Health and social care: national workforce strategy

Introduction

We are clear that we need to take a people-led approach and work across government, with our local government partners, wider public sector communities and other parts of civil society on critical aspects of recovery to address the systemic inequalities made worse by COVID.

We are also exploring how we can work together on three initial cross-portfolio priorities (children, climate and communities, fair work) that are rooted in the COVID Recovery Strategy^[1] and have the potential to make a significant difference to wellbeing and health.

As we move forward with recovery we will also look to implement the Health and Care (Staffing) (Scotland) Act 2019. This legislation continues the focus on the engagement and wellbeing of staff. Its application will encourage innovation and creativity, as the structures and tools required by the legislation ensure transparent risk mitigation and the effective use of resources.

Through the emerging National Care and Wellbeing Portfolio, aimed at driving reform and innovation in our Health and Social Care system in conjunction with partners, we are looking to improve healthy life expectancy and work to address health inequalities.

The portfolio provides an opportunity to design a progressive Health and Social Care reform agenda that provides coherence, sustainability and improved outcomes across four core programmes - Integrated Planned Care, Unscheduled Care, Preventative and Proactive Care and Place and Wellbeing.

This Workforce Strategy is primarily aimed at our Health and Social Care employers across the statutory, third and independent sectors. It provides an overarching framework of activity at a national level, in turn supporting local partners and partnerships to continue to plan and deliver the workforce needed to provide excellent services that promote better population and public health outcomes. We anticipate that it also aligns with the work of many national partners.

The challenges identified in this Strategy and the projected demand for workforce over the next decade make it clear that as we live through and learn to live with COVID, we will need to grow the workforce at the same time as transforming how we work to further increase capacity.

A suite of initial actions forms part of the Strategy and these will be kept under review and further developed through partnership working with NHS Employers, Local Government, Social Care Employers, Trade Unions, Professional Organisations and our regulators.

We want those working in the sector and those considering a move into it, to know that they are equally valued, whatever their role. While the pandemic context has been unprecedented and challenging, the opportunities for careers in Health and Social Care remain extensive and rewarding.

There are many routes in, flexibility in roles, and access to training and development, all while making a positive difference to people's lives.

This Workforce Strategy sets out:

• The changing demands on Health and Social Care and our workforce
• Our workforce vision, values and principles
• The five pillars of the workforce journey:
  • Plan
  • Attract
  • Train
  • Employ
  • Nurture

It sets out the evidence base and actions which will be taken over the short, medium and long term to achieve our tripartite ambition of Recovery, Growth and Transformation of our Health and Social Care services. These actions include:

• Growing our NHS workforce over the next 5 years by 1%, 1,800 WTE, growth to ensure there is workforce capacity to address backlogs and increase capacity in the NHS as committed to in the Scottish Government's NHS Recovery Plan.
• Increasing frontline Health spending by at least 20% over this parliament (c£2.5bn) and increase Adult Social Care investment by at least by 25% (c. £840m) over this parliament.
• Investing £11 million over this parliament to fund the establishment of the Centre for Workforce Supply and directly underwrite recruitment campaign activity to grow our Health and Social Care Workforce.
• Increasing the number of medical school places over the course of this parliament by 500.
• Supporting up to 1,800 training places through the National Transition Training Fund for those interested in roles in Adult Social Care, which will respond directly to current recruitment challenges and increase knowledge and understanding about the variety of skilled roles available in Adult Social Care.
• Recruiting 800 additional GPs by 2028.
• Investing over £230 million per annum in nursing and midwifery training costs, including our commitment to maintain a student bursary.
• Providing £22m for local authorities in the next financial year 2022/23, and recurring thereafter, to provide additional Social Work workforce capacity within local authorities.

In pursuit of our vision for the Health and Social Care workforce, we have already undertaken a great deal of work and through this Strategy we remain committed to enabling the right workforce, with the right skills in the right place at the right time.

Social Care

Growth

Overall Social Service workforce has increased by 6.5% headcount (from 196,970 to 209,680) between December 2008 and December 2020.

Registration

Registration of the social services workforce commenced in 2003 with around 164,000 workers registered with SSSC at January 2022.

Qualifications

Over £3 million invested in workforce development in 2021-22 including £1.1m for the Voluntary Sector Development Fund.

Created new SVQ modules, including one for palliative care.

Fair Work

Since 2016, we have funded the real living wage for Social Care.

In October 2021, the Scottish Government committed to provide additional funding of up to £48m to uplift the hourly rate for third and independent sector Social Care workers from at least £9.50 per hour to at least £10.02 per hour, effective from the 1st December 2021.

As part of the 2022-23 budget, we announced that the hourly pay for those providing direct care within Adult Social Care will rise to £10.50.

We continue to work with partners to further develop a shared programme of activity around Fair Work in Social Care.

Development

A Continuous Professional Learning System and app have been developed by SSSC enabling registered workers to record learning. This is alongside a variety of resources supporting awareness of career pathways.

Health

Growth

Overall Health Workforce increased by over 22% (from 127,061 WTE at September 2006 to 155,834 WTE at December 2021).

Nursing and Midwifery Workforce – increased by 14.5% since 2006, (by 8,206 WTE to 64,989 WTE).

NHS Medical and Dental Workforce – increased by 45% since September 2006 (by 4,569 WTE to 14,730 WTE).

Consultant Workforce – increased by over 62% since September 2006 (by 2,266 WTE to 5,903 WTE).

GP Workforce – increased by 13% headcount (from 4,598 at September 2006 to 5,195 at September 2021.

The WTE Primary Care multidisciplinary team Workforce - increased from 313 in March 2018 to 2,463 in March 2021.

Training

Nursing and Midwifery – Student intake has increased by 34.5% (3,351-4,507) from 2010 to 2021.

Medical Students - Student intake has increased by over 42% (increase of 362) from 2015 to 2021.

Following the conclusion of medical trainee recruitment, the recruitment of new GP trainees in 2021 has been better than any other year on record with 98% of advertised GP training posts filled which builds on the success of 2020 trainee recruitment when 97% of posts were filled.

Between 2015 and 2022, the number of available medical school places at Scottish universities has increased by 32% (an extra 269 places) - to a record high of 1,117. The majority of these new places are focused on general practice. These include:

• 55 ScotGEM (Scotland's first Graduate Entry Programme) places which includes offering 'return of service' bursaries for those who commit to stay and work in the NHS after graduation.
• 60 additional places from 2019/20 onwards at Aberdeen and Glasgow Medical Schools (30 places at each Medical School, per academic year).

Fair Work

Our NHS staff are the best paid in the UK. The 2021/22 NHS Scotland AfC Pay Deal saw staff receive an average 4% pay raise, the biggest pay rise in the UK.

Staff Wellbeing

In response to the pandemic, Scottish Government now provides funding specifically earmarked for wellbeing resources for Health and Social Care staff. This is in addition to the wide range of employee wellbeing supports provided by health boards, councils and other Social Care providers.

For financial year 2020/21 Scottish Government provided £5 million to support the wellbeing of people working in Health, Social Care and Social Work. In financial year 21/22 we increased this to £12 million, an increase of 240%.

The number of visits to the National Wellbeing Hub (one of our wellbeing resources) – currently at over 170,000 since its launch in May 2020. This resource includes the Workforce Specialist Service, a primary care-led, multidisciplinary, mental health treatment service that can treat professionals suffering from a range of mental health issues such as stress, anxiety, depression or addiction, with a focus on the impact this may have on their work.

This Workforce Specialist Service is available to all regulated professionals working in Health and Social Work/Social Care in Scotland.