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Scottish Health Workforce Plan - 2004 Baseline
1 introduction
A New Beginning
Workforce Strategy
Objectives of the Workforce Plan
Workforce Planning in Corporate NHSScotland - A New Beginning
The future of the NHS depends on its workforce - how many staff there are, what skills they have and how well they work together for patients.
This baseline Scottish Health Workforce Plan is a significant milestone in the development of a truly corporate NHSScotland. The establishment of unified NHS Boards across Scotland from 1 April 2004 and the recognition of a shared responsibility beyond the boundaries of individual Boards for strategic working in many areas, create the necessary platform for an integrated approach to long-term planning; for services and for the workforce that delivers them.
In August 2002,
Working for Health1 set out our plans for a step change in workforce planning and development at local, regional and national levels. It went beyond the traditional view of workforce planning as a relatively static numbers-driven exercise, to encompass proper co-ordination between workforce development and service planning and redesign. Issues crucial to
workforce development are the way in which the NHS educates and trains its staff, the methods it uses to recruit new staff and retain those it has, the way that changing roles can drive and enhance the effectiveness of a planned approach and the vital part played by new careers and career pathways. The National Workforce Committee was established early in 2003 to provide leadership for the workforce development agenda. As the range of activities that it oversees expands considerably, one year on we are now significantly enhancing its membership, with a supporting structure of sub-groups and programmes of work.
In the Health White Paper
Partnership for Care (February 2003) the importance of workforce planning was underscored. Capacity for workforce planning at all levels is now significantly enhanced. This baseline report on the workforce seeks to give the high-level leadership that will maximise the strategic workforce planning at local and at regional level required to sustain and improve services to patients.
The NHS Reform Bill currently going through the Scottish Parliament will further underpin the fundamental importance of planning the workforce by requiring NHS employers to have in place arrangements for workforce planning. This requirement, in support of wider staff governance responsibilities which will also for the first time have statutory force, is welcome and timely.
We do not see the National Workforce Plan as a passive document - we want it to kick-start an interactive dialogue with our partners about workforce numbers.
This first version in particular is very deliberately termed as a baseline - it is not yet a plan in the sense of providing specific projections of future requirements. For example, we know that we need to develop workforce capacity, skills and roles to enhance the provision of primary and community based services, and that there are gaps in the detailed information around staff employed by independent contractors. The baseline, however, sets out what we know and what we are doing to grow that knowledge so that, progressively, we are able to manage workforce planning within an integrated framework to deliver the results that are needed.
The Workforce Strategy - Workforce Planning in Context
As well as understanding current and future demand for staff, we need to achieve a balance between supply and demand in the longer term.
Understanding this balance will require better information, mutual understanding, coordination and joint working across the care spectrum: health, social, voluntary and independent sectors. Given the increasingly permeable health/social care boundary, we are at the early stages of this work and focusing initially on the Joint Future agenda. The emerging Community Health Partnerships will have a leading role to play in facilitating some of this development at a local level (www.show.scot.nhs.uk/sehd/chp).
The developing infrastructure for workforce development, outlined at chapter 5, together with service planning activity at local, regional and national levels, is now giving us a clearer picture about workforce numbers. But this picture needs to be part of a compelling vision of the future shape of the workforce - a vision setting out the options for new ways of working, skills development and modern careers. Without these it looks static and one-dimensional. NHSScotland also needs to be able to make more coherent sense around the "supply side", working together with educational and employment partners to agree longer-term strategies and alliances.
The Workforce Strategy clearly sets out these responsibilities and the outputs required, and articulates the links between workforce development and national, regional and local services.
The
Workforce Strategy aims to create: An authoritative picture of the
future shape of the workforce and the way it
will work Staff whose work benefits from a happy and confident approach and who operate effectively in
teams Improved corporate and clinical
leadership for health in Scotland NHSScotland as an effective and instantly recognisable
employment brand with a reputation for providing modern careers - allowing it to recruit and to hold on to the staff it needs NHSScotland as an
exemplar employer with gold standard employment practices in a supportive working environment Effective
strategic alliances with education and employment bodies which deliver the workforce NHSScotland needs Consistent and enlightened
HR policies which staff know about, find supportive and which are user-friendly Fit-for-purpose staff who benefit from improved learning, training and development, professional regulation and properly defined occupational standards Momentum to overcome practical and cultural obstacles to change and increase flexibility, improve productivity and effectiveness and embed team work HR and workforce
capacity with the weight to deliver the strategy
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The strategy is organised into three areas but all elements interconnect and support each other.
Culture and Behaviour
Supply and Demand
Mobilisation and Change
The following diagram illustrates the interdependence of these elements. Work is now underway in all these areas, led and overseen by the National Workforce Committee and the HR Forum, on behalf of NHSScotland and the Health Department Board.
NATIONAL WORKFORCE STRATEGY
Objectives of the Workforce Plan
As an integral part of the Workforce Strategy, the National Workforce Plan is designed to:
provide a national perspective which leads and defines our needs on workforce numbers, characteristics and trends - both now and in the future;
link together local, regional and national workforce planning into a single NHSScotland profile;
synchronise this profile with service planning and educational commissioning; and
provide an evidence base to inform the development of policy and decision-making at all levels.
This 2004 Baseline Workforce Plan provides the necessary leadership and direction for
the NHSScotland Workforce, supported by action to improve the quality of workforce information, including proper investment in effective, integrated workforce information systems.
Many partners have a part to play in ensuring that workforce supply is more closely aligned with demand, and that service redesign takes workforce issues fully into account. This Plan lays the foundations for our efforts in the years to come. It is also a declaration of intent, mapping out the work that will be done to improve our ability to understand and manage workforce flows in the future, and to make subsequent plans that are authoritative assessments of our future workforce needs.
In this Baseline Plan we: discuss the dynamic policy context within which workforce development is proceeding for the health sector in Scotland: there are many drivers (
Chapter 2 and
Appendix A) summarise the current position on the workforce and its key characteristics, nationally and regionally (
Chapter 3 and
Appendix B) consider recent and prospective shifts in the capacity of the clinical workforce and the key questions these raise (
Chapter 4) map out the structures and processes that are now in place to take forward work on an ongoing basis (
Chapter 5).
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The challenge is to establish the workforce requirements for the short, medium and long term. As will be made clear in this baseline document, authoritative forecasts will require answers to a number of questions, including the following:
What is the long-term service vision?
What impact will pay modernisation (GMS contract, consultant contract and Agenda for Change) have on shape of the workforce, working patterns and employee behaviour (e.g. productivity, effectiveness, recruitment, retention, returning to work, work-life balance, career progress, career flexibility)?
What impact will legislation on working times have?
What impact will Modernisation of Medical Careers have on the medical skill mix, workforce mix, specialist/generalist balance, primary care/secondary care career choice decisions?
What will be the impact the Partnership Implementation Network (PIN) guidelines covering various topics such as family-friendly policies on employee behaviour (e.g. recruitment, retention, work life balance)?
What has been, and will be, the impact of the recruitment and retention incentives already put in place?
What difference will new ways of working make to recruitment and retention?
What should the role of emerging Community Health Partnerships be in informing workforce planning & development locally?
How can staff employed by independent contractors be incorporated into national workforce planning?
The programme of work now underway, and described in the following chapters will provide the answers.
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