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WORKING FOR HEALTH
WORKING FOR HEALTH - PART 1
THE VISION FOR WORKFORCE DEVELOPMENT
1.1 The Future Role of Workforce Development in NHSScotland
Workforce development is pivotal to the reform of health services in Scotland and to the improvement of patient care. It is concerned with securing the workforce for NHSScotland in the short, medium and long-term.
It is about getting the right people with the right skills to be in the right places at the right time.
Workforce development is therefore about more than just workforce planning and a focus on workforce data and information. It interacts with service planning and service redesign, allowing the future workforce for health to be seen dynamically, directly linked to the future shape of services, local and national employment markets, and the supply and demand that exists now and in future.
It covers related issues including:
education and training of staff
recruitment and retention
new ways of working and job redesign
changing roles
career packages and pathways.
Workforce development will act as a key driver of the reform agenda by developing a workforce which can embrace the changes required to sustain and improve services.
It will focus on the attachment of staff to
services rather than
institutions; changing skill mix; expansion of roles; and the development of skills and knowledge. In doing so it looks to the further development of Managed Clinical Networks, as outlined in the recently published report
Future Practice
2. Workforce Development therefore not only lies at the heart of modern Human Resources in Scotland but is an essential building block for the future of Scotland 's health itself.
The dynamic framework for workforce development is set out at Appendix 2.
1.2 The Need for Action Now
This is a crucial moment to be addressing these issues. Over the next five years, NHSScotland will enjoy the largest ever sustained increase in health spending. That places an onus on everyone involved in healthcare to ensure that resources are properly targeted, and that the future priorities for the workforce - accounting for some 60% of total health board spending - are properly defined and addressed.
Everyone with a stake in the future of health services shares a collective responsibility to ensure that the extra investment is used wisely and effectively to bring about the right mix of talent, creativity and expertise to create and sustain a reformed NHSScotland delivering better healthcare for patients.
There are many pressures in the system that require solutions and there is already a large amount of workforce development activity underway in NHSScotland. Some of the key national issues are set out in Appendix 3.
1.3 The Challenge
Meeting the growing challenge of the future in health services demands a change in the priority placed on workforce development and a greater emphasis on skill, drive and leadership at all levels.
To realise the aspirations contained in
Our National Health, and to deliver reformed health services, we need to develop a much more co-ordinated approach to the creation of a new workforce.
This has to be done at all levels - locally, regionally and nationally. We need to see the workforce as an integrated whole across primary care, community care and acute care, with an emphasis on teamwork and multi-professional practice delivering health and community care to all the citizens of Scotland.
We need to see the employment markets for health workers more broadly, so as to attract and retain the staff needed to deliver services.
And most fundamentally we need to align workforce planning with service planning.
This Plan recognises the challenges involved and the key role played by building workforce planning capacity. Baseline information on the workforce - on numbers, specialties, turnover, retention, attrition, gender, movement, career progression, and so on - is currently patchy, and reflects the lack of dedicated data systems. A powerful underpinning theme running throughout the Action Plan is the need to develop robust data systems and the skills to use information effectively.
The challenge is also to create a workforce development function that embraces the broad family of health services in Scotland, including the independent contractors who deliver general medical services, dental services, ophthalmology services and pharmacy services.
This plan also embraces the need for greater integration of the social care and healthcare sectors embodied in the concept of
Joint Future, and the major impact which that will have on workforce development in years to come. There is a shift of approach needed to place workforce development in the context of the whole labour market for healthcare, recognising that it reaches beyond the NHS to include the voluntary and independent healthcare sectors, the private sector and the wider public sector market. This includes recognising that the factors governing supply and demand are influenced by services such as agency and bank nursing.
1.4 Workforce Development - Core Functions
The workforce development proposals issued by the Scottish Executive Health Department (SEHD) in January 2002 outlined the core functions, to be delivered at local, regional and national level, that will underpin effective workforce development for NHSScotland. They encompass six key strands:
Capacity - Assessing the future size and shape is the core function of workforce planning and the key building block for workforce development. It is best done locally and regionally and linked to a clear vision for service reform and development, as part of a co-ordinated national approach to matching supply and demand now and in future.
Service delivery - This covers demands arising from the service planning process, and should be integrated with the assessment of capacity made through workforce planning. The clear direction of travel should be towards integration of service planning and workforce development at NHS Board, regional and national levels. Key to this will be the effective integration of the regional workforce arrangements with regional planning groups.
Service redesign - New ways of working are vital to workforce development. They place workforce issues at the heart of service redesign and the wider reform of the NHS. Workforce plans must reflect and support change if they are to keep pace with innovations in service delivery and the changing aspirations and needs of patients.
Training and education - Training can be a key constraint on supply of the professional workforce, but it can also be an agent for enabling staff to deliver better-quality patient care. Many decisions about training and education will need to be taken at national level by the National Workforce Committee, on the basis of advice from NHS Education for Scotland. Close and effective working between the Committee and NHS Boards, NHS Education for Scotland and the regional workforce groups will help to ensure that decisions are based on a thorough assessment of needs and constraints at local and regional levels.
Career development - Closely linked to training and education, this covers areas such as the development of new career pathways, recruitment and retention packages, continuing professional development (CPD), mentoring and flexible approaches to working.
Research and best practice - A well-focused research and evidence base for workforce development is vital. Robust models of workforce development, building on existing expertise and evidence of what works and what does not work, should be accessed, devised and deployed in NHSScotland, working closely with the Health Service and the public sector in other parts of the UK and beyond.
1.5 Workforce Development - New Infrastructure
The Executive's proposals on workforce development were followed by a consultative Workforce Development Action Day with key stakeholders (
see Appendix 1). The feedback was broadly supportive of our proposals and the Action Plan now puts in hand the implementation of the infrastructure to support workforce initiatives in NHSScotland. These will consist of:
Three Regional Groups where workforce and service planning come together
These Regional Groups, supported by Regional Workforce Co-ordinators and more locally, Workforce Officers, will:
be organised to match service planning groups covering the North, East and West;
develop, promote and maintain joined-up strategies for workforce development in each constituent NHS Board area and, where appropriate, at regional level;
pull together integrated regional workforce plans;
work with stakeholders - local authorities, Careers Scotland, Jobcentre Plus, education providers and local enterprise companies, for example - to ensure a comprehensive approach to managing demand and planning the supply of the health workforce.
A key guiding principle will be the integration of service planning with workforce development.
A National Workforce Committee
The committee will:
report to the Health Department Board, will be chaired by the Director of Human Resources for Scotland and be serviced by a National Workforce Unit;
set strategic direction for the Regional Workforce Co-ordinators and Regional Groups and define the framework within which workforce development will operate at all levels;
develop with the National Workforce Unit, the Regional Workforce Co-ordinators and NHS Boards, action that takes account of a number of ongoing workforce initiatives in NHSScotland.
The Regional Workforce Co-ordinators will be accountable to the Chair of the National Workforce Committee.
National Leadership from the Health Department Board and from its Directors and their teams in Human Resources, Service Planning and Performance Management, and the Chief Medical Officer and Chief Nursing Officer.
Local Leadership from NHS and Trust Boards and their executive and non-executive directors, including the medical, nursing, human resources, planning and partnership directors.
More detail on these groups and the relationships on which they depend are set out in detail in the Action Plan that follows and at Appendix 4.
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