Future Practice
A Review of the Scottish Medical Workforce
The Response of the Scottish Executive
July 2002
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Introduction
The medical workforce is crucial to the future of NHSScotland and to reform of the NHS, which is this administration's key priority. Our doctors, placed within the unified context of the whole NHS workforce, have a pivotal role to play in achieving the vision we set out in Our National Health, a plan for action, a plan for change 1.
That is why I very much welcome the publication of Future Practice 2, Professor John Temple's report on his review of the medical workforce. I would like to thank him and the members of his review group for making such a valuable contribution to tackling this challenging subject, which is key to making NHSScotland fit for purpose for the 21st Century.
Susan Deacon announced the establishment of this review a year ago in fulfilment of the commitment in Our National Health, a plan for action, a plan for change to carry out a fundamental examination of medical workforce planning, including the intake of medical students and the possibility of fast-track graduate-entry medical degree courses in Scotland. That reflected our recognition of the importance of workforce planning in tackling the challenges at the heart of the reform of NHSScotland.
If anything, workforce issues have become even more pivotal over the year during which the review has been carrying out its work. It is a profound truth that the success of NHSScotland rests on the workforce which delivers the service day in, day out. And doctors are key to that team effort - at the heart of providing direct patient care and forging new modes of healthcare delivery.
This review has been asked to explore difficult territory and the report confirms that there are no easy answers to the complexities of planning our medical workforce needs, whether they involve questions around basic medical education, the impact of the Working Time regulations, or the circumstances faced by remote and rural GPs. The report also makes some challenging points about the design and configuration of our services which have an impact beyond the medical workforce and will require further thought and consideration within and beyond the Service. All in all, Future Practice gives us an invaluable analysis of the key issues affecting the workforce both now and in the years ahead, and an excellent basis on which to plan ahead.
The fundamental imperative flowing from Future Practice is the need to ensure the sustainability of effective services throughout the country, and we will be guided by this principle in following up on its recommendations. The report's overriding message is the need for change if the Service is to be able to respond effectively to the pressures being experienced by the medical workforce, and thereby sustain services. We embrace and endorse that message. That is why the record levels of sustained additional investment which we have announced must go hand in hand with a programme of Service reform.
And the people who work for NHSScotland will be the engines of that reform. To release that potential we are clear that the needs of the medical workforce must be addressed within the wider context of a unified approach to the workforce as a whole, recognising that our strategies for the medical workforce cannot be about doctors in isolation, but must be about their pivotal role in the integrated healthcare team. So we must ensure that the extra financial resources are used effectively to build the right mix of numbers, talent, creativity and expertise across an NHSScotland workforce which is fit to respond to new ways of working and fresh modes of service delivery, focusing not only on immediate Service needs but also three, five, ten, fifteen years ahead.
That agenda will be supported and taken forward through our plans for workforce development which will establish, for the first time, a robust and comprehensive workforce development function for NHSScotland at local, regional and national level. This will offer clear national leadership on workforce issues, looking at the workforce as a single entity across all staff groups and putting workforce development at the heart of all service planning.
Having clear strategies for assessing and acting on our medical workforce needs is absolutely key to that endeavour, and Future Practice provides us with a good platform on which to develop and deliver those strategies.
This paper provides specific responses to each of the report's 37 recommendations. We have identified four major themes which run through the recommendations and which we believe define the overarching strands of work to be taken forward in the wake of Future Practice:
- First, a series of recommendations (1-3, 16-18, 19, 20, 22, 24, 26, 28, 29, 31, 35, 36 and 37) aimed at establishing a more robust and systematic workforce planning function for the medical workforce, taking into account factors such as the Working Time regulations. These will be addressed through the new workforce development arrangements which we will be establishing over the next year;
- Second, a series of recommendations on medical careers. These cover two broad areas, which we will take forward through the creation of the following two Working Groups:
- proposals to develop career options to aid the recruitment and retention of doctors in Scotland (recommendations 11, 24, 26, 27, 28 and 29). These will be addressed as part of the wider remit of a short-life group to drive urgent actions on NHS careers across all staff groups where there is a need for such action. This group will be chaired by SEHD's Director of Human Resources;
- proposals to review career structures for all hospital doctors from PRHO to consultant, including consideration of the forthcoming report expected on modernisation of the SHO grade (recommendations 3, 5, 6, 21 and 30). I am very pleased to confirm that Professor John Temple, President of the Royal College of Surgeons of Edinburgh, has agreed to chair this group, which will report within a year;
- Third, recommendations on basic medical education (recommendations 32 and 33). These will be addressed by a short-life Working Group convened jointly by the Scottish Executive Health Department (SEHD) and the Scottish Executive Enterprise and Lifelong Learning Department (SEELLD), and tasked with reporting to Ministers within a year. I am delighted to be able to confirm that this group will be chaired by Sir Kenneth Calman, Vice Chancellor and Warden, University of Durham; and
- Fourth, a number of recommendations flagging the urgent need for all involved in responding to this report, both within the Scottish Executive and NHSScotland, to embrace Service reform. This is a powerful message which runs throughout the report and one which we fully support. Reform, including the re-design and reconfiguration of services, is a constant imperative to which NHSScotland must respond to keep pace with a rapidly changing world where the needs and aspirations of patients and staff are continually evolving and developing. We are committed to providing the leadership and support which ensures that that process of reform is fully embraced by the Service.
The terms of reference and membership of the three groups referred to above will be made available shortly. They will all work in an inclusive manner, consulting with and taking evidence from stakeholders as they take forward their deliberations to ensure that they take all views into account in presenting their recommendations to Ministers.
We would also welcome comments on Future Practice, its recommendations and on our Response. We invite interested parties to contact Scott Miller with any views at:
Scottish Executive Health Department
Directorate of Human Resources
Ground Floor Rear
St Andrew's House
Regent Road
Edinburgh EH1 3DG
or by e-mail at scott.miller@scotland.gsi.gov.uk.
Malcolm Chisholm, MSP
Minister for Health and Community Care
July 2002
Specific Responses to the Recommendations contained in Future Practice
1. Picturing the future
Recommendation 1 | The Scottish Executive Health Department (SEHD) should set out a long-term view of the future to guide service and workforce development, and to influence expectations by: - forecasting expected change in medical science and other factors likely to impact on service provision;
- providing a vision of the future with mechanisms to refresh that vision regularly; and
- establishing data and information flows to support that process; and
- Involving key partners.
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Response | Accept. This recommendation will be taken forward by the new national Workforce Committee to be chaired by SEHD's Director of Human Resources. This will be established as part of the new workforce development arrangements being set up in the wake of Planning Together 3. |
Recommendation 2 | SEHD should publicise, promote and revisit the vision. |
Response | Accept. This recommendation will be taken forward by the national Workforce Committee referred to at Recommendation 1. |
2. Demand for doctors
2.1 How doctors work
Recommendation 3 | Confirm and co-ordinate a strategy to move towards specialist-delivered services including general practice. |
Response | Accept. SEHD will work with relevant stakeholders and through the new workforce development arrangements being set up in the wake of Planning Together to take forward such a strategy. The Working Group to be established to review hospital career structures (see response to Recommendation 5) will also address this recommendation as part of its remit. |
Recommendation 4 | Promote the recognition of generalist skills as desirable for all doctors. |
Response | Accept. We look to NHS Education for Scotland and the Royal Colleges to support training and education in generalist skills. We would welcome the views of these bodies, and others with an interest - such as the Remote and Rural Areas Resource Initiative (RARARI) - on how that proposal might be progressed. |
Recommendation 5 | Review the hospital career and training grade structures: - include the staff and associate specialist grades;
- take account of recommendations to modernise the SHO grade;
- consider how short-term service appointments can contribute to the provision of services and the development of the workforce; and
- consider different models for specialists using listing on the Specialist Register of the GMC as the basis for identifying a trained doctor.
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Response | Accept. SEHD will establish a short-life Working Group under the chairmanship of Professor John Temple to carry out this review and to report with advice to Ministers by July 2003. The Group will also be tasked with advising Ministers on taking forward any proposals for modernisation of the SHO grade. |
Recommendation 6 | Plan the training grades to satisfy the need for trained doctors, not to provide service. |
Response | Accept. This is an aspect to be included within the remit of the Working Group which will review hospital career and training grade structures (see response to Recommendation 5), to be pursued as an objective by the new workforce development arrangements being set up in the wake of Planning Together, and by NHS Education for Scotland. |
| Recommendation 7 | Give service re-design a high priority as a co-ordinated, resourced effort covering primary and secondary care: - review all current acute service configurations;
- involve patients and public in service re-design; and
- promote enhanced services rather than institutions
|
Response | Re-design and reconfiguration of services to provide a modern, quality and patient focused service is a high priority across all health sectors and continues to be demonstrated by: - work to take forward the development of Managed Clinical Networks and collaboratives;
- the work of the Primary Care Modernisation Group;
- the Joint Futures initiative;
- the Centre for Change and Innovation, incorporating the work of the Strategic Change Unit and the Designed Healthcare Initiative;
- the Waiting Times Unit;
- the work on Patient Focus and Public Involvement;
- the work of the Clinical Standards Board for Scotland (and the successor organisation the Quality and Standards Board for Health in Scotland); and
- the establishment of the Working Time Regulations Solutions Group.
The workforce aspects of re-design will also be a key part of the agenda of the workforce development arrangements being set up in the wake of Planning Together. We agree that now would be a suitable time to review implementation of the recommendations of the Acute Services Review and the range of other developments which have affected the sector since the report of the Review was published in June 1998. We very much endorse an approach based on enhanced services rather than institutions, and with strong patient focus and public involvement. The acute sector cannot be looked at in isolation, as the enhancement of services will require better links between the primary, secondary and tertiary sectors, but this review will bring a focus to the considerable volume of activity ongoing on service re-design and will be a vehicle for forging a more co-ordinated and coherent approach to this agenda from the centre. There are clear links between this recommendation and Recommendation 35, and the read-across between the two will need to be taken into account in taking forward this response. We also endorse the call for public involvement in service re-design, which chimes with the arrangements for public involvement outlined in our document Patient Focus and Public Involvement4 and in the Health Department Letter issued on service change 5. |
Recommendation 8 | Identify and pursue opportunities for Managed Clinical Networks: - ensure that their essential features are clear and agreed;
- ensure that they are managed;
- develop and co-ordinate networks nationally; and
- explore the linking of employment contracts to networks.
|
Response | Accept. This recommendation is consistent with the report of the Acute Services Review and Our National Health, a plan for action, a plan for change. The importance of Managed Clinical Networks has also been highlighted in strategic documents such as the cancer action plan 6, the CHD/Stroke Task Force report 7 and the Scottish Diabetes Framework 8. We are already encouraging a wide range of managed clinical network development, at local, regional and national level, and this has been welcomed particularly by clinicians and patients. We are currently preparing a further Health Department Letter on the subject, and the points made in Planning Together will be taken into account in that Letter, including those which refer to the linking of employment contracts to Networks. Facilitating the workforce aspects of Managed Clinical Networks will be a key priority for the new workforce development arrangements, and in pursuing this work these will link closely with the new regional service planning groups. |
Recommendation 9 | Establish a clear position on intermediate care - explain it to the public; and
- secure the support of the public and the professions for it.
Note: The term 'intermediate care' in this context means care that is delivered at the interface between primary and secondary care. |
Response | Accept. The Primary Care Modernisation Group has pointed the way to developing a more patient-focused approach to the interface between primary and secondary care by encouraging LHCCs to work in collaboration with specialist services to develop the most appropriate models of care, with shared protocols and integrated communications systems. Other vehicles include the 'collaboratives' approach to create fundamental improvements in service utilisation, patient satisfaction and clinical outcomes. The Primary Care Modernisation Group will continue as a standing group and will be one forum in which this agenda can be taken forward. Included in the work to be pursued in this area is an exploration of the benefits of Managed Clinical Networks as applied to GP community hospitals, looking at acute admissions to GP beds and establishing how these hospitals and their pattern of care could fit with the concept of managed networks. The report of the Acute Services Review thought that Managed Clinical Networks would also provide a home for the development of intermediate care, and the way in which the concept is defined by Future Practice is entirely consistent with that view. This type of intermediate care could mean the development of specialist skills on the part of a member of the primary care team, or a shift in the locus of activity of a hospital specialist. Appointments of this type are being explored in Managed Clinical Network developments relating to Coronary Heart Disease, stroke, neurological conditions and vascular services. The review of the implementation of the Acute Services Report referred to at Recommendation 7 will also help to take this agenda forward. It is evident therefore that there is more than one forum in which it would be fruitful to pursue the concept of intermediate care, and we recognise the valuable contribution to be made by a number of different interests in this area, whether from the perspective of primary care or among acute clinicians. We also acknowledge that there is therefore a need for SEHD to develop mechanisms to co-ordinate a coherent approach to the concept of intermediate care, ensuring that the various strands are brought together effectively to contribute to a clear and unified national position. We also endorse the need for public involvement in this area. The national approach to public involvement outlined in our framework Patient Focus and Public Involvement builds on the approach of the Designed to Involve project in primary care 9.We would be happy to support LHCCs address these issues with their local communities. |
Recommendation 10 | Give the development of teamwork high priority: - involve the public;
- disseminate good practice; and
- build team skills into training.
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Response | Accept. We look to all in NHSScotland to pursue teamworking opportunities where appropriate, for example when planning or re-designing services. The Primary Care Modernisation Group has given strong support to team-based primary care and NHS Education for Scotland will champion the teamworking agenda in supporting education and training. We expect NHS Boards to build this concept into their local strategies where relevant, raising awareness among the public as they do so, in line with the principles and practice outlined in Patient Focus and Public Involvement. This is also a theme with which we would look to the new workforce development arrangements being set up in the wake of Planning Together to engage, as well as the Royal Colleges and professional advisory groups. |
Recommendation 11 | Encourage the provision of more flexible opportunities for employment and career development: - pursue a more proactive approach to the professional development of all doctors.
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Response | Accept. We already support the flexible trainee scheme for doctors-in-training. We look to NHS Boards to address this recommendation in conjunction with NHS Education for Scotland through the provision and promotion of flexible options for the professional development of doctors, supported by the application of the PIN guidelines on good employment practice 10. The new contractual frameworks for consultants and GPs also underpin more coherent career development pathways which are more responsive to individual needs and aspirations. Furthermore, we will be establishing a Working Group - chaired by SEHD's Director of Human Resources: - to look at NHS careers across the NHSScotland workforce and identify urgent actions to be taken;
- to help create more flexible employment packages;
- to support recruitment and retention; and
- to undertake, where necessary, national recruitment initiatives.
|
Recommendation 12 | Address the reallocation of administrative and other tasks currently carried out by doctors, to maximise the use of doctors' clinical skills. |
Response | Accept. We endorse the principle of delegating administrative and other tasks in order to free up doctors' time for the clinical work for which they have been trained. We look to NHS Boards to respond to this recommendation in their approaches to job design and administration of workloads. |
2.2 Doctors in remote and rural areas
Recommendation 13 | Define: - remote and rural practice;
- core services for each remote and rural community; and
- standards by outcome, allowing variation in methods to achieve them.
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Response | We recognise that there are considerable challenges in arriving at objective and accepted definitions of 'rural practice' and 'core services.' The dynamic nature of clinical practice, which changes as a result of advances in treatments and technologies and the interests of local practitioners, militates against applying hard and fast definitions. However we agree that this issue is worth examining and we will consider it further. In relation to standards, we would welcome the views of the forthcoming Quality and Standards Board for Scotland on the suggestion that the way standards are defined should allow for variation in the methods used to achieve those standards. |
Recommendation 14 | Conduct an option appraisal for maintaining acute services in small hospitals . |
Response | We agree that such an option appraisal would be worthwhile. We will take this forward as part of the more co-ordinated approach to enhancing services rather than institutions, referred to at Recommendation 7. The appraisal will be overseen from the centre through a set of clear national parameters and criteria, and co-ordinated at local level by the relevant NHS Boards with the full engagement of the local communities served by those hospitals. We would also look to RARARI to help conduct this exercise at local level. It will be placed within the context of extending the concept and establishment of Managed Clinical Networks throughout Scotland and will be informed by the work applied to acute admissions to GP community hospitals, as referred to at Recommendation 9. |
Recommendation 15 | Politicians, managers and professionals to engage with and involve the public in the process of determining effective, sustainable services. |
Response | Accept. SEHD is fully committed to ensuring the full and genuine engagement of the public in determining national strategies for sustaining effective services in remote and rural areas. We also look to relevant NHS Boards to take an inclusive and transparent approach to determining effective and sustainable services in these areas, ensuring that there is ample opportunity for public participation in developing and agreeing on local strategies for service delivery. In doing so, they should apply the principles and practice outlined in Patient Focus and Public Involvement. |
Recommendation 16 | Maximise effective use of staff through flexible arrangements for service provision supported by networks: - accelerate and extend use of Managed Clinical Networks.
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Response | Accept. Much of this recommendation is covered by our response to Recommendation 8. We also look to the new workforce development arrangements being set up in the wake of Planning Together to work with the regional service planning groups and the strategies supporting new service frameworks to help take this recommendation forward. Rather than building separate networks of their own, we would in many cases see scope for remote and rural areas to be included in wider managed networks covering the highly specialised elements of a particular service, with the other less specialised elements being provided more locally. The conclusions of Future Practice would support this model. |
Recommendation 17 | Establish remote and rural strategies for staff development but linked to proposed regional planning provisions. |
Response | Accept. We see this being taken forward by the new workforce development arrangements being set up in the wake of Planning Together. The new regional workforce centres will work on this with regional planning networks, RARARI , NHS Education for Scotland and the Working Group referred to at Recommendation 5. |
2.3 Understanding the demand for doctors
Recommendation 18 | Establish working assumptions for the numbers of specialists and other doctors required and keep them under review. |
Response | Accept. This task will be incorporated into the work of the new workforce development arrangements at national, regional and local levels now being established in the light of Planning Together. |
Recommendation 19 | Gear the numbers of doctors in training posts to the future numbers of trained specialists required . |
Response | Accept. This task will be incorporated into the work of the new workforce development arrangements at national, regional and local levels now being established in the light of Planning Together, linking closely with NHS Education for Scotland. |
Recommendation 20 | Address pressures on working hours and how they may be resolved. |
Response | Accept. We already have a joint SEHD/BMA partnership group, the Implementation Support Group, helping the Service to respond to the hours limits applied by the New Deal contract for junior doctors. This is now complemented by two groups charged with helping NHS Boards to implement the Working Time regulations: - a Working Group convened by the Scottish Partnership Forum to help guide the Service in achieving compliance with the Working Time regulations;
- a Service-led Working Time Regulations Solutions Group tasked with identifying and promoting working patterns and examples of service redesign which will help compliance with the Directive.
These will be supported by the new workforce development arrangements being set up in the wake of Planning Together. |
Recommendation 21 | Explore the role of non-training experiential posts below the level of specialist . |
Response | Accept. We recognise the issues which have given rise to this recommendation. We agree that it warrants further consideration and we will therefore ask the Working Group referred to in response to Recommendation 5 to respond to this recommendation as part of its remit, and to make specific proposals on how it might be addressed. |
Recommendation 22 | Address shortage specialties and their direct and indirect effect on service. |
Response | Accept. This is a key task which NHS Boards and Trusts already have among their priorities and will continue to focus on as an immediate action. It is also a matter which will be incorporated into the work of the new workforce development arrangements at national, regional and local levels now being established in the light of Planning Together. |
Recommendation 23 | Pursue: - service re-design;
- teamwork; and
- Managed Clinical Networks.
|
Response | Accept. The response to this recommendation is already incorporated into our responses to recommendations 7, 8 and 10. |
Recommendation 24 | Increase the recruitment of doctors: establish how that is best achieved. |
Response | Accept. The new arrangements for workforce development at local, regional and national level will carry out the all-important task of assessing how great that increase should be. Furthermore, the Working Group to be established on careers in NHSScotland (see response to Recommendation 11) will work with Boards and Trusts to help them identify any actions to be taken on recruitment. |
Recommendation 25 | Identify ways in which the use of IT can lead to more effective use of doctors' time. |
Response | Accept. The Audit Commission has estimated that 25% of doctors' and nurses' time was spent collecting data and using paper-based information. By making this information available in electronic record form there is potential to considerably reduce this proportion while supporting clinical decision-making through more effective presentation of patient information. This clinical support vision is at the heart of Strategy for Information, the NHSScotland plan for IM&T published in February 2002 11. |
3. Supplying Doctors
3.1 Recruitment and retention
Recommendation 26 | Manage recruitment: - set national and local targets; and
- establish authority and accountability of those responsible for meeting targets.
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Response | Accept. The new arrangements for workforce development at local, regional and national level will be tasked with making effective assessments of national and local medical workforce needs, tied to clear lines of accountability and authority. Furthermore, the Working Group to be established on careers in NHSScotland (see response to Recommendation 11) will help Boards and Trusts to identify any actions which may help to address this recommendation. |
Recommendation 27 | Promote Scottish medical careers - facilitate local incentives within a national framework;
- promote a positive Scottish identity; and
- engage schools and education institutions.
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Response | Accept. We recognise the need for a more strategic and coherent Scottish Executive-led approach to promoting Scottish medical careers than has been taken in the past. We intend to work with the Service to produce nationally branded material (to be used as a generic template by the Service) that promotes to all potential Health Service staff the career opportunities offered by NHSScotland, and which can be used to engage schools and other education institutions. This work will also be a key element of the Working Group to be established on careers in NHSScotland (see response to Recommendation 11). |
Recommendation 28 | Maximise retention: - delay retirement by step-down and return options;
- improve scope for and attitude to flexible training and working; and
- address morale factors, including positive changes in work practices.
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Response | Accept. The new workforce development arrangements to be established at local, regional and national levels will help NHS Boards and Trusts to take forward new initiatives of this nature. They will also be facilitated through the implementation of the report of the Primary Care Modernisation Group - Making the Connections; and through the emphasis on phased careers flowing from the new contractual frameworks agreed for hospital consultants and GPs. In addition, the Working Group to be established on careers in NHSScotland (see response to Recommendation 11) will add focus to this work. |
Recommendation 29 | Take particular actions for remote and rural areas through: - selective additional investment;
- rural 'packages' for doctors and other health professionals and their families;
- targeted recruitment, training and career planning for remote and rural practice;
- arrangements for continuing professional development and for maintaining clinical competence.
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Response | We agree that NHS Boards and Trusts which have recruitment and retention difficulties linked to remote and rural circumstances will wish to explore cost-effective options for providing recruitment and retention 'packages' in remote and rural areas. SEHD will look to the new workforce development arrangements at national and regional levels to support Boards in developing creative approaches to this issue. The Working Group to be established on careers in NHSScotland (see response to Recommendation 11) will help to lead this agenda. |
Recommendation 30 | Maintain and support the contribution of overseas doctors: - include their interests in reviews of career and training grades.
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Response | Accept. This recommendation is closely linked to the review of medical career structures referred to at Recommendation 5. We will ask the Working Group to be set up to carry out that review to address this recommendation as part of its remit. |
Recommendation 31 | Support academic and research medicine: - recognise its needs and accommodate within workforce planning processes.
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Response | Accept. This part of the medical workforce will be addressed by the new workforce development arrangements at local, regional and national levels now being established in the light of Planning Together. |
3.2 Supply from the education sector
Recommendation 32 | Explore increased output from Scotland's medical schools by: - quantifying the case for further increase;
- providing for mature entry and improved social diversity; and
- enabling some or all of St Andrews graduates to complete their clinical training in Scotland.
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Response | We agree that these are important issues which warrant further exploration and the Executive has therefore decided to establish a short-life Working Group under the chairmanship of Sir Kenneth Calman to address these topics and make recommendations to Ministers within the next year. |
Recommendation 33 | Review student support systems to facilitate wider access to medicine: - particularly for mature students.
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Response | We agree that the provision of mature entry courses needs to be examined and this is an aspect of medical education which we will ask Sir Kenneth Calman to explore within the remit of the Working Group referred to in response to Recommendation 32. We do not see the remit of this group including a review of student support systems, which is a matter for Scottish Executive Ministers to consider. |
Recommendation 34 | Review funding for additional cost of undergraduate teaching (ACT): - seek a new system for ensuring sufficient high quality clinical teaching; and
- recognise that ACT funding largely supports acute services in the teaching centres.
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Response | Accept. We have already commissioned the Standing Committee on Resource Allocation to undertake such a review. That group, chaired by Professor Sir John Arbuthnott, has now commenced its work and will take into account the contents of this report in its considerations. |
4. Planning the workforce - improving the workforce
Recommendation 35 | Establish much larger managed health economies for Scotland than presently exist covering workforce planning and all services: except those highly specialised services which have to be managed at a national level. |
Response | In relation to workforce development our response to this recommendation is already reflected in the plans outlined in our response to Planning Together and our subsequent workforce development action plan to establish three regional workforce centres to add a regional perspective to relevant aspects of workforce planning. In relation to service delivery, the new regional service planning arrangements 12 also reflect a recognition that there are a number of aspects of service delivery which require a co-ordinated regional approach. We look to the regional workforce and service planning groupings to link closely in pursuing regional approaches to service and workforce planning issues which are best tackled at regional rather than individual Board level. We also recognise that, as well as the need to complement and strengthen existing national-level planning for highly specialised services, there remains a key need for workforce planning to continue and develop at individual Board and Trust level, and that the overall approach should always be based on the principle of allowing tasks to be done at whichever level is most effective. We are currently carrying out a major review of management and decision-making in NHSScotland. This recommendation will be considered as part of the deliberations of that review, which is due to report in 2003. |
Recommendation 36 | Take action to ensure that workforce data and information is generated, collected and validated in a timely way. |
Response | Accept. A key element of the workforce development arrangements now being established at local, regional and national level will be the development of robust and effective workforce information systems. Work is already underway to scope the options for delivering robust, timely and comprehensive data and the national Workforce Committee will provide leadership for this process. |
Recommendation 37 | Develop a coherent, nationally-led medical workforce planning system as a part of the workforce development arrangements in the SEHD in response to Planning Together. |
Response | Accept. This will be a key remit of the new workforce development arrangements now being established at local, regional and national level in response to Planning Together. |