Respiratory care action plan draft: consultation report

Question 11: Workforce 

Commitment 13 – We will support a programme of innovation and the development of a phased approach to implementation where emerging evidence supports changing models of workforce, such as testing new roles of Advanced Practice for nurses

A total of 113 people responded to this question, with 50 responses being expanded to include comments. Of the people who responded, 93 agreed with the commitment, 14 were unsure and 6 disagreed. To further breakdown the figures of those who responded: 

• NHS (boards and organisations) 10
• Third sector organisations 13
• Private sector companies 7
• General public individuals 83

Overall, the general themes that came out of the responses to this question were: role of Allied Healthcare Professionals (AHPs); additional responsibility for staff; multidisciplinary teams; general workplace concerns; training for staff; clinical leads; and data. 

Breakdown of the most common themes:

Allied Healthcare Professionals

There was significant overlap in comments between question 11 and 12, with reoccurring themes in both. In particular, there was concern that AHPs were not considered part of the main workforce.  26 respondents stated that AHPs should be included within this section. Several comments were made about the role that AHPs have in multi-disciplinary teams and suggestions of AHP-led respiratory teams caring for people in primary care settings. 

For some, the lack of inclusion of AHPs was confusing given the commitment on the importance of Pulmonary Rehabilitation. Respondents provided examples of AHPs providing vital services, such as; dieticians supporting people with respiratory conditions to remain healthy and respiratory physiotherapists encouraging self-management throughout a patient's journey. Others suggested advanced roles for pharmacists working with GPs in care homes and in rural areas. In some areas pharmacists are already providing respiratory clinics, which supports medical sustainability. 

Additional responsibility for staff

Additional responsibility for staff was the second largest issue of those who expanded their responses to this question – both for nurses and AHPs. The role of specialist nurses such as Advanced Nurse Practitioners (ANPs) was highlighted, with comments suggesting a respiratory ANP in every GP surgery. It was felt by some respondents that there is currently a shortage in the number of ANPs across Scotland, although other respondents provided a more cautious response, noting that upscaling nurses may cause issues elsewhere.

It was felt by some that specialist nurses could support clinicians with specialist interests, with increased training of specific conditions for student nurses, or nurses specialising in combined clinical areas. Specialist training for AHPs and Pharmacists was also suggested.   

Multi-disciplinary teams

In addition to Allied Healthcare Professionals and additional responsibility for staff, Multi-Disciplinary Teams (MDTs) were also discussed. It was considered by some respondents that the role and development of MDTs should be included in the commitment as patient treatment and care includes staff from across the healthcare spectrum. 

General workforce 

There were a number of general workforce comments made by respondents, which varied in subject. The current workforce situation was noted, with an acknowledgement that the oncoming workforce issues caused by an ageing workforce need to be addressed. Funding of posts was suggested to support boards to create more sustainable services.  

Staff training

Training was an area respondents considered important.  Suggestions were made to incorporate continuous protected training time into roles. 

Data

The responses to this question had some overlap with the data commitment responses; particularly around the lack of integrated systems across health and social care. There was support for the use of new technology, including around the potential of smart spirometers at home on an app.

General 

There were multiple responses which expressed concern at the wording of the commitment, with several noting that it needs clarification. It was also viewed by some respondents that the wording could be stronger and more specific, with added targets.  Several respondents perceived that the commitment focused on nurses; clarification will be needed. 

A chart showing phrases from the Q11 responses. AHPs had 26 mentions; MDTs had 4.

A chart showing phrases from the Q11 responses. AHPs had 26 mentions; MDTs had 4.