New Times,
New Thinking.

How NHS Scotland became a leader in workforce planning

Under the Scottish government, the health service's workforce has grown by more than 20 per cent north of the border.

By Martyn Day

The NHS and social care sectors are experiencing significant and sustained pressures, and at the highest level in my lifetime. I’m sure everyone shares my deep gratitude for the hard work, commitment and professionalism of health and social care workers during these unprecedented challenges – the challenges of not only dealing with Covid-19, but also with a backlog of operations and record-breaking waiting lists. 

The bombardment of physical, psychological and emotional pressures that the pandemic created has, inevitably, led to staff burnout. Yet the pandemic exposed and compounded long-standing issues that remained unresolved before Covid-19.

Issues such as critical staff shortages, affecting NHS and social care workforces and their service provisions are driven by funding instead of need.

Boris Johnson promised two years ago to “fix” social care in England. Yet it was afforded just a single line in the Queen’s Speech, which only promised to outline future plans. Even the newly planned tax hike will merely help one in ten of those needing assistance. The new funding promises reform from 2023 onwards, with no plans to help the sector survive the current crises and make it through.

The SNP has called for more investment in the English NHS so that more healthcare funding can be passed on to Scotland under the terms of the Barnett guarantee. However, the tax being raised by the Tories will hit the poorest hardest.

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Care homes in England are calling on the UK government to relax immigration requirements on low-paid care staff, as staff shortages (already around 112,000 before the pandemic) are set to worsen in November when potentially another 70,000 care staff are forced out of the sector by the UK government’s vaccination requirements.

Workers in England’s care sector have also been leaving to work for Amazon and other employers offering better pay. Compared to Scotland, care workers in England earn less.

The UK government has also overseen a staffing crisis in NHS England, with vacancies up 23 per cent from March. House of Commons Library research revealed 15 per cent of NHS England’s workforce self-identify as a nationality other than British, with EU staff making up 5.4 per cent of workers across England, and more than 10 per cent in London.

With our healthcare services so reliant on immigrant workers, it is wrong-headed of the UK government to pursue its hostile environment, which drives away the very workers it needs.  

This litany of pressures faced by the NHS and social care sectors will not surprise anyone.  While we can argue about the root causes for many years, the challenge is how to go forward. How do we deliver a plan for recovery that puts health and social care at the heart of our policymaking?

Allow me to impart a tale of two governments, because the SNP Scottish government is choosing a different path.  

A report on the future of the NHS across the UK, published in May by the Lancet and the London School of Economics, stated that “Scotland has made the most progress in its approach to workforce planning”, and highlighted our success in “drawing on factors from both the supply and demand sides and moving away from a focus on individual professions to consider the collective health and care workforce”.

Under the Scottish government, NHS Scotland’s workforce has grown by more than 20 per cent. This means an extra 25,000 staff working in our health service, achieved by nine consecutive years of staffing increases. Yet Brexit has caused vacancies that impacts how we deliver health and care services.  

The Scottish government will recruit at least 1,500 more NHS staff to deliver its National Elective Centre Programme and increase specialist capacity. It is ensuring the next generation of doctors, nurses, GPs and paramedics with generous student bursaries and access to free tuition.  

Scottish health and social care staff are the best paid in the UK, with a recent pay increase given to more than 150,000 NHS Scotland employees ensuring that almost 95 per cent of staff on Agenda for Change pay scales – including nurses, paramedics, allied health professionals, porters and domestics – receive a minimum 4 per cent rise compared with 2020/21.

The Scottish government also provided additional funding of £8.8m to the nation’s Integration Authorities to deliver the real living wage commitment to ensure at least £9.30 per hour for social care staff. As a small token of gratitude, the Scottish government gave health and social care staff a £500 thank you bonus too.

[See also: Jeremy Hunt on why money alone will not fix the NHS]

Scotland is pushing forward with new ideas to deliver health and social care services fit for the 21st century. Its government is delivering a new deal for the care sector, building a new National Care Service that will improve workers’ conditions and standards of care and prepare the sector for the future.

The NHS Pharmacy First Scotland scheme has been developed too, placing local pharmacies at the heart of first-line provision. This will be supported by creating an NHS National Pharmaceutical Agency to ensure secure and sustainable supply chains for vital medicines, and support investment in cutting-edge vaccine and medicines research. 

One of the Scottish government’s Programme for Government commitments is establishing the Patient Safety Commissioner role, and it has given this priority because patient safety has been, and remains, key to delivering healthcare.

An independent Scotland under an SNP government would never sell or privatise the NHS. We would have a fair immigration system that continues to bring in workers to support our NHS, rather than a Brexit Britain that demonises immigrants.

Martyn Day is an MP and shadow SNP spokesperson (public health and primary care)

This article originally appeared in our Spotlight on health. To read the full supplement click here.

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