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Future Practice: A Review of the Scottish Medical Workforce
TEN KEY MESSAGES...
1. The core service issue is the delivery of a 24-hour acute care service for primary and secondary care. |
2. We should plan for tomorrow and for the next 10 years. |
A sound nationally-led workforce planning process is essential, and must be informed by authoritative evidence. |
3. We need more doctors to support a specialist-delivered service. |
Too much care is provided by doctors in training. |
4. Scotland should be organised around much larger regional health economies than exist at present. |
Each should address workforce planning and the delivery of all but the most highly specialised services. |
The public must be involved in service re-design. |
5. A review of the traditional hospital career and training grade structure for doctors is required. |
6. Team-delivered care is an over-arching theme. |
The workforce must accommodate new and changing working practices. |
7. Travel time increases clinical risk for emergency care, but so can lack of capacity, critical mass or experience in a small unit. |
This applies across the whole of Scotland. |
8. We need the right incentives to recruit the doctors we require and to retain enough of those we already have. |
We need to promote and publicise medical careers in Scotland. |
9. The output of basic medical education must produce new doctors who are fit for purpose. |
Further work is required to identify the options for modifying the present arrangements for entry to Scotland's medical schools. |
10. Political, professional, public and service leadership is needed to create a clear and realistic public awareness of the issues and priorities. |
...AND A SINGLE CONCLUSION
The medical workforce in Scotland is under pressure. Service demand is rising and will continue to rise; the capacity to respond is already limited and will be further restricted as the Working Time Directive is applied across the workforce and as practitioners seek and expect less demanding hours of work. THE SERVICE WILL ONLY SURVIVE WITH CHANGE. |
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