Shortage occupations list 2018: call for evidence - our response for health and social care

Measures Taken to Reduce Shortages

65. To accommodate changes in the Health Workforce, NHS Scotland has grown by ~5000 WTE in the past 5 years and continues to grow^[36]. The Scottish Government has undertaken extensive workforce planning to mitigate the impact of Shortage Occupations. This includes the publication of a national Health and Social Care Workforce Plan.

66. The Scottish Government has a continuing commitment to "Grow our Own" NHS Scotland workforce. Between 2015-16 and 2020-21 the Scottish Government will have increased the annual intake of medical places in Scottish universities from 848 to 1038 (22%), including funding Scotland's first Graduate Entry Medical programme. The Scottish Government has responded to vacancies in entry level and non-medical roles by introducing a tranche of funding to support Modern Apprenticeships through the "Get Into Healthcare programme"^[37].

67. To increase the attractiveness of work in remote and rural areas: Improvements have been made to digital networks, so that staff receive the support they need, and can access professional development opportunities. Support for remote and rural GPs has been provided through the rural fellowship scheme, as well as the attend anywhere video-conferencing service. The Scottish Government has offered a Targeted Enhanced Recruitment Scheme (TERS) with a bursary for £20,000 for successful applicants from selected GP programmes, to support those working in a more rural location. NHS Scotland have also responded to changing demands to the health system by developing enhanced and expanded multi-disciplinary community care teams, and restructuring the provision of essential services where necessary.

68. To meet projected future requirements, 2,600 additional nursing and midwifery training places are being created over this parliament as part of a wider package of measures to accelerate the supply of newly qualified nurses and midwives. It was announced in November 2018 that the number of nursing and midwifery student places will be increased by 7.6% in the 2019-20 educational year^[38]. This will be the seventh year in succession that student numbers in this field has increased in Scotland. On 9 October 2018, the Scottish Government announced its intention to increase student bursaries for nursing and midwifery students to £10,000 in 2020-21 up from up from £6,578. All eligible students will also benefit from an interim increase to £8,100 in 2019-20. This rise of £3,422 a year will help cover accommodation and living expenses during their studies. In addition, bursaries for care experienced students will move to £8,100 this financial year, an uplift of £1,522^[39]. An additional discretionary fund of at least £1 million was launched in 2016 to provide a 'safety net' for nursing and midwifery students in most need. In 2017/18 we invested an extra £3 million per year to increase support for nursing and midwifery students with children or dependents.

69. NHS Scotland have made valuable use of the existing exemptions for Doctors and Nurses to the Tier 2 cap, investing £4 million in domestic and international recruitment^[40]. On 06 October 2018, the Cabinet Secretary for Health and Sport formally approved the creation of an NHS Scotland International Recruitment Unit.

70. Specific areas of shortage have been addressed through targeted campaigns, with an additional £4 million spent on the Radiology Transformation Programme^[41]. The Scottish Government is also undertaking a targeted recruitment campaign across all levels of Psychiatry.

Social Care Workforce

71. Professionalisation:Staff within the social care workforce must acquire a qualification as part of their registration. This qualification typically leads to higher retention levels and improves transferable skills enhancing career development.

72. In contrast to the health and social care sector in England, registration requirements ensure that the majority of adult social care staff in Scotland will be trained to RQF level 3. As a result social care staff in Scotland would qualify for the minimum skills threshold recommended by MAC within the White Paper (Point 6.19), for the new skilled workers route, even where they may not meet the proposed salary threshold.

73. If as indicated, the skills threshold for inclusion on the Shortage Occupations List will be RQF level 6, this would be applicable to a lower proportion of staff, including approximately 22,000 jobs across the Scottish social service sector, including service managers, supervisor, social worker, nurses and occupational therapists.

74. Integration and Workforce Planning: The National Health and Social Care Workforce Plan Part 2 – a framework for improving workforce planning for social care in Scotland, recognises the diverse nature of social care and has seven key recommendations. The recommendations help services to ensure that they get the 'right people in the right place, at the right-time, to deliver sustainable and high-quality services with improved outcomes for those who use them.' They include:

• Collation of data to support workforce planning; analysis of labour markets to underpin workforce planning; improving guidance for workforce planning to support partnership working across the sector; co-production of workforce planning tools to enable service redesign and new models of care.
• Actions to address existing workforce challenges, including a national campaign to promote the sector as a positive career choice; enhancements to career pathways; improvements to training and education for the workforce and development of a professional framework in practice for social care and social work

Pay Provisions – Health and Social Care

75. The Scottish Government has also recently agreed a 3 year pay deal for all non-medical, dental or executive staff in Scotland, to ensure that pay is competitive, and that NHS Scotland remains an attractive place to work. Staff at the top of their pay scale earning up to £80,000 will receive a 9% pay rise over 3 years. The increase for staff not yet at the top of their band could be considerably more – up to 27% over the 3 years. This maintains competitive pay, with staff of equivalent grades across the UK.

76. The Scottish Government has also introduced the real Living Wage for adult social care, currently £8.75 per hour. There will now be the expectation that adult social care workers are paid at least the real Living Wage regardless of whether they work for the public, private or voluntary sectors. The Scottish Government's budget includes support for additional expenditure by local government on social care, with an ongoing commitment to ensure all adult social care workers receive at least the real living wage.