INCREASING MEDICAL CONSULTANTS IN SCOTLAND
CASE STUDY: SCOTTISH GOVERNMENT
Focussed project management in developing and recommending a way forward for target achievement detailing short/medium and longer term strategies.
Background
A ministerial target, relating to increasing the number of medical consultants in Scotland was in danger of not being achieved. The Head of Workforce Planning sought external support to ensure focussed project management in developing and recommending a way forward for target achievement.
Approach
Worked with CEO’s/Clinical Directors, Senior Managers and HR Directors across NHS Scotland, the Department of Health, NHS Education Scotland and other relevant bodies, to undertake a comprehensive diagnostic, to understand the underlying issues and challenges for:
- Improving retention rates
- Improving attraction strategy
- Improving conversion rate from Scottish qualified specialist registrars (SPRS)to consultant jobs in Scotland
The issues were highly complex and influenced by a diverse stakeholder group with different priorities. A considerable level of debate on this issue had already taken place, but commitment appeared to be mixed and progress towards the target was far from assured.
A comprehensive action plan, with clear deliverables and accountabilities was urgently required. Key issues and challenges were identified which cause and exacerbate difficulties in retaining senior medical staff in Scotland. These include an apparent lack of cohesion between the time SPRs become qualified and the subsequent timing of consultant recruitment by NHS trusts, as well as a rather piecemeal approach to attraction and recruitment at national level. The problems of mapping supply and demand requirements over the time period taken to qualify also caused problems. This was all exacerbated by the often very generous salary packages, offered by many English NHS Trusts.
Result
To address the key issues Wildcat One developed a comprehensive action plan, detailing short/medium and longer term strategies. This included improving SPR conversion rates to Scottish jobs, through improved co-ordination between NHS Education Scotland and Trusts, as well as improved career management. Retention of existing consultants through better career development, mentoring and increased use of flexible working at different stages in their career. Improved attraction strategies, for consultants interested in relocating to Scotland etc. In comparison with England and Wales, the Scottish plan was more modest, yet highly focused and eminently achievable, with adequate resourcing and ownership across all key stakeholders.
The plan was accepted by the Department of Health as pragmatic and realistic. It was recognised as offering potential to make significant inroads into achieving a difficult target in increasingly tight timescales. The plan was submitted to the then Health Minister for approval in early 2005.
This work was undertaken in 2004. It is now understood that the context in which the target was originally set has been reviewed, in light of changing NHS workforce needs and priorities. It is likely that aspects of the Action Plan may have been implemented but not in its entirety due to changed circumstances.