Health and social care: national workforce strategy

Part 2: Implementing the Strategy

We will realise our workforce vision, outcomes and strategic ambitions articulated in this Strategy, by ensuring that the actions we take will address Recovery, Growth and Transformation as appropriate to their timing and as the foundations for a sustainable Health and Social Care workforce. All of the actions set out in this Strategy are informed by values and recognise that achieving our vision is a collective and inclusive endeavour.

Approach to Implementation

Delivery of this National Strategy will be supported at local level, for example through the development of 3 year workforce plans developed by Health and Social Care Partnerships.

This Strategy sets out actions at national level across the 5 pillars of workforce which support recovery, growth and transformation of services and the workforce. The annex to this Strategy groups actions according to whether they are short-term (next 12-24 months), medium term (next 3-5 years) or longer term (5+ years).

Many of the short term actions focus on supporting the recovery of the Health and Social Care system and create the conditions for lasting reform as we move towards living with and through COVID.

Medium and longer-term actions focus more on sustaining workforce growth, continuous improvement and service reform and transformation.

Actions will involve and impact the diverse spectrum of organisations, services and people who collectively represent our Health and Social Care services. Collectively, and over time, delivery of the actions and aims to continuously improve key aspects of the architecture which ensures we have the Health and Social Care workforce needed now and into the future, including:

• Changing baseline community and population health needs and how we equip staff to respond to deliver improved population level health outcomes.
• Our workforce data and how this is analysed, leading to improved strategic workforce planning at all levels;
• How we proactively respond to changing workforce demography and local, national and international employment markets;
• Key workforce issues affecting Health and Social Care service delivery, the quality of staff experience, wellbeing and staff retention;

The implementation of this Strategy will be regularly monitored and kept under active review in partnership with local authorities, Health Boards, Health and Social Care Partnerships and the third and independent sectors, and also in conjunction with our employees and their representatives.

Actions for implementation will reflect, and where relevant incorporate, developments, and provide further opportunity to revisit the planned Health and Social Care service growth projections, which are set out in this Strategy.

Implementation at Local Level

Health Boards, Local Authorities and Health and Social Care Partnerships (HSCPs) have an important leadership role in helping to operationalise this Strategy and its outcomes through 3-year Workforce Plans.

At a local level, these 3-year plans should focus on defining the workforce needed to support the health and wellbeing of our people and align with service planning for remobilisation and recovery, whilst acknowledging that we must safely manage living with COVID and be flexible to the challenges this will undoubtedly bring.

The role of early intervention and prevention across the life course must be articulated, and take into account health inequalities.

Health Board and HSCPs workforce plans should be developed in partnership, including with third and independent sector partners, reflecting that there remains significant system pressures alongside some uncertainty about the future trajectory of COVID as we adapt to living with it. The plans will be submitted to the Scottish Government by summer 2022, whereupon they will be reviewed and feedback will be provided to partners as part of a valuable feedback loop between local and national work. Thereafter, a review process will ensure that delivery, both locally and nationally, remains aligned.

Implementation at a National Level

It is hoped that national partners will also find the framework, outcomes and actions provided by this Strategy useful and will be able to align their own strategies and plans, where appropriate, in support of delivery.

Investing in Our Workforce

Many of the short-term actions set out in this Strategy, particularly where they relate to recovery and systems pressures, are already funded directly from the Scottish Government budget. Further detail on specific investment is set out in the sections that follow.

Record investment of over £300 million has been provided in-year to support winter planning and preparedness and is directly supporting on-going recruitment activity alongside pay increases in Adult Social Care to bring the minimum hourly rate to £10.50 per hour in 2022/23; above the Scottish Real Living Wage.

Additionally, targeted investment of over £1 billion as set out in the NHS Recovery Plan, is directly funding both short and medium term recruitment across key services, alongside new training and transformation opportunities through the NHS Academy and Centre for Sustainable Delivery.

Going forward, further investment in the workforce will be identified in line with the Scottish Government's commitment to increase frontline health spending by 20% (c. £2.5 billion) and increase Adult Social Care investment by at least 25% (c. £840 million) over the lifetime of this parliament.

In May 2021, Scottish Government agreed an average 4% pay-rise for Agenda for Change (AfC) staff in NHS Scotland.

It was the biggest pay uplift for NHS staff since devolution, and has ensured our NHS staff remain the best paid in the UK. In addition, agreement has been reached to implement the recommendations of the Doctors and Dentists Review Board. Negotiations with NHS AfC staff representation will commence as soon as practical in 2022 to secure a single year pay uplift for 2022/23.

Action Currently Underway

Future Developments

In 2022, Scottish Government will publish its response to the Consultation on the National Care Service, will scrutinise Health Board and Health and Social Care Partnerships' 3-year Workforce Plans, and will set out further detail on next steps in our approach as part of the publication of the Resource Spending Review.

Responding to the Challenges Ahead – Workforce Growth Projections

To successfully deliver our tripartite ambition of Recovery, Growth and Transformation, it is clear that workforce growth will be a key determinant for Health and Social Care services to meet the projected needs of the people of Scotland. Although we know we need to grow our workforce, we must also recognise the vacancies in the system and ensure that we consider these in understanding our workforce need into the future.

We indicated in the National Health and Social Care Integrated Workforce Plan^[8] our anticipated growth projections for workforce based on the Scottish Government's Medium-Term Financial Framework. We are further developing this work in partnership, identifying anticipated projected growth over the coming decade which expressly considers current vacancies as well as service transformation, demography and other essential local and national modelling assumptions.

We will, for the first time, publish our indicative projections for Health and Social Care Workforce growth later this year. This will allow us to expressly incorporate evidence from a range of sources, including 3 year Workforce Plans and the forthcoming revised Medium-Term Financial Framework. We will review these projections annually, in line with new and emerging evidence.