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Building on Success - Future Directions for the Allied Health Professions in Scotland

Shaping the Future
9. Recruitment and Retention

Allied health professionals are vital team players in the drive to deliver the changes required by Our National Health: a Plan for Action a Plan for Change. But they and other health and social care professionals across Scotland are facing challenges in shaping and forming their workforce, with demand currently outstripping supply in many disciplines. This chapter explores what steps can be taken to secure the AHP workforce now and for the future.

9. Recruitment and Retention

Ensuring the availability of professional and support staff with the right skills and competencies is vitally important for the provision of the multi-professional services people need and value. The challenge of growing and sustaining the workforce in what can be regarded as a competitive global market for talent now requires creative and flexible responses from all the professions.

Integrated workforce planning

The Scottish Executive is committed to developing a more integrated approach to workforce planning that will be central to the national strategic and local planning systems for health and social care priorities. Plans for a new National Workforce Unit and regional Workforce Centres that are to be established to drive and support this systematic multi-professional workforce planning process are currently being progressed.

The Workforce Centres will work with NHSScotland and the National Workforce Unit in helping to plan the future AHP workforce and in addressing the balance between supply and demand. This was highlighted as a particular priority by the Acute Services Review Report (1998), which stated:

'A significant concern for the Review was the lack of information relating to [AHPs], their target staffing levels and indeed their patient care activities. This has to be seen against the backdrop of an agreed need for equity to the full range of therapy provision in the community, primary care, hospitals, schools, health surveillance, screening and health promotion.'

The action plan for the Centres to be established will be published in 2002.

Agenda for Change

The Scottish Executive continues to be fully committed to UK-wide proposals under Agenda for Change to modernise the existing NHS pay system. The proposals aim to support flexibility in rewarding staff fairly for changes or expansion of their roles and extensions of the scope of their practice, resulting in better career progression and the evolution of more modern conditions of service.

It is hoped that agreement on these change proposals can be finalised for implementation in Scotland in 2004. Links between health, local government and social care are also being examined, with a view to establishing a more integrated approach to pay and conditions in future.

Creating the workforce of the future

Many factors influence the career choices that individuals make - as school leavers, as graduates, and in later life as their career develops. The development of suitable career pathways is undoubtedly a factor in all of these choices.

While in the past there has been little difficulty in attracting students to pre-registration courses, the emerging trend is one of falling numbers of applicants to many professional AHP courses across Scotland. This development requires further review.

Current AHP students consulted during the development of the document described variable experiences in obtaining accurate careers information or work experience which would support them to make positive informed choices. Some new graduates reported that they did not always feel fully prepared for the challenges of the workplace. A concerted effort by AHP service providers, university staff and careers officers is required to provide accurate information to support decision-making and clarify workplace roles.

Students also indicated their enthusiasm for having a better understanding of the roles of professional colleagues during their training programmes. They saw this as an opportunity to enhance team communication and joint working, and impact on patient outcomes and multi-professional efforts to improve the health and wellbeing of the population.

New practitioners

Early experiences in the workplace are crucial determinants of job satisfaction. Support for newly qualified staff in the transitional phase between being a student and becoming a qualified practitioner is central to ensuring that they develop the competencies necessary to do the job and gain a rich and satisfying experience of work as a registered practitioner. Initiatives such as the induction and mentoring arrangements developed in many departments will help newly qualified practitioners to achieve these goals, and may also assist in the ongoing retention of staff.

>> Orthoptists are using the mentoring scheme for new graduates developed by the British Orthoptics Society to support new practitioners in NHSScotland. <<

Many junior staff from a range of disciplines express a desire to gain a variety of experiences in the clinical setting, a practice that is important to them in selecting their first job. The wish to gain life experience through world travel is also common among this group. Creative recruitment practices for junior grades may enable this flexibility to be written into their first post, ensuring practical cover and enhancing the retention of skilled staff within NHSScotland.

Balancing the requirements for clinical education

Current students and junior staff indicate that they are likely to seek employment in a workplace where they have previously been on clinical placement. The limited availability of student fieldwork placements nationally is therefore not only likely to impact on the number of students who can be trained, but will also have negative implications for recruitment. Given the difficulties of recruiting to remote and rural areas, it is particularly vital that opportunities for clinical placements in these areas are enhanced.

A partnership approach between health and local authority AHP leaders, Trust Human Resource Directors and the universities is required to overcome existing and perceived barriers to developing clinical placement opportunities.

New career pathways

Many professions have particular difficulties recruiting and retaining experienced staff. Lack of opportunities to update dormant skills for AHPs who have not been practising for some time, limitations on the numbers of hours many AHPs are available for work, and deficiencies of skilled personnel in many parts of Scotland all figure among the problems NHSScotland recruiters face. The Scottish Executive is now taking steps to tackle some of the issues.

>> A return to practice learning programme for Radiographers has been developed at Robert Gordon University and a distance learning return to practice package has been developed for Dietitians at Queen Margaret University College.<<

>> NHS Grampian have also introduced mentors to support Dietetic returners. <<

Current opportunities for specialist or 'high-level' generalist practitioners are increasing, and opportunities for extended scope of practice are emerging all over Scotland. AHP leaders, in partnership with other clinical colleagues, need to drive forward such developments, which not only offer opportunities to fully utilise the expertise of AHPs and improve service-users' experience of care, but are also attractive to many potential recruits.

Developing future leaders

Developing and supporting the AHP leaders of the future is critical to succession planning and effective delivery of care. Leadership development opportunities currently exist through the multiprofessional Xceed programme and locally through Trust leadership development initiatives, but more needs to be done to tap the potential leadership qualities of AHPs in Scotland.

>> AHP Leaders at Yorkhill Trust have established an 'Aspiring Manager' programme to support the development of leadership, influencing and change management skills for multi-professional clinical leaders. <<

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