Better Health, Better Care: Planning Tomorrow's Workforce Today

CHAPTER 4:
CHANGING FACE OF WORKFORCE PLANNING

Workforce planning in NHSScotland is still relatively new and has been developing over the last few years to build both capacity and capability across the organisation. There is now a network of people who have workforce planning at the heart of their jobs and many, many more people who undertake elements of workforce planning in their day-to-day working.

Regional workforce planning processes and the Regional Workforce Directors have been instrumental in developing these workforce planning networks and the workforce planning community across NHS Boards. Each region has workforce planning processes in place which ensures that workforce planning is an integral component of the wider regional service planning agenda. The Regional Workforce Directors have also provided regional coordination to a range of workforce planning issues within and across regions, such as the planning and implementation of Modernising Medical Careers.

Although this base acts as a good springboard for developing more dynamic workforce planning, a number of challenges remain in relation to developing the workforce planning function such as the provision of consistent and quality information, the need to improve the robustness of workforce projections, the need to move towards more sophisticated and dynamic workforce planning and to ensure the fiscal position is given due consideration. We also need to balance up the desire to encourage NHS Boards to workforce plan around the Local Delivery Plan strategic priorities alongside the need for full workforce projections for planning purposes.

Therefore, although there has been steady progress, it is acknowledged that there is still some way to go and NHS Boards need to continue to develop comprehensive workforce plans to reflect future service provision and reconfiguration.

Action
NHS Boards and Regions to continue to embed their workforce planning processes and publish their annual workforce plans.

Moving Towards Capacity and Delivery Plans

This chapter signals the direction of travel over the next 2-3 years enabling a move towards the potential development of capacity and delivery plans.

A core element of the move towards a more integrated approach to planning is that Local Delivery Plans this year will be explicitly required to include supporting financial and workforce planning information. This will enable NHS Boards to demonstrate that workforce planning is clearly supporting the delivery of the strategic outcomes as part of our vision for a healthier Scotland.

Once these Local Delivery Plans have been submitted by NHS Boards to the Scottish Government Health Directorates in February 2008, joint consideration of these plans across Health Directorates will allow one set of feedback to NHS Boards covering all aspects of the plans. This timetable has some flexibility built in, recognising that there have been rapid advancements in moving towards integration over the past few months and that the way forward is challenging. It is therefore not anticipated that all Boards will be able to submit fully integrated Local Delivery Plans, including workforce, by February 2008. However, it is expected that by demonstrating clearer linkages between workforce and financial plans, and considering how these might best support the delivery of effective services, we will be moving closer towards the potential development of a capacity and delivery plan.

As the HEAT targets will not capture the total workforce, then some headline information data on staff groups will still need to be captured. Regional Workforce Directors provide leadership in developing workforce planning at both regional and local level. As part of this work, they are well placed to determine what further work needs to be done and how this should be taken forward.

Action
Regional Workforce Directors to lead developments around how best to capture headline information data on staff groups over the short to medium term.

In the longer term, work is underway to bring financial and workforce planning more closely together with the service planning role through the development of an overarching capacity and delivery plan which would describe not just what services NHS Boards provide, but also how services would be provided, including detail of the workforce changes required to deliver those services. Such a plan will be focused around service change and priority areas, such as those outlined in the Better Health, Better Care: Action Plan and would be fully aligned with each NHS Board's financial plan.

Workforce Plans

During the course of the coming year, NHS Board workforce plans will reflect progress made in moving towards a more dynamic system of workforce planning, supporting good practice in integrating workforce, service and financial planning. NHS Board workforce plans are primarily for the use of NHS Boards in the development of their business providing healthcare services to their local populations. Local workforce planning is essential to support service redesign and service delivery and is therefore an essential element of all NHS Boards' strategic planning. However, to streamline Scottish Government information requirements, the formal requirement for NHS Boards to submit their full plans to the Health Directorates of the Scottish Government is being removed. This does not reflect any change in the priority of developing these plans, and there does remain a requirement for these to be published by the Board and be in the public domain.

Regional Workforce Plans have been developed over the last few years to support the growing need for regionally-planned services where patient's needs are best served by a collaborative approach to service delivery across Boards. Regional workforce plans are an important part of the planning process and essentially for the use of NHS Boards in the development of regionally planned services. They also do not require to be submitted to the Health Directorates of the Scottish Government; however, there is still a need for hot issues to be identified that require a national approach.

Workforce Projections, Information and Data

There remains a need for NHS Boards to provide their staffing forecasts to inform national training numbers for staff groups that have training numbers set centrally. A template has been developed in partnership with ISD Scotland to assist this process and requires to be submitted to Scottish Government Health Directorates by April 2008.

In line with moves towards integrated planning, NHS Boards are required to demonstrate that their workforce projections are affordable and sustainable in line with the financial budget agreed as part of their Local Delivery Plan, particularly for the three 3-year predictions. Planning over the longer-term for 5 and 10 years also needs to take into account changes in service needs and impact on staffing required. It is recognised that there may not be financial certainty, but the longer term planning exercise is essential to inform training number requirements. NHS Boards understandably have some unease about the affordability of these longer-term predictions but a degree of latitude will be important to allow for sensible planning to take place.

The importance of robust data in workforce planning is high on everyone's agenda. Considerable work has already been undertaken on improving data consistency and quality, and ISD Scotland is working closely with NHS Boards to identify and iron out data issues. The implementation and further development of Scottish Workforce Information Standard System ( SWISS) will assist further in this process along with the e HR system currently being considered. There are positive outcomes from work to date already and there is now greater clarity on the medical workforce and job planning. Further work is underway to standardise data and key assumptions to be used in reporting workforce data to ensure consistency and to enable NHS Board information to be reconciled with ISD Scotland published information.

Action
Scottish Government and ISD Scotland to work together to better align planning and data gathering cycles.

Action
NHS Boards and ISD Scotland to work together to improve quality and consistency across workforce and financial planning data, including ensuring a robust baseline for workforce planning.

Building Workforce Planning Capability

There is recognition that there is a need for training and development support for those contributing to workforce planning at all levels. Work is underway to commission a series of modules that would support the development of workforce planning competencies in NHSScotland prioritising those who have a workforce planning remit within their NHS Board. This will build on the capacity and capability of the workforce requirements in this area. Over the period of time that workforce planning has become embedded in NHS Board practice, there are a number of workforce models that have been developed at local level. Although there has been some sharing of this locally, there is a wider opportunity to share best practice. It is important to demonstrate that workforce planning is not just a case of finger in the air projections leading to more of the same but has a sound evidence base linked to service configuration. The work on capability will be taken forward along with signposting of other practical sources of support through development of the virtual network currently in place.

Action
Regional Workforce Directors and NHS Education for Scotland to work together to plan and deliver a programme to develop workforce planning capabilities across NHS Boards.