National health and social care workforce plan: part two

Joint COSLA/ Ministerial foreword

The integration of health and social care is one of the most ambitious programmes of public sector reform undertaken in Scotland. Through integration there will be a greater emphasis on community-based services along with more joined-up, anticipatory and preventive care to ensure that people get the right care, at the right time and in the right place, and are supported to live as independently as possible.

The Scottish Government and COSLA are jointly committed to the achievement of the National Outcomes and National Health and Wellbeing Outcomes. We recognise the key role that Integration Authorities have in looking at the best way, locally, to transform, plan and deliver high quality and sustainable care in our communities. We also recognise that in the social care sector, independent and third sector employers play a major role in delivery and that their involvement in planning for these outcomes is critical.

We know that Scotland’s social care services are valued by those who use them: in the Health & Care Experience Survey of 2015/16, 81% of people receiving formal social care services rated their overall help, care or support services as either excellent or good. Little could be more important to the achievement of those outcomes than the workforce that delivers our services.

The purpose of the National Workforce Plan for Health and Social Care is to enable better local and national workforce planning to support improvements in service delivery and redesign. We are seeking a whole system, complementary approach to workforce planning recognising the new integrated landscape, and it is clear that the NHS and social care employers have taken different approaches to date. As we progress, it is important that we strive for and support continuous improvement in our workforce planning. The recommendations in this Plan recognise that we can all benefit from taking a national approach to some aspects of workforce planning as we move forward.

Workforce planning in respect of social care faces distinct challenges. The social service workforce is the largest publicly funded workforce in Scotland, making up 7.7% of all Scottish employment. That’s 200,650 people currently in paid employment within the independent, public and third sectors who are working with citizens who need support - ranging from vulnerability in older people to those with disabilities, mental ill-health and homelessness, children’s services and criminal justice.

The social care workforce, unlike that for the NHS, has many different employers in local government and in the third and independent sectors. Volunteers and unpaid carers also play an important role as part of local assets and support to the employed workforce. Looking to the future, Integration Authorities will need to be able to draw on a more integrated and multidisciplinary workforce and so the workforce we currently have and our approach to recruitment and retention, training and education will need to be supported to respond to that challenge.

At national and local government levels, we are also conscious of the fact that the current financial environment means that we have to make the best of the resources that we have. In addition, it is likely that the impact of leaving the EU will place a particular pressure on the social care landscape.

We have listened to the views of councils, Integration Joint Boards, regulatory bodies, commissioners and providers of services, professional bodies and trade unions in articulating the scale of the challenge we all face – not least of which is the complexity of the landscape and diversity of need.

This publication starts to provide a shared understanding of the scale of this challenge and the priorities therein, and affirms our collective commitment to building more informed, strategic and locally sensitive workforce planning. That, in turn, enables us all to deliver better, more sustainable, high quality services for those who need them now and into the future. This plan will support the integration journey by giving a national focus to workforce planning at a time of local innovation and service redesign, and will set out recommendations which will start to dismantle any systemic barriers to effective, integrated, local workforce planning.

Clearly in this dynamic environment, the agenda will evolve and the plans we make nationally will have to be iterative also. In light of this, the commitments made here are for progress over the next 12 months, with a further commitment to publishing a fully integrated National Workforce Plan in 2018 which brings together Parts 1, 2 and 3 (Primary Care) to build on progress being made.

How we understand and plan for our social care workforce is critical to the whole ambition of integrated high-quality services, to the staff we value and the outcomes for our citizens. This plan lays out the first steps we will jointly take to improve and support workforce planning for social care.

Peter Johnston

Shona Robison