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The Report of the Student Nurse Intake Planning Exercise 2003

EXECUTIVE SUMMARY

The Student Nurse Intake Planning (SNIP) exercise remains an established process for providing guidance on the commissioning of nursing and midwifery student places that will meet the anticipated demand for qualified nurses and midwives. This is met through a mixture of data collection and workforce modelling on given scenarios, as well as imparting an element of professional judgement to the statistical methodology.

Informed by this process, the report highlights the agreed commissioning numbers for 2004/05 for each of the nursing and midwifery categories. However, in beginning to recognise the wider context in which workforce planning sits, the report also offers regional projections on growth and vacancies that allows for the development of a workforce plan for nurses and midwives in Scotland.

Policy Context

A number of policy documents provide a context for this year's report:

• Partnership for Care: Scotland's White Paper is about the promotion of health in its broadest sense and the creation of a health service that is fit for the 21st century. This document builds on the Our National Health: A plan for action, a plan for change. This white paper sets out a clear direction to improve services as well as heralding a new approach to improve the health of the nation through the devolvement of power and the involvement of patients, staff and the public. In particular it views patients and the development of national standards as key drivers for change and the requirement to support, value and empower staff to lead the change process.
• Planning Together builds on the initiatives flowing from Our National Health. It looks to establish a sound workable approach to workforce planning into the long term.
  It proposes that workforce planning be integrated with management and planning
  at all levels, most crucially linked with service planning. Planning Together makes clear recommendations for creating a dynamic and effective workforce planning function
  at a national, regional and NHS Board level, and lays the foundations for workforce planning becoming an integral part of an effective modern health service in Scotland.
• A Partnership for a Better Scotland: Partnership Agreement (May 2003) sets out the coalition government's commitments to improving public services in Scotland. Within health there are a number of commitments pertaining to nurses and midwives. Indeed it is seen as a high level priority to "... increase our programme to train, recruit and retain nurses and midwives, bringing 12,000 into the NHS by 2007 as part of our overall improvements in workforce planning in the NHS". Further commitments include the continuation of the One Year Guarantee Scheme, a commitment to treble Nurse Consultant numbers to 54, and a commitment to implement nationally co-ordinated nursing bank arrangements that assists with nurse placement, improves patient services and helps curb expenditure on agency nursing.
• Working for Health identifies that workforce development has a key role to play in order to bring about reform and improvement of the health service in Scotland. It sets a vision for workforce development and identifies the role workforce development will play now and in the future, putting workforce development in a wider context of developing a workforce in Scotland that is fit for purpose. It also sets out an action plan and lays out the practical steps to be taken to achieve this vision from a local, regional and national perspective.
• Facing the Future is the banner under which a number of initiatives were launched to ultimately build capacity in the nursing and midwifery workforce, by improving upon the recruitment, retention and development of nurses and midwives across Scotland. Its Action Plan identifies eight key themes within which a sub-set of action points were established to help achieve Facing the Future's goals and objectives. These initiatives to build capacity within the nursing and midwifery workforce are offered in addition to the SNIP process, but will ultimately influence future SNIP exercises in terms of any future supply and demand for nurses and midwives. Facing the Future has also helped to earmark funding to support a range of measures including Return to Practice schemes, an additional 525 student places during 2003/04, as well as support for Continuing Professional Development (CPD) for nurses and midwives.
• Audit Scotland's Report: 'Planning Ward Nursing - Legacy or Design?' looked at numbers of nurses, costs and quality indicators in 6 ward types in all Primary and Acute NHS Trusts in Scotland. The ward types were: Acute Medical Receiving, Gynaecology, Continuing Care of the Elderly, Orthopaedics, Paediatrics and Old Age Psychiatry. Its key findings included:
  • The need for improvements in workforce planning.
  • Unexplained variations in the number and costs for nurses at ward level.
  • The need to develop and agree quality of care measures, which focus on continuing improvement rather than service failures.
• A National Workforce Strategy for NHSScotland has been developed; its purpose being to provide a vision of the future shape of the workforce in Scotland. The workforce strategy is underpinned by three key elements, these being:
  • Culture and Behaviours.
  • Supply and Demand.
  • Mobilisation and Change,

Work is underway on a total of nine strands of work emanating from each of the above elements, all of which are overseen by the National Workforce Committee.

• The first National Workforce Plan for NHSScotland was published in April 2004. The Scottish Health workforce Plan - 2004 Baseline represents an important step forward to ensuring effective workforce planning to underpin effective health service delivery. It forms part of the workforce strategy and as an annual publication, it will provide useful intelligence and guidance to service and workforce planners at local regional and national levels. It will help identify current gaps as well as support actions to address these.
• SNIP Review 2004. A comprehensive review of the Student Nurse Intake Planning process has been completed. This highlighted the benefits gained from the process to date, however it also flagged areas/gaps where improvements could be made. It recognised the need to capture data and intelligence on the wider nursing and midwifery workforce to allow for the development of a comprehensive nursing and midwifery workforce plan. This will be developed on an iterative basis commencing in 2004.

SNIP 2003

This year's exercise was led by the SNIP Project Team (for full membership see appendix 3). As in previous years, consultation took place with NHS Employers, private hospitals as well as with Higher Education Institutions.

A high level of commitment to this process was established, with 100% returns achieved once again from those involved in the data collection process. This was in no small measure attributable to the high level of support and guidance offered by the SNIP Project Team.

Outcomes from SNIP 2003

Pre-registration nursing and midwifery education in Scotland has been provided by the tertiary education sector mainly through contracts agreed by the Scottish Executive since 1996. To support the contracting process, the SNIP exercise is undertaken annually to determine the future nursing and midwifery requirements across Scotland. This process is now well established and the recommendations laid out in this report will inform the contracting process for pre-registration nursing and midwifery education for 2004/05, led by the Chief Nursing Officer for Scotland.

This year's report on the future workforce details the assumptions and parameters used in the modelling process and can be viewed in Chapter 5 of the report.

The report also highlights a number of parallel strategies to build capacity within the nursing workforce. These will have a further bearing on the future demand and supply of nurses and midwives in Scotland. Many of these fall under the banner of 'Facing the Future' and have been developed to improve the recruitment, retention and development of nurses and midwives in Scotland. These include Return to Practice schemes, guaranteed employment for newly qualified nurses, leadership development programmes, review of nursing and midwifery workload and developing flexibility within the workplace. These can be viewed in detail in Chapter 6.

This year's report sets out a list of recommendations on the continuing improvement of the SNIP process, as well as detailing the recommended intakes for each student category. These recommendations include viewing the SNIP exercise as part of an overall workforce development strategy, identifying other solutions to building capacity that run in parallel to as well as inform the SNIP process and a need to review workforce and pay information systems. These can be viewed in full in Chapter 7.

The demand from NHS employers for additional nurses and midwives anticipates a further 5,000 over the next five years - see Chapter 3.

This year the SNIP exercise, led by the Executive, oversaw the collection of nursing and midwifery workforce data and applied quality assurance measures before modelling the information against supply and demand indicators. From this, a range of projected intake requirements were arrived at for each of the student nurse categories. The figures are derived from initial recommendations received from the SNIP Reference Group. Subsequent alterations were agreed by the Scottish Executive. This had the effect of increasing the overall recommended intake figure to 3,955, up slightly on last year's figure.

Explanations for these intake figures are provided in Chapter 5.

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