Stroke improvement plan 2023

4. Workforce

The Scottish Government understands that the provision of high-quality stroke care, throughout the patient pathway, is highly dependent on having an appropriately skilled workforce, delivering the right care, in the right place, at the right time.

In March 2022, The Scottish Government published the Health and social care: national workforce strategy, setting out a vision for the health and social care workforce to support recovery, growth and transformation of our workforce. The strategy set out numerous actions to help bolster the health and social care workforce, many of which are relevant to stroke care provision.

Understanding the available stroke workforce, and their education and learning needs, is a key component of the SSIP review process and we will continue to assess the impact of the actions from the NHS health and social care workforce strategy on local stroke workforces.

We will engage regularly with NHS Boards through SSIP reviews, to establish where workforce challenges exist. Through the organisational audit component of reviews, we will capture and record data relating to stroke workforce numbers and consider how this might be reported. It is imperative that NHS Boards ensure their stroke workforce is appropriately staffed throughout the patient pathway. These reviews will be used to review staffing levels, seek assurances regarding local stroke workforce planning and reiterate the vital importance of reaching and maintaining appropriate levels of staffing.

Whilst ensuring staffing levels are appropriate is critical, ensuring the skills and knowledge of the workforce is of equal importance. NHS Boards should seek to ensure their stroke workforce reaches, and maintains, an appropriate level of skills and knowledge. NHS Boards should consider whether a dedicated staff member functioning as a stroke trainer will be required in supporting this work.

Several criteria have been included in the revised SSIP RAG chart for NHS Board reviews to provide assurance that the stroke workforce is suitably knowledgeable and skilled. In addition to utilisation of the education training template to demonstrate appropriate competency within the stroke workforce, NHS Boards are now required to demonstrate:

• Evidence of planning to identify training needs for the stroke workforce.
• That all staff working in stroke services complete, as a minimum, the STARS core competency training modules and Advanced modules as required.
• That all staff potentially dealing with hyperacute stroke patients have completed the appropriate training (such as STAT+, STARS Advanced Modules).
• That training is supported by rolling educational plans, comprising blended learning with simulation and web-based training.
• Evidence of regular educational sessions (which may be internal or external) to support shared learning amongst professional groups.
• Evidence of training stroke service staff with a focus on support with having difficult conversations.
• That stroke physicians and radiologists have received up to date training in advanced imaging for stroke.

We will continue to review performance against these criteria and consider whether further work is required to drive the upskilling and education of the stroke workforce.

In addition to ensuring the stroke workforce is suitably staffed, and skills and knowledge are maintained, the stroke workforce should be supported by suitable use of technology-enabled working practices. Reviews of NHS Boards now ask that they demonstrate the appropriate use of information technology to allow the workforce to function as effectively as possible. This should facilitate cross-NHS Board working, networking between clinicians, reliable and prompt access to information and the provision of tailored information to patients.