The NHS in Scotland faces a number of challenges, not least a population living with multiple long-term health conditions. In order to cope with these challenges and deliver the best possible patient care, Scotland must continue to recruit and retain a world class medical workforce.
Furthermore, it is essential that evidence-based approaches are taken to support workforce planning along with reassessment of the size and structure of the consultant workforce taking account of such changes as the rise of part-time working, extended working, and the needs of an ageing population.
The Royal College of Physicians of Edinburgh is committed to supporting doctors throughout their careers. Our Time For Doctors campaign explores three core ideas, which we think will prepare the medical workforce for the challenges the NHS in Scotland faces:
1. Time to train: The NHS workforce in Scotland must be supported with an increased number of medical school places. Excellent training is essential in providing quality patient care. Doctors in training provide a significant level of core hospital services and care, and are vital in identifying concerns in service provision and standards of patient care. Our trainees will become future NHS leaders.
The College calls for the Government to ensure that: UK wide training standards, as regulated by the GMC, must be met throughout Scotland; development of Shape of Training should be conducted in Scotland with input from the College and implementation must be appropriately evaluated; medical Royal Colleges need to be able to devise curricula according to patient need, independent of government involvement; training and service are inherently linked and both must be supported in order to deliver high quality patient care. Full adoption of the College’s Charter for Medical Training provides this environment.
2. Time to retain: the NHS must retain the experience, skills and knowledge of doctors at every level, from trainees to senior consultants. Schemes such as the Medical Training Initiative – which recruits international doctors - must be fully supported along with EU doctors, to help fill rota gaps. This is vital for maintaining quality patient care.
This College maintains that more positive measures need to be pursued to ensure that the NHS is an attractive environment in which to pursue a career. It is important to achieve a change in culture where medical students and trainees feel a valued part of the NHS otherwise we risk alienating the future generation of doctors. The College challenges the assumption that increasing undergraduate places alone will actually address the underlying problem, which is that significant numbers of graduates leave the NHS within a few years of qualifying.
Much remains to be clarified about the impact of Brexit on issues such as our NHS workforce; research; freedom of movement; medicines; and implications for public health. Given the current shortfalls being experienced in staffing in both the health and social care sectors, the UK Government must clarify its intentions on the ability of EU nationals to work in health and social care roles in the UK.
3. Time to value: at a time when doctors are under greater professional pressures, they must be made to feel valued. Doctors’ wellbeing must be supported around areas such as mental health, diet, exercise, time management and work-life balance. We back a review of the amenities and services available to the medical workforce, including wellbeing and mental health support.
Workforce planning needs a clear strategic direction to tackle the recruitment and retention issues that exist. There are workforce shortages across the country with rota gaps creating additional pressures in an already difficult environment. We must value healthcare professionals at every stage in their careers to ensure medicine remains an attractive choice and offer support for medical professionals as they progress throughout their careers.
EU staff who are currently working in the NHS must feel valued for their significant contribution and do not decide to leave to work in other countries. It is essential that the voice of all medical professionals is recognised by policy makers at the heart of the Brexit negotiations.
Time to care. We believe that providing excellent training, retaining our workforce, and making our workforce feel valued will help the NHS in Scotland overcome challenges and maintain quality patient care.
