Health and social care: national workforce strategy

Annex: Summary of Actions

Summary of Short-term Actions across the 5 Pillars of Workforce

Plan

• Analyse the detail in 3 year workforce plans, ensuring the analysis informs and is considered in policy development.
• Publish our indicative projections for the Health and Social Care Workforce growth later this year. This will allow us to expressly incorporate evidence from 3 year Workforce Plans and the forthcoming revised Medium-Term Financial Framework. We will review these projections annually, in line with emerging evidence.
• Deliver on the commitment made in the Integrated Plan to design and oversee work to obtain a national picture of workforce planning capacity, methodology and capability in Local Authorities/ Health and Social Care Partnerships for planning Social Care services. We will respond by considering how best to support effective collaborative and strategic workforce planning in light of the findings.
• Analyse and do a needs assessment of available workforce data and sources building recommendations for workforce data collection design, quantity and quality.
• Identify options for working collaboratively with stakeholders to review the Social Care workforce data landscape as part of a whole system approach.
• Identify options for obtaining accurate data on the unregistered workforce ensuring we consider our whole workforce when planning.
• Continuing on from the Integrated Plan and the workforce planning guidance developed as part of that, working with partners we will develop a suite of tools to support workforce planning capability across Health and Social Care providers.
• Model a sustainable cancer workforce, collecting and improving data on the cancer workforce to support sustainable workforce planning.
• Revisit the specialist public health workforce arrangements taking into account learning from COVID-19, to support the renewal of the public health system.
• Develop an effective workforce planning system which enables the public health workforce to predict future capacity, and capability requirements along with identifying gaps and pressure points.
• Introduce an Annual Survey of the General Practice Workforce by the end of April 2022, the first of which will be published in October 2022, ensuring that we capture Primary Care workforce data to inform policy making and service change.
• Review Antimicrobial Stewardship, Health Protection and Infection Prevention and Control Workforce with a draft strategy being issued for consultation early February 2022, and the final strategy being published at the end of March 2022.
• Improve workforce equalities data by including demographics questions in national staff surveys to ensure that we capture the breadth and experience of people from all backgrounds.
• Develop a Remote and Rural workforce recruitment strategy by the end of 2024, providing a framework which will support employers to ensure that the Health and Social Care needs of people who live in remote and rural communities are met.
• We will publish a national framework for acute oncology by
• 2022. This will provide mechanisms for maximising and developing existing workforce capacity ensure consistent services for patients across Scotland.

Attract

• Increase the hourly rate of Social Care staff in line with discussions through the Fair Work in Social Care Group.
• Support up to 1,800 training places through the National Transition Training Fund for those interested in careers in Adult Social Care.
• Work with SSSC and key partners to promote career opportunities in Social Care and deliver policies on upskilling and developing the workforce to attract new people to Social Care and address retention issues.
• Expand the reach of employability programmes, and consider the introduction of new national target measures to promote the recruitment through apprenticeships and new employability programmes in every health board area, with a particular focus on health and care roles in acute services, community based multidisciplinary care teams and in public health teams.
• £1 million in-year funding to territorial health boards to allow each board to host an international recruitment lead, supported with recurring funding of £1 million per annum going forward.
• Establish the Centre for Workforce Supply within NHS NES to provide labour market intelligence and develop links, supporting boards to coordinate recruitment efforts and act on intelligence to increase response rates to recruitment efforts.
• The Centre for Workforce Supply will promote NHS Scotland Brand identity and work with partners to advertise opportunities to build a career in Health and Social Care.
• Set new international recruitment targets annually and coordinate, through the CWS national campaigns, focusing on key areas of shortage and directly supporting key commitments set out in our NHS Recovery Plan – including meeting our anticipated 1% net growth.
• Set targets to recruit nurses and medics to meet our commitment to 1,500 new staff for NTCs in the period up to and including 2027.

Train

• NHS Academy create, in collaboration with NES and SSSC, a learning source for "Preparation for Work in Health and Social Care" to help immediate winter pressures.
• National Clinical Skills for Pharmacists Programme – supporting community Pharmacists to become independent prescribers. 122 places have already been provided with a further 118 to be delivered by the end of 2021 and a further 165 places to be offered in the first 3 months of 2022.
• Shape future training programmes to support the development of the pain management workforce.
• Accelerate training to increase Endoscopists, providing much needed capacity to address endoscopy and cancer waiting times.
• Increase the number of undergraduate medical school places by around 100 per annum in each year of this parliament (an investment of £47.5m) and double the number of widening access places.
• In 2022/23 we will increase funded places for nursing and midwifery by over 8% to 4,837, increases will be across all nursing training pathways.
• Deliver a national induction framework for adult Social Care which includes developing Infection Prevention Control (IPC) induction resources and a professional support tool.
• Promote career pathways and deliver policies on upskilling and developing the Health and Social Care workforce, including the development of foundation and modern apprenticeships and resources for those providing careers advice.
• Grow the newly established Enhanced Psychology Practitioner (EPP) training programme, aiming to deliver approx. 100 new EPPs per annum.
• Support development of a trauma-informed workforce via the National Trauma Training Programme.
• Develop the Social Work advanced practice career pathway. The advanced social work practitioner will broadly mirror the advanced nurse practitioner role in health and will strengthen the multi-disciplinary models and public health commitments.
• Working with relevant stakeholders to determine the feasibility of developing multi-year intake numbers for nurse and paramedic training places to provide certainty and sustainability to this workforce.
• Review the wider opportunities available to access a career across nursing and midwifery, AHP and HCS by exploring the potential to further increase the use of approaches such as Open University and Apprenticeship models. This will assist in ensuring the recruitment pipeline and future service models meets the needs of the population whilst promoting diversity in the workplace.
• Increase paramedic training numbers by 32% bringing the total student numbers for 2022/23 to 941.
• Publish a scoping review of AHP and HCS education needs by the end of 2022. Through comprehensive modernising career framework reviews we will identify gaps in training programmes and the actions required to meet future service needs.
• We will develop, in partnership with stakeholders, a mandatory supported year for newly qualified social workers, which will provide an effective transition from professional qualification to employment.
• Scottish Government will work closely with SSSC and sector partners to develop a pilot Graduate Apprenticeship scheme, within the next 6-12 months to improve career pathways for Social Care staff into Social Work.
• Develop pilot model for Primary Care Training Hubs in partnership with NES and NHS Boards to increase training capacity within Primary Care for GPs and all members of MDT workforce.

Employ

• Work with NHS Boards, Skills Development Scotland PACE service and Department of Work and Pensions to promote the wide range of opportunities available in the Health and Social Care Workforce to those whose employment has been affected by the pandemic.
• Prioritise the refresh of the PIN Policies, particularly the Home Working PIN Policy, which is part of the 'Supporting the Work-Life Balance' suite of policies and consider requests to develop new policies.
• Work in partnership with UK Government's Department of Health and Social Care on developing partnerships with individual countries which will support direct access to international labour markets.
• We are analysing the response to the recent national Adult Social Care marketing campaign (There's More to Care than Caring) through a post-campaign evaluation and engaging with providers to obtain data on the impact of the campaign on their recruitment efforts. This will inform the planning of future campaigns, as well as our overall recruitment strategy to support the sector with rising levels of demand. The recruitment strategy for Social Care will be developed by the end of 2022.
• Continue to work with HSCPs and providers to identify local Social Care campaigns, recruitment efforts, and employability programmes to identify areas where we can support while bringing HSCPs and providers together to increase collaboration between them.
• Support international staff through development of support, such as OSCE training to help gain regulatory body registration.
• Continue to push for emergency changes to the UK immigration system to combat acute post EU Exit skills and labour shortages exacerbated by the pandemic.
• Continue to push for an immigration system that is responsive to real life skills shortages that does not arbitrarily equate skill level with salary.
• We will recruit an additional 1,500 staff to deliver the additional capacity in elective surgeries and procedures, which will be created by the National Treatment Centres, through domestic and international recruitment.
• Create a network of 1,000 additional dedicated staff who can help grow community mental health resilience and help direct social prescribing, by 2026. Recruitment for these multi-disciplinary Services will commence early in the 2022/23 financial year.
• Recruit 320 additional Child and Adolescent Mental Health Services staff.
• We will provide further funding for SACT and Acute Oncology using a phased approach to ensure we build a sustainable workforce. The funding will reach up to £10 million and will support increased regional working, workforce recruitment and maximise capacity across the existing workforce through initiatives like non-medical prescribing and treatment closer to home.

Nurture

• Provide financial Investment to help Health and Social Care staff with their practical and emotional needs, including pastoral care and other measures to aid rest and recuperation.
• Develop an engagement programme across our workforce to inform a set of shared values which we all hold.
• Launch a new National Leadership Development Programme (NLDP) in the Summer of 2022 for all different levels within Health and Social Care organisations and work to influence culture change across Health and Social Care through this programme.
• Ongoing development and evaluation of a National Wellbeing Programme that seeks to support the mental health and wellbeing of the Health and Social Care workforce.
• Deliver an 'effective voice' pilot in early 2022, ensuring the experiences and needs of the workforce underpin the principles and delivery of any changes.
• Improve the formal conditions associated with CPD time for Adult Social Care workers to ensure they have the time to attend continuous professional development opportunities.
• Improve staff networking – working with the NHS National Ethnic Minority Forum (EMF) to develop outcomes to support staff from minority ethnic backgrounds.
• Develop a national online portal to support all staff equality networks to share resources, information and support in 2022/23.
• Over two years we will work in collaboration with staff and external partners to develop race specific staff equality training which will cover identifying structural racism, impact racism has on mental and physical health, racialised health inequalities, intersectional racism, and reporting structures and support.
• Ensure that there is a staff equality focus for example in the Women's Health Plan and the Immediate Priorities Plan for Race Equality, that will outline our priorities and work to deliver meaningful outcomes in this area, over the next 18 months.
• Develop a further programme of work in relation to Public Health Leadership and Succession Planning in Scotland.
• Redevelop the implementation and transition timetable for the H&C Staffing Act.
• Via NHS Education for Scotland (NES) we are delivering a workforce development programme to increase capacity and capability to provide psychological therapies and interventions for the Health and Social Care workforce. This programme includes national and local delivery of training and supervision in psychological therapy and interventions.
• Up to 16 WTE posts will be created to support the workforce over the next two financial years, including Clinical Psychologists, Counsellors, Project Coordinators, Community Navigators, and Assistant Psychologists.
• Campaign to increase disclosure rates on protected characteristics starting with ethnicity for NHS staff, involving staff networks in the messaging for the campaign.
• Develop a menopause and menstrual health workplace policy for NHS Scotland as an example of best practice, prior to roll out across other sectors, including Social Care.
• Between 2021 – 2023, the Scottish Government will invest £200,000 in a Social Work Professional Support Service to provide peer support for career development, promote wellbeing, and the development of a stronger professional identity.

Summary of Medium-term Actions across the five Pillars of Workforce

Plan

• Improve parity of data collection design and data quality across the Health and Social Care workforce and integration of workforce data with service delivery plans across multiple services and organisations.
• Following the refresh and re-focus our Mental Health Strategy in 2022, develop a mental health workforce plan in the first half of this parliament.
• Assess and identify the role of AI in delivering Health and Social Care services to address demand and capacity issues.
• Work with NHS Boards and HSCPs to ensure workforce plans are part of wider integrated plans which include and triangulate with financial and service/operational planning arrangements.

Attract

• Scottish Government will continue developing 'Once for Scotland' Workforce policies promoting NHS Scotland as a modern, exemplar employer; showcasing our core values, and promoting consistent employment policy and practice that supports the implementation of the Staff Governance Standard and effective recruitment and retention.
• Consider changes in the professional registration of unregistered groups within the Social Care workforce.
• Scottish Government propose establishing a National Social Work Agency as part of the NCS infrastructure. This would support the social work profession to fulfil its statutory and ethical functions, provide national leadership, oversee and support social work education, improvement, workforce planning, training and development and improve consistency and scaling up of good practice.

Train

• By 2024/25 this will have increased by a further 89 places to bring the total to 120 pharmacist trainees over 5 years staying in Scotland to complete their pre-registration training.
• Fully implement our existing commitments for Digital Skills and Leadership as part of the Digital Health & Care Strategy, so that digital skills are seen as core skills for the workforce across the health and care sector.
• Upskill our cancer workforce, including guidance and support on developing leadership skills.
• Develop national workforce strategies for AHPs and HCSs underpinned by comprehensive data and population and demographic need, beginning work in early 2022. These will focus on how AHPs & HCSs can most effectively contribute to population health, reduce inequalities, remobilise and modernise healthcare through an action orientated workforce plan ensuring the availability of high quality education, training and development of staff and an effective supply of AHPs and HCSs to meet the growing demands of the service.
• Establish a Public Health Workforce Development Programme to build workforce quality, capacity and capability to ensure high standards of public health practice, maintained through a culture of learning, qualifications, registration and regulation for the public health workforce.

Employ

• We will grow our workforce over the next 5 years by 1%, in addition to projected required growth, ensuring there is workforce capacity to address backlogs and increase capacity in the NHS.
• Support for those wishing to join the Health and Social Care workforce through increased use of national schemes such as modern apprenticeships.
• Take forward Fair Work recommendations for minimum standards of terms and conditions in Social Care, reflecting Fair Work principles.
• Continue to push for a migration system tailored to Scotland's needs, including a Scottish Visa, and work with partners and employers to develop proposals that suit their requirements.
• Establish a programme of work to review and support public health workforce recruitment which addresses some of the current challenges.

Nurture

• Deliver up-to-date, relevant and impactful training for staff around Equality, Diversity and Inclusion.
• Build on the work outlined in the "Tackling race inequality in employment: statement", to ensure NHS Scotland has equitable and inclusive recruitment, retention, representation, and promotion practices.
• Implement the August 2021, the Women's Health Plan which sets out a number of actions for us to take to support women working in the NHS.
• Ongoing evaluation of the National Wellbeing Programme, working closely with partners, to identify specific areas of work.
• Continue working with partners to establish a series of meaningful anti-racist objectives and performance measures for NHS Board Chairs.
• Work with a Health Board to gain Equally Safe accreditation (through initiatives to reduce violence against women and girls through domestic abuse, sexual assault and harassment). This will be a pilot before national rollout in the NHS.
• Introduce the Flying Finish initiative across all Health Boards to help retain older workers.
• Improve the granularity of workforce data, across the protected characteristics to show information on pay, promotion and recruitment, ensuring this is recorded in a standardised way, so it can be published.
• Working with NES to improve mandatory Equality, Diversity and Inclusion training for Health and Social Care staff, and ensure that it is up to date and relevant and not seen as a tick box exercise.

Summary of Long-term Actions across the 5 Pillars of Workforce

Plan

• Actively share National Workforce Data and Intelligence for use in planning across all aspects of Health and Social Care in order to enable flexible service delivery, and more agile ways of working.
• Ensure our workforce continue to have the skills to deliver services, service transformation and role redesign.
• Continue to identify emerging technology to bridge the gap between service capacity and demand, alongside expanding workforce capabilities and expertise.

Attract

• Ensure that the pay and terms and conditions of NHS staff continue to remain competitive, and that NHS Scotland remains an employer of choice for people seeking a career in health care.
• Continue to promote Fair Work and support employers to embed Fair Work practices.

Train

• Continue to assess and improve education and career pathways for our workforce, ensuring provision of relevant skills and training.
• Investigate new routes of workforce supply, ensuring the Health and Social Care workforce is accessible to all as a career choice.
• Through the CfSD and the NHS Academy, continue to support role re-design and innovation across Health and Social Care, and enhance the knowledge and experience of our workforce, including identification and training to maximise the benefits of technological advances in the delivery services.

Employ

• Continue to assess and review our approaches to recruitment, ensuring we maximise opportunities and learn from previous experience.

Nurture

• Ensure Senior Leadership in the Health and Social Care workforce reflects the diversity in our population, the NLDP accelerated development programme for minority ethnic staff in the NHS and Social Care will help with this.
• Continue to work in partnership to achieve the best possible outcomes for the workforce and the people of Scotland as we develop national policies and enablers.
• Establishing other National Forums (in line with EMF) by linking up local equality networks on disability, LGBTI+ etc. to help shape future policy, initiatives and training. Flowing from this, there will be consideration of providing more specialist training and resources about equality.