National health and social care workforce plan: part three

Foreword

I am delighted to publish the National Health and Social Care Workforce Plan: Part 3 – Improving workforce planning for primary care in Scotland, which sits alongside the workforce plan parts one and two published last year. We are embarked on a long-term journey to reform primary care in Scotland to better serve the needs of our people, promote prevention and self-management, and put services on a sustainable footing. This plan is an important further step on that journey.

The plan focusses on developing, building and expanding Multidisciplinary Teams ( MDTs), made up of professionals each contributing their unique skills to managing care and improving outcomes. This government has previously set out a series of ambitious commitments to significantly expand and strengthen the primary care workforce, backed by a historic increase in investment in primary care. The plan outlines how we intend to deliver these pledges. What is clear however, is that we are already seeing considerable benefits from enhanced MDT working and new models of care across Scotland, and I am confident this will gather pace in the coming years through the initiatives we and our partners are taking forward.

The Chief Nursing Officer, together with Scottish Executive Nurse Directors and partners, is leading an important piece of work to maximise the contribution of the nursing, midwifery and health professionals ( NMaHP) workforce. The Transforming Roles programme is ensuring nationally consistent, sustainable and progressive roles, education and career pathways to meet the current and future needs of our population, and will inform and support local workforce planning. We will invest £6.9 million over three years for the training and education of General Practice Nurses and District Nurses to help support a sustainable 24/7 community nursing workforce.

In addition, recognising the importance of the District Nursing workforce in shifting the balance of care from hospitals to community settings, we will work alongside partners, including the Royal College of Nursing, to understand the requirements for sustaining and expanding this workforce. We are committed to undertaking this work at pace and will be in a position by September 2018 to better understand the requirements and investment necessary to grow the workforce. Integration Authorities and NHS Boards retain responsibility for planning and funding District Nurse vacancies and projected retirals from existing budgets.

The new GP contract, which I was delighted to see strongly endorsed by Scotland's GPs in January, will be crucial in making general practice a more attractive career choice. I recently announced our commitment to increase the number of GPs in Scotland by at least 800 over the next 10 years. This is challenging, requiring action across a number of fronts and with the input and support of many individuals and organisations. We can deliver, and the initiatives we set out in this plan move us along that road.

However, I fully recognise the considerable pressure our health services are under to meet the increasing demands of our ageing population. I hear the concerns expressed around our ageing primary care workforce and the need for bold action to address current vacancies across professions. The actions set out in this plan, alongside our wider programme of reform of primary care, will accelerate the pace of change but I acknowledge we will continue to face significant challenges and tough decisions along the way.

Finally, I'd like to take this opportunity to thank the Royal College of Nursing, the British Medical Association, the Royal College of General Practitioners, Chief Officers, Allied Health Professions Federation Scotland, Optometry Scotland, Community Pharmacy Scotland, British Dental Association and other stakeholders who have helped shape the plan. I am aware the plan doesn't address all concerns raised by our partners but it is an important starting point. It sets a marker for further developments needed to improve workforce planning in Scotland, and we will continue to work closely with partners in developing an integrated workforce plan to be published by the end of this year.

Looking ahead, there is still much to be done but we have already come far in realising our ambition of a modernised primary care service. That is down to the skill and dedication of the many individuals – both clinical and non-clinical – that make up our workforce.

Shona Robison
Cabinet Secretary for Health and Sport

Summary of Key Recommendations and Next Steps

This Plan sets out recommendations and the next steps that will improve primary care workforce planning in Scotland. These complement the recommendations in parts one and two and, taken together, will form the basis of the integrated workforce plan in 2018. The recommendations below set out how we will enable the expansion and up-skilling of our primary care workforce, the national facilitators to enable this, and how this will complement local workforce planning.

Facilitating primary care reform

Recommendations and commitments:

1. Reform of primary care is driven by developing multidisciplinary capacity across Scotland. Workforce planners including NHS Boards, Integration Authorities and General Practices will need to consider the configuration of local multidisciplinary teams that offer high quality, person-centred care.

2. In recognition of an ageing workforce, local planners have responsibility for workforce planning and managing anticipated levels of staff turnover.

3. The implementation of the new GP contract will require services to be reconfigured to maximise workforce competencies and capabilities, and ensure people see the right person, at the right time and in the right place.

4. The National Workforce Planning Group will play a strategic role in implementing the recommendations of part three of the plan, and strengthen the development of approaches for the primary care workforce.

5. An integrated workforce plan to be published later in 2018 will move towards a better articulated joint vision for health and social care workforce planning.

Building primary care workforce capacity

Recommendations and commitments:

6. Significant investment will be made available over the next 3-5 years, as part of the First Minister's commitment to an additional £500 million for community health services, to plan for, recruit and support a workforce in general practice, primary care and wider community health, including community nursing.

7. Scotland's multidisciplinary primary care workforce will become more fully developed and equipped, building capacity and extending roles for a range of professionals, enabling those professionals to address communities' primary healthcare needs.

8. As part of national, regional and local activity to support leadership and talent management development, planners will need to continuously consider staff training needs in their workforce planning exercises; invest appropriately so that leaders in primary care are fully equipped to drive change; and enhance opportunities for the primary care workforce to further develop rewarding and attractive careers.

Improving data, intelligence and infrastructure in primary care

Recommendations and commitments:

9. More integrated workforce data for primary care is required, in the context of the workforce data platform being developed by NHS Education for Scotland.

10. Local planners should consider workforce planning tools (such as the six step methodology) in developing their workforce strategies to address local population needs.

11. Planning for future staffing in primary care should identify and make use of available guidance and intelligence on local recruitment and retention issues, and of wider developments in workforce data and scenario planning.

12. The Scottish Government will publish the Primary Care Monitoring and Evaluation Strategy 2018-2028 by summer 2018.