Introduction to Workforce Planning & Development
1.1 CHANGING REQUIREMENTS OF THE NHS WORKFORCE
The National Health Service in Scotland continues to face enormous change, particularly in relation to advances in medicine and in the way in which a wide range of robust health care services are delivered. In order that we continue to improve on our range of services across NHSScotland, it is essential that a responsive and flexible workforce is developed that underpins the delivery of a first class health service to the population of Scotland. Workforce development is pivotal to securing the workforce for NHSScotland in the short, medium and longer term, encompassing a range of planned activity in education and training, through staff recruitment and retention, enhancing the development of new roles and job redesign, and in promoting career packages and pathways.
1.2 PRESSURE POINTS
The NHS in Scotland currently faces a number of workforce pressure points. Through publications such as the Wanless Report* and Future Practice: A Review of the Scottish Medical Workforce, we now recognise that the UK workforce is under pressure from a number of directions including:
Through strategic publications such as Partnership for Care, Scotland's White Paper and Working for Health, the Workforce Development Action Plan for NHSScotland, the requirement to integrate service planning with workforce planning at all levels is clearly established.
*http://www.hm-treasury.gov.uk/consultations-and-legislation/wanless/consult-wanless-final.cfm
1.3 THE NURSING AND MIDWIFERY WORKFORCE
Nursing and Midwifery numbers continue to grow across NHSScotland and this remains the largest clinical staff group. As at September 2003, the total number of qualified and unqualified staff stood at 54, 217 Whole Time Equivalent (WTE). This reflects a steady increase year on year since 1998, with qualified nurses and midwives reaching a high of 38,262.5 WTE in 2003. Working in partnership with fellow healthcare professionals as well as patients and carers, nurses and midwives play a dynamic and vital role in improving health by delivering a range of first-class health services to the people of Scotland.
A Partnership for a Better Scotland: Partnership Agreement 2003 was published in May 2003. This sets out the coalition government's commitments to improving public services in Scotland. Within health, this document includes a number of commitments to developing and supporting the NHS workforce. Similarly a number of commitments are made in relation to the nursing and midwifery workforce. Indeed, it is viewed as a high level commitment to increase the 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 trebling of Nurse Consultant posts in Scotland to 54 as well as to continue the guarantee of one year's employment for all newly qualified nurses and midwives.
In addition, the Scottish Executive continues to develop a range of initiatives to aid recruitment and retention of nurses and midwives in Scotland under the banner of 'Facing the Future'. These include return to practice programmes, leadership development investment, a review of nursing and midwifery workload and a review of future nursing roles. Further details on these initiatives are offered in Chapter 6.
1.4 STUDENT NURSE INTAKE PLANNING (SNIP)
An annual student nurse intake planning exercise (SNIP) has been carried out for the past eight years. The last three years have witnessed a step increase in 'demand forecast' from within the service. SNIP 2001 saw a change in the demand forecasts and recommended considerable increase in the student intakes for both adult and mental health nursing, amounting to an additional 510 places managed over two years. SNIP 2002 confirmed a large increase in demand for a second year and recommended an increase of 525 places on the SNIP 2001 intake.
The SNIP 2003 exercise reflects a similar level of demand to the previous year's exercise.
This overall demand forecast is consistent and in line with the reported workforce pressures which have a direct or indirect effect on the nursing and midwifery workforce. With additional student places comes the responsibility of managing and providing appropriate support during clinical placement. To help ease the pressure within NHS systems, 100 Practice Educators have been funded to provide additional support in the management of student placements. The majority of these posts have been established.
Alternative routes into nursing and midwifery training continue to be promoted in the form of the Open University (OU) route and the NES endorsed HNC in Healthcare. The advantage of the Open University route is that because it is work based, it can be delivered in remote and rural areas, where there is greater capacity to support clinical placements. Similarly, many of the HNC outcomes can be achieved in the student's own workplace, where the student is known and can provide some contribution to the smooth running of that clinical area. In both scenarios, the student will already have experience of working in healthcare.