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| Towards a New Way of Working |
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| Section 4 - The Flexible
Workforce |
| 37. Technological and scientific advances in
medicine, improvements in clinical processes and the way in which we function as an
organisation will require us to work more cohesively. Added to this are the changing
working patterns and wider choices of lifestyles and careers of the NHS in Scotland
workforce. Patient expectations are also increasing and with them demands for high quality
services. The NHS in Scotland therefore needs to continue to adapt its approach to meet
the requirements of patients and staff. |
| 38. Analysis of the composition of the
workforce of the NHS in Scotland assists in planning the future staffing requirements to
meet changing Service needs. |
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| 39. The largest single group of staff is
nurses, of whom 91% are female, just under half of whom work part time. Administrative and
clerical staff are also predominantly female with three quarters working part time. The
other predominantly female staff groups such as PAMs and ancillary staff also have
considerable numbers in part time work. This contrasts with medical staff, with two thirds
male employees and over 80% in full time employment, although the proportion of female and
part time doctors is rising. |
| 40. The special funding arrangements for
students announced by the Government in response to the Dearing Report will be implemented
in Scotland to ensure an adequate future supply of high quality healthcare professionals.
Close cooperation with The Scottish Office Education and Industry Department and the
higher education sector will make sure these arrangements are put in place for the benefit
of the NHS in Scotland. |
| 41. Workforce plans are produced annually for
doctors and nurses. However there are gaps in information and links between the planning
groups are poor. There is a need to review the whole planning process in order to address
comprehensively the supply, demand and qualitative issues to meet service need. Most of
all there is a need to adopt an integrated approach to workforce planning and utilisation.
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| 42. The implication of the New Deal for
junior doctors, the effect of the Calman Report on Specialist Medical Training, Post
Registration Education and Practice for Nurses, Midwives and Health Visitors, the outcome
of the Acute Services Review and other ongoing initiatives will require a review of how we
plan and integrate the delivery of the service. |
| 43. A clearer understanding of what staff
actually do to deliver a wide range of services is needed. Information on workforce
utilisation and productivity needs to be improved. There has been little investment in
research into new ways of delivering services and altering workforce plans as a
consequence. |
| 44. The Government has announced £3m funding
for pilots in the redesign of service delivery. While much will be learned about reshaping
the workforce from such pilots, consultation on the Human Resource Strategy has
demonstrated a clear consensus to establish a more integrated approach to workforce
planning and utilisation on a Scottish-wide basis. |
| 45. The requirements for working in
multi-disciplinary teams in Acute or Primary Care, in major conurbations or in rural
settings, necessitates individuals assuming different roles as they work more flexibly and
apply different skills. Increasingly some of the more traditional boundaries are
disappearing as staff acquire new skills supported by training and development and changes
in employment practice. |
46. A Scottish Integrated Workforce Planning
Group will be established to commission research and development in new areas of work. The
group will be established by September 1998 with the following draft remit:
- to be a single advisory group for integrated workforce planning which will take a
strategic, long term, view of health care needs and workforce demands;
- to consider overlap with other organisations providing health and social care and the
impact on the workforce;
- to consider changes in relationships between and within the professions providing
healthcare.
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47. This group will not cut across existing
arrangements for workforce planning which are in place in Scotland, but will work closely
with and complement existing mechanisms. It will be a short life expert group which will
report to the Management Executive in June 1999 and April 2000. The Management Executive
will consult on membership, remit and method of working prior to September 1998.
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