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Why do we need to change?
The NHS is about people: the patients and their families who rely on its services, and the people who provide those services, often in difficult circumstances.
People told us that they expect their NHS to provide effective and professional healthcare. In the vast majority of cases, that is what people experience. For those who work in the NHS, providing an effective, professional and caring service is a key part of their commitment. The consistently high regard in which the public hold NHS staff is a tribute to their commitment and dedication.
Overall, 81% of people receiving care in hospital were satisfied.Overall, 84% of people using out-patient services were satisfied. Overall, 90% ofpeople using GP services were satisfied.
The public values NHS staff, and the NHS must do the same. The capacity of the NHS to provide the services the public expect will depend on its continued ability to recruit and retain well-trained and motivated staff. With a workforce of more than 130,000, the NHS is Scotland's biggest employer. We are committed to help it become Scotland's best.
The internal market established NHS Trusts as separate employers with freedom to set their own terms and conditions. But most staff continue to think of themselves first and foremost as working for a National Health Service. The reality is that few NHS Trusts have used their freedom to offer staff significantly different terms and conditions of service.
The abolition of the internal market and work on pay modernisation provides an opportunity to re-establish fairness and consistency across the NHS in Scotland. We want to encourage innovative and creative solutions to local problems, but we know that staff and their representative bodies place great store on ensuring that personnel policies are developed and implemented consistently across Scotland.
We have consulted widely with NHS staff, trade unions and professional bodies and the message is clear: they want to be involved in decisions that affect how they work. They want us to build on the good start we have made in establishing more inclusive working through partnership. And they want better communications within the NHS and with the Scottish Executive.
Partnership working is the cornerstone of Towards a new way of working, the human resources strategy for the NHS, launched in April 1998.
Government and NHS management must work with staff 'around the table' not 'across the table'.
The Scottish Partnership Forum has led the way in the development of partnership working at national level and it will play a key role in the implementation of the proposals in this Plan.
The NHS has made a good start with partnership working at local level but we need to go further. In future, we will ensure that:
We intend also to raise the status of good people management in the NHS in Scotland, to emphasise its importance alongside corporate and clinical governance.
Under the Staff Governance Standard, staff will be entitled to be:
Performance against the Staff Governance Standard will be assessed by the Scottish Partnership Forum and local partnership forums and form an integral part of the new performance and accountability framework described elsewhere in this Plan.
Protecting the health and well being of NHS staff must be a priority. Every NHS employee has a right to be protected from the risk of violence or infection in the workplace. As part of our commitment to providing a safe working environment for NHS staff:
The Partnership Information Network (PIN) Board has been established by the Scottish Partnership Forum to produce best practice guidelines on people management. The guidelines address many of the issues of particular importance to staff. These include family friendly policies, equal opportunities policies, the management of employee conduct, personal development planning and review, dignity at work and facilities arrangements.
"THE PUBLIC VALUES NHS STAFF, AND THE NHS MUST DO THE SAME"
Developing flexible employment policies is key to ensuring that the NHS retains and recruits the staff it needs. Enabling staff to balance their family and working lives must be a priority for all NHS employers. Caring is at the heart of the NHS_this must extend to the way the NHS cares for its staff and the way it enables its staff to care for others.
Nearly eight out of 10 NHS staff are women, more than half of whom work 'part-time'. For the first time ever in Scotland more women than men are entering medical school. In Glasgow, for example, 58% of the 1998-99 intake were women. This has significant implications for future patterns of working and underlines the need for the NHS to develop flexible working practices.
The forthcoming guidelines on family-friendly policies will cover important issues such as flexible working arrangements, better workplace childcare facilities, breast feeding at work and career breaks.
In keeping with our desire to recreate a National Health Service:
To support nurses and midwives and the professions allied to medicine throughout their careers:
"NEARLY 8 OUT OF 10 NHS STAFF ARE WOMEN, MORE THAN HALF OF WHOM WORK 'PART-TIME' "
Overall, Scotland does not have staff shortages on the scale experienced in other parts of the UK. But there are parts of the country and specific areas where capacity issues need to be addressed. We take workforce planning seriously and we have demonstrated our willingness to make targeted investment in additional staff where necessary.
In general medical practice the future requirement for GPs is closely bound up with the primary care developments set out elsewhere in this Plan.
We need to improve the way we plan our workforce to match changes in the design and demand for services. Local Health Plans will include workforce plans and we will improve our support and co-ordination of those htmects of workforce planning which need to be done centrally.
Workforce planning for the supply of trained doctors is particularly complex. We think the time is right for:
We believe that an investment in staff is a direct investment in patient care. NHS staff are committed to providing high-quality patient care and we are determined that they should be rewarded fairly for the contribution they make.
In the past two years, all NHS staff covered by the independent Pay Review Bodies have received in full, and without staging, the recommended pay awards. This has resulted in total increases of at least 8.3% for all nurses, midwives and professions allied to medicine, and at least 6.9% for all doctors and dentists. We have also agreed a three-year pay deal for non-Review Body staff which guarantees above-inflation increases for these important staff groups.
We are determined to go further. All of the staff organisations tell us that the current NHS pay system is outdated, inflexible and unfair. We share the view widely held in the NHS that pay modernisation is essential if staff are to be successful in creating more flexible roles reaching across traditional barriers.
"WE BELIEVE THAT AN INVESTMENT IN STAFF IS A DIRECT INVESTMENT IN PATIENT CARE "
We recognise the views of staff representatives that rewards are about more than pay:
Traditional working patterns for hospital doctors have been called into question for a range of compelling reasons. Developments in the NHS and new contractual arrangements will require new ways of working:
The introduction of annual appraisal for consultants, effective job planning and continuing professional development will provide the opportunity to match service demands with consultants' htmirations.
We believe it is important that commitment to the NHS in Scotland should be properly valued and rewarded.
While the amount of private practice in Scotland may be less than in other parts of the UK, the public are concerned that consultants' time and commitment to the NHS could be compromised by their work in private practice. We believe it is in the best interests of the NHS, patients and consultants themselves to ensure that such conflicts do not arise. This is an important htmect of the work now being taken forward at a UK level, which we support.
We will ensure that any changes to the consultants' contract are implemented in ways which are appropriate and proportionate to the needs of the NHS in Scotland.
Since the inception of the NHS, general practitioners have not been employed directly by the NHS but have worked as independent contractors to the service. While this arrangement has generally served patients and the Service well in the past, we believe it has growing limitations. The current career opportunities are less attractive to the younger generation of doctors, male and female. The existing GP contract is based on complex and inflexible fee-based arrangements.
We intend to explore other options for the employment of GPs including the development of salaried service direct to the NHS. This will enable us to address some of the gaps in provision which currently exist in some parts of the country and will provide different contractual options for those entering into general practice.
Subject to satisfactory evaluation of the existing Personal Medical Services (PMS) pilots, it will not be necessary in future to undertake a pilot phase for new PMS practitioners. Our aim is to offer flexibility and choice, both to GPs and to patients.
"TRADITIONAL WORKING PATTERNS FOR HOSPITAL DOCTORS HAVE BEEN CALLED INTO QUESTION FOR A RANGE OF COMPELLING REASONS"
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