recognise the immense personal contribution made by our staff, we must also allow them to develop professionally to ensure patients continue to receive the best possible care. Education which supports multi-disciplinary learning and working will allow staff to take on more flexible roles, and allow them more varied and flexible careers. In recruiting the staff we need to run our services, we must also look to build and enhance fulfilling careers in our health and social care services, particularly for our young people. Making the most of those opportunities will require us to look closely and constructively not only at how we recruit, but also at our training models, and the Plan makes important recommendations about this.

We have also committed to considering safe staffing legislation, placing the nursing and midwifery workforce planning tools on a statutory footing, and it is important that the practical implementation of that goes forward in line with the developments and ideas in this Plan. Our incremental approach should allow this to proceed effectively to ensure needs are met while taking account of a changing future landscape.

There is much still to do. Many dynamics operate between respective workforces, and the Discussion Document outlined some of the key differences which Part 2 of this Plan will address in more detail. The consequences of the changes resulting from the UK's exit from the European Union also bring fresh challenges in a Scottish context, right across the health and social care workforce. So as well as continuing to build our local workforce, we must continue to welcome people from the EU who want to work in our country's health and social care system.

This Plan heralds the positive steps we must now start to take in planning the workforce for the future, so our health and social care workforce can build further on its excellent record of achievement in providing care and treatment for our citizens, young and old. I look forward to seeing good progress on the recommendations for action in this Part 1, in Parts 2 and 3 when they issue later this year, and in future editions of the Plan.

Shona Robison