6.1 THE PARTNERSHIP AGREEMENT
As part of the discussions following the Scottish Parliament elections in May 2003, the Labour/Liberal Democrat coalition produced A Partnership for a Better Scotland: Partnership Agreement as part of its programme to deliver excellent public services in Scotland. This commits the Scottish Executive Health Department to step up action on health improvement, to improve the quality and consistency of care through national standards, inspection and support; and to improve the delivery of services. The Partnership Agreement also commits the Scottish Executive Health Department to delivering improvements to NHSScotland through the empowerment of the workforce. Within this document there are a number of commitments which are specific to nurses and midwives. These are:
In support of these commitments, a number of initiatives are ongoing under the banner of 'Facing the Future'. The following provides an update against these as well as other issues of interest.
6.2 STUDENT NURSING INTAKE PLANNING (SNIP) 2002
As part of the large increase in the recommended intake, a number of alternative paths to nurse training have been approved. Concerns on the capacity to deal with the number of clinical placements have also influenced the development of alternative training routes. The additional 525 places can be broken down as follows:
To support clinical placements for these additional places, 100 Practice Educator posts have been established. These are funded on a joint basis from the Executive, NES Higher Education Institutions as well as NHS Employers. These posts have begun to come on stream since February 2004.
The SNIP process has been reviewed with a move to develop this into a workforce plan for the nursing and midwifery workforce. This will allow for scoping and projection on the wider workforce that will help inform the development of a national workforce plan for NHSScotland.
6.3 NURSE CONSULTANTS
This represents another commitment within the Partnership Agreement. An Action Plan to deliver 54 Nurse Consultants has been developed in partnership with Chief Executives and Medical Directors to take this forward.
To date 23 Nurse Consultant posts are in place. Fields of practice include midwifery, older people's services, public health, paediatrics, pain management, perinatal mental illness, epidemiology, acute medicine/surgical receiving, cancer, enduring mental health, learning disabilities, forensic rehabilitation, health protection, family planning and sexual health, infection control and Macmillan cancer nursing.
A further five posts have been established and are in the process of being filled.
6.4 ONE YEAR GUARANTEE
The One Year Guarantee of employment for all newly qualified nurses and midwives was introduced on 1 September 2002. The initiative was developed in full partnership with NHS employers, universities, professional organisations (incl. RCN, RCM, UNISON), as well as NHS Education for Scotland (NES) which administers the scheme. The Guarantee is based on the normal recruitment process, whereby the majority of newly qualified nurses and midwives secure a job through their own efforts, informed by career aspirations and their choice of location. If, after trying to obtain suitable employment, the nurse or midwife has been unable to secure a job in their part of the register or geographical location, and if they wish to take advantage of the national scheme, they can contact NHS Education for Scotland, for information about other locations in Scotland with suitable jobs.
The Guarantee is designed to ensure that all newly qualified nurses and midwives have the opportunity to build on the clinical experience gained during their pre-registration programme. Any vacancies offered should have at least a one-year contract of employment.
As part of the Partnership Agreement, this initiative has been extended from September 2003.
Further information and guidance on the One Year Guarantee is available on the Facing the Future website.
NHS Education for Scotland has carried out two evaluations of the scheme. The first looked at the experience of those who used the scheme in 2002-2003, and the second was a random sample of newly qualified nurses and midwives who did not participate in the scheme to evaluate how they obtained employment. The results of the second survey can be viewed on the Facing the Future website: www.show.scot.nhs.uk/sehd/facingthefuture
6.5 RETURN TO PRACTICE
The Return to Practice scheme was launched with a view to increase the number of nurses and midwives in work across Scotland. As well as helping to reduce the number of vacancies, the scheme is aimed at minimising the loss of skills/expertise invested to date. £1 million has been allocated to fund Return to Practice for nurses and midwives across NHSScotland for the next few years. The funding for each individual for a Return to Practice programme is linked to an offer of employment in NHSScotland, either on a permanent basis or on a nursing Bank with regular hours of work required. Up to £1,500 of funding is available for each successful returnee.
SEHD has made considerable investment in Return to Practice Projects. To date over 400 people have returned to practice since March 2002.
6.6 NATIONALLY CO-ORDINATED NURSE BANK ARRANGEMENTS
Demands on hospitals/trusts for bank and agency staff to fill gaps in the service continue to escalate. This was highlighted in the Audit Scotland report of 2002. The report identified a need for more effective management and co-ordination in the provision of bank and agency staff.
The Partnership Agreement also commits to implementing nationally co-ordinated nurse bank arrangements that assist nurse placement, improve patient services and reduce the cost of agency nurses. A project Manager has been appointed to:
6.7 NURSING AND MIDWIFERY WORKLOAD
Research into workload and workforce planning was commissioned by the Facing the Future Group. The Nursing and Midwifery Workload and Workforce Planning Project builds on the Audit Scotland report, Planning Ward Nursing - Legacy or Design? Its aims were to:
The project covered all parts of NHSScotland where nursing and midwifery services are delivered - acute care, primary care, psychiatry, learning disabilities, paediatrics and maternity. Five separate but broadly similar questionnaires were developed. The questionnaires focused on key issues relevant to nursing workload and workforce planning, such as:
The Nursing and Midwifery Workload and Workforce Planning Project identified twenty (20) recommendations which have been accepted in principle by the Scottish Executive. The recommendations lay the foundation for the development of a more systematic approach to nursing and midwifery workload and workforce planning. Further scoping work at local and national levels is now required.
6.8 NEW ROLES
Another strand of Facing the Future has been to look at the career development patterns. In particular, patterns that reflects flexibility and transferability - with practitioners moving sideways as well as vertically into new roles within clinical areas and organisations. These can prove to be enormously beneficial for individuals and organisations alike.
A two-day Consensus Conference on new nursing roles was held in November 2003 from which a Consensus Statement was produced. This includes the development of a national framework. In addition, three (3) regional role development events have been held to further develop this framework which will be officially launched for widespread consultation at the National Facing the Future Conference in June 2004. It is intended that this framework will be of use to other professions such as AHPs and Pharmacists.
This work will form part of the National Workforce Strategy on Workforce Design particularly around the development of new roles, new ways of working and a review of workload across NHSScotland. This is being led by the Centre for Change and Innovation.