NHS Recovery Plan 2021-2026: annual progress update report 2024

Staffing and Wellbeing

The Scottish Government has established a new internal Advisory Panel for Controlled Student Intakes, bringing together expertise across the organisation to integrate our healthcare student planning. The Panel will initially focus on the current controlled intake professions of dentistry, medicine, nursing & midwifery, optometry and paramedicine but will be cognisant of the full range of healthcare professions. The Panel will take a holistic view and consider service reform and role redesign when making decisions about future student intakes. Alongside the Panel an external Student Intake Education and Training Advisory Group will work with Scottish Government to continually improve our workforce supply via the student pipeline.

A significant programme of work is also underway to improve NHS Scotland’s approach to the use of agency staff. While spending on such staff represents a fraction of overall workforce costs, it is nevertheless important that we seek to secure best value whenever we are delivering services, allowing us to maximise the impact that our investment has on the quality and availability of patient care.

That is why we are taking forward work in partnership with NHS Boards, supported by two national oversight groups, to agree measures designed to reduce our reliance on agency staff. As part of this, a series of controls were introduced from May 2023 in order to gradually reduce the number of shifts being filled by nurse agency workers and these are already having a significant impact on local decisions regarding the engagement of staff. A similar programme of improvement work is now being taken forward for the medical and Allied Health Profession (AHP) workforces.

Progress on Delivering Commitments During 2024

Increase the number of undergraduate medical training places by 100 per annum by 2026 and double the number of Widening Participation places – The first three tranches of the commitment were fulfilled with 100 students being added during 2021/22, 2022/23 and 2023/24, respectively. For 2024/25, there is currently a pause on the number of additional places whilst this is reviewed, and the Cabinet Secretary for Health and Social Care will update the Health, Sport, and Social Care Committee at an appropriate juncture. Overall, the 2024-25 undergraduate intake was agreed at 1,417 places.

Invest an additional £3 million a year to provide enhanced wellbeing support, both locally and nationally – Going forward, this will no longer be specific additional funding, and Boards will support workforce wellbeing through their overall core budgets.

Offer further practical support for the physical and emotional needs of the workforce – Scoping work is being undertaken to consider the essential practical needs of our workforce with a view to considering what might further support their wellbeing. The facilities and guidance related aspects of ‘Junior Doctors Expert Working Group’ Recommendations have been adopted to ensure these are developed through a wellbeing lens, and support has been given to the development of Nursing and Midwifery Taskforce Recommendations for Wellbeing and are committed to taking these forward once finalised.

In addition, reflective practice options for the workforce are being explored, and continuously reviewing Wellbeing Hub content and updating this to include additional support for staff. During 2024 this included ongoing work around ‘Postvention’ and developing accessible Peer Support modules.

Enhance occupational health for staff, and continuously evaluate the range of wellbeing support in place to ensure it is sufficient - “Improving Wellbeing and Working Cultures” was published in July 2024, setting out the ambition to enhance working cultures through programmes of work at a national level that focus in the pillars of: wellbeing, leadership and equality. Delivery of national interventions across the three pillars will support delivery of wider ambitions within health, social care and social work, including staff retention, improving wellbeing, longer-term recovery and service reform.

In addition, the NHS Scotland Menopause and Menstrual Health Policy, launched on 31 October 2023, supports all staff who are experiencing menopause or menstrual health related symptoms. The aim of the policy is to provide a supportive environment, where staff can perform at their best, in a way that supports their wellbeing and ultimately helps staff retention.

Development of National Wellbeing Programme to be implemented from Autumn 2021 – The National Wellbeing Programme has now been delivered with committed regular funding to ensure a sustainable future. The programme comprises of the National Wellbeing Hub, The Workforce Specialist Service, The National Wellbeing Helpline and support for local psychological therapies and interventions through our Workforce Development Programme.

Invest £11 million over life of plan in national and international recruitment campaigns – Due to the significant changes in approaches to workforce recruitment over recent years, this is no longer being progressed as a specific action, and instead has been incorporated into the wider workforce recruitment programme.

Provide additional training opportunities through the NHS Academy for new and existing staff in key areas of need, including pre and perioperative care and endoscopy – The NHS Scotland Academy is now well established, delivered as a partnership between NHS Golden Jubilee and NHS Education for Scotland to offer accelerated training for a wide range of health and social care roles and professions. As part of this, the Academy continues to deliver a broad range of bespoke training opportunities in areas including pharmacy, diagnostics and peri-operative practice as well as tailored support aimed at those staff who have been recruited internationally and broader induction resources for those who are new to Scotland’s health & social care workforce.

225 new advanced musculoskeletal practitioners by 2024/25 – 194 students have been funded towards meeting this target to date.

Publish a National Workforce Strategy – The National Workforce Strategy was published in March 2022 and the Scottish Government continues to monitor the actions contained within the Strategy and remains committed to achieving the overall vision for “A sustainable, skilled workforce with attractive career choices and fair work where all are respected and valued for the work they do”.

Continue to invest in and grow the Workforce Specialist Service in line with what staff tell us they need – A national wellbeing programme is being taken forward with a budget of approximately £2.6 million each year to support wellbeing. Additionally, progress is underway for procurement for a new contract for our Workforce Specialist Service.

The progress throughout 2024 builds on the successful delivery in previous years which:

• Established a National Centre for Workforce Supply Completed November 2021
• Created 30 training places in cardiac physiology
• Created 30 new reporting radiographer training places over the next 3 years
• Introduced a new Paramedic Students Bursary
• Implemented the recommendations of the Doctors and Dentists Review Board