Transforming nursing, midwifery and health professions roles: introduction

The first in a series of brief papers on the Transforming Roles programme focuses on the background, policy context and education framework.

Paper 1: Introduction

This series of brief papers on the Transforming Roles programme aims to update stakeholders on the professions’ contribution to the wider transformational change agenda in health and social care in Scotland. The first introductory paper focuses on the background, policy context and education framework of Transforming Roles.


The integration of health and social care in Scotland calls for new models of care, delivered by multidisciplinary, integrated teams. This means historical boundaries between services, settings and roles will become blurred.

Refocus and redesign is now needed to bring about transformational change in improving population health and deliver high-quality, integrated and tailored care and services that maximise the contribution of all health and social care professionals.

Programmes of work that drive improvements in population health, enhance quality and safety, and secure best value from health and social care services are needed to deliver this transformational change in service design. The nursing, midwifery and health professions ( NMaHP) workforce has a crucial role in developing and delivering these programmes.

The Chief Nursing Officer ( CNO) is committed to maximising the contribution of the NMaHP workforce and pushing the traditional boundaries of professional roles. The Transforming Roles programme aims to provide strategic oversight, direction and governance to:

  • develop and transform NMaHP roles to meet the current and future needs of Scotland’s health and care system
  • ensure nationally consistent, sustainable and progressive roles, education and career pathways.

Policy context

Improving Scotland’s health through a renewed focus on integrated, multidisciplinary approaches to prevention and tackling health inequalities is central to the Scottish Government’s vision of creating a more successful country. The integration of health and social care is essential to empowering local communities to take charge of their own health and wellbeing in innovative ways.

Scottish Government policies, including the Transformational Change Plan, National Clinical Strategy and Realistic Medicine, signal the need for service redesign that:

  • ensures quality is at the heart of service delivery
  • focuses on prevention, population health and links between health and economic prosperity
  • puts people at the centre of health and social care services
  • delivers the right care, in the right places, at the right time
  • makes best use of resources
  • enables people to take more responsibility for their health and wellbeing.

This calls for high-quality, compassionate, efficient and effective health and social care systems that deliver accessible and responsive services.

Education and development framework

A structured, coordinated and future-focused model for education and development for NMaHPs beyond registration will be essential to the success of Transforming Roles. NHS Education for Scotland ( NES) is working with key stakeholders through the national Postgraduate Education and Development Group to take this forward.

Setting the Direction, the CNO’s review of nurse education, tasked NES with developing a national commissioning approach to post-qualification education to support nurses and midwives’ development across career pathways, from registration to specialist and advanced roles. Transforming Roles broadens this approach to include the allied health professions and other roles under the CNO’s leadership.

Career pathways, aligned with the NES Post-registration Career Development Framework, are being developed to address the balance between generalist and specialist knowledge and skills required to meet people’s complex needs across a wide range of settings. Education and development that support career pathways will ensure:

  • practitioners are well supported and appropriately prepared for new and enhanced roles
  • education and development is aligned to priorities and supports sustainable service provision
  • practitioners are enabled to practice to the full extent of their capability.

A key element of the education model will be flexibility in acquiring knowledge, skills and formal qualifications to support expert practice at all levels towards advanced and consultant practice. Education that covers broad core components will be shared across pathways, providing the foundation for more specific and higher-level learning required by practitioners as they diversify into more specialised roles or advanced levels of practice within specific career pathways. The objective is to recruit, develop and support a highly skilled, effective and professional workforce with clear career pathways that are aligned to service requirements.

Future papers

Phase 1 of Transforming Roles prioritised nursing and the next two papers in the series will be nursing-focused. Future activity will expand to include other health professions and roles aligned to service priorities and responsive to emerging population needs.


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