Healthcare waiting times: improvement plan

Ensuring our Workforce Can Support Improvement

Action in different specialties and clinical areas requires a supported and skilled workforce. While NHS Scotland's workforce has grown for the past six consecutive years, we know that there are key staffing constraints on our ambitions to improve access to care, particularly in specialties such as urology, dermatology and general surgery. At the same time, withdrawal from the EU presents serious challenges to retention and recruitment across our health and care services, and is causing significant uncertainty for the workforce.

We are taking action in response to these challenges over the next 12 months. The Improvement Plan will:

• Invest £4 million over the next three years in domestic and international recruitment for GPs, nursing, midwifery and consultant specialties with the highest existing vacancy rates
• Encourage more capacity through the existing workforce, for example, by working with Staff Side and Employers to reduce sickness absence rates with a focus on staff health and wellbeing, and by rolling out eRostering technology to ensure staff time is used more effectively
• Enhance workforce capacity in key specialties, for example, by developing a 'Once for Scotland' approach to NHS workforce policies across Boards, where appropriate
• Improve career pathways in key specialties, for example, through Advanced Nurse Practitioner and General Nurse posts to ensure patients are seen appropriately and more quickly, and by creating multi-disciplinary clinical teams of surgeons, trainees, anaesthetists, theatre staff, Allied Health Professionals, diagnostics and nursing staff

In particular, the availability of a trained workforce is critical to the successful delivery of the elective centres. Work is underway to develop workforce plans that will ensure our workforce models will be delivered and are sustainable and affordable. By Spring 2020, actions will include:

• A national workforce plan for the elective centres will be developed that will inform planning to ensure that there is sufficient workforce to support the new centres without disrupting existing services, including managing student intake numbers and supporting national enhanced practitioner training requirements
• A draft framework to support joint recruitment and appointment processes across NHS Boards, so workforce capacity issues can be addressed more effectively

This will build on the work already underway to tackle key elements of the workforce, including provision of:

• 800 more GPs (headcount) over the next ten years
• 100 more medical undergraduate places by 2021
• 2,600 extra nurse and midwifery training places by the end of this Parliament
• An increase in GP Specialty Training posts from 300 to 400 per year
• 500 more Health Visitors by the end of 2018
• 50 more Radiology Specialty Training posts over the next five years, supported by an additional £3 million investment
• 500 more Advanced Nurse Practitioner posts by the end of this Parliament

The Improvement Plan will also build on the significant investments in staffing that are already taking place. Working in partnership with trade unions and NHS employers, we recently delivered a three-year pay deal for all Agenda for Change staff, which for those earning up to £80,000 provides consolidated pay increases for staff at the top of their pay band of 9%, with higher increases for those lower down the pay scale. Moreover, a national and intensive approach to workforce planning will be further progressed with the publication of the integrated national workforce plan by the end of this year.