Workforce Recruitment & Retention
At the SRHP, we recognise that workforce recruitment and retention is currently a high priority, if not the top priority, for the majority of organisations delivering health and care services in remote and rural areas of Scotland.
A combination of factors including a growing elderly population, increasing demand for treatment and care, a dispersed population and challenges associated with workforce supply are all having an impact of local authorities, general practice, and community, secondary and tertiary services.
We're bringing together information on the various rural recruitment and retention projects and initiatives that are underway or have recently been completed across Scotland starting with general practice.
Information will follow shortly on nursing and midwifery, and other allied health professionals. Examples of good practice, and links to tool kits, resources and evaluation reports will be added over the coming weeks and months.
Please contact us if you have a project or information that you’d like us to add.
Primary Care Services
NATIONAL HEALTH AND SOCIAL CARE WORKFORCE PLAN PART 3 - IMPROVING WORKFORCE PLANNING FOR PRIMARY CARE IN SCOTLAND
Monday, April 30, 2018 ISBN: 9781788517034
Part 3 of the National Health and Social Care Workforce Plan, published by the Scottish Government on 30 April. This plan sets out how primary care services are in a strong position to respond to the changing and growing needs of our population; describes the anticipated changes in the way services will be developed to meet population need; how Multidisciplinary Teams will be strengthened to deliver an enhanced and sustainable workforce and how the NHS in Scotland will work with partners to ensure that better quality and more timely data is developed to drive effective local and national workforce planning.
Recruit and Retain
Northern Peripheries Programme (EU)
01/06/2011 to 30/06/2014
Recruit and Retain set out to find solutions to the persistent problem of difficulties in recruiting and retaining high quality people to work in the public sector in the remote rural areas of Northern Europe. The core project addressed issues and solutions with respect to health care workers. Project outputs can be found here.
An approach to building sustainability of health and care services in remote and rural areas
In 2013, NHS Highland was awarded £1.5 million to devise and test innovative ways of recruiting and retaining healthcare professionals, and particularly GPs, in remote and rural areas. Four areas where chosen to test new models for remote and rural health and care services in Scotland: the Small Isles and Acharacle; Mid-Argyll; Kintyre; and Islay.
Information can be found here.
Recruit and Retain 2: Making it Work
Northern Peripheries Programme (EU)
31/01/2016 to 30/01/2019
Making it Work consisted of five recruitment and retention case studies, at scale, across Northern Europe and Canada, including the Scottish Highlands, using the business model tailored to local and regional needs. It applied a community focused lens, a detailed planning process, along with a structured evaluation highlighting costs and benefits of the interventions. A flexible policy framework and a practical online toolkit were developed to allow knowledge transfer of key factors of success. The project closed in January 2019 with a forum.
GP Recruitment and Retention Fund
Sixteen projects were supported through the Scottish Government’s GP Recruitment and Retention Fund, only one, the Scottish Rural Medicine Collaborative, is currently ongoing. Most of these projects were designed to address specific challenges within individual Health Boards. However, three projects were funded with a remote and rural focus, they were:
- NHS Shetland - Promoting Shetland as a place to life and work through the development of 4 GP videos
- NHS Highland with Argyll & Bute Health and Social Care Partnership - the development of a sustainable service model which was attractive to recruit and retain staff
- The Scottish Rural Medicine Collaborative.
The Scottish Rural Medicine Collaborative
The Scottish Rural Medicine Collaborative (SRMC) is a programme funded by the Scottish Government’s GP Recruitment and Retention Fund. The programme - chaired by Ralph Roberts (Chief Executive of NHS Borders) - is about developing ways to improve the recruitment and retention of GPs working in a rural setting across ten Health Board areas in Scotland - Grampian, Highland, Orkney, Shetland, Western Isles, Dumfries & Galloway, Ayrshire & Arran, Fife, Tayside and Borders. Also involved are NES, NHS HR Directors, RCGP Scotland and Rural GP Association. The first phase of the SRMC programme included
- Recruitment Good Practice Guidelines, with tailored content to rural GP recruitment
- GP Recruitment Yearly Wheel (or calendar)
- Marketing resources, working with NSS to develop rural GP content for the national GP recruitment website
- Valuing Rural Practice, including BASICS course, resilience, creating greater capacity to learn and GPs4GPs Scheme
- Recruitment & Retention Toolkit with Making It Work project
- Recruitment Support, including specific support for employers and for potential and actual rural GPs
Various websites provide information for GPs working in remote & rural areas and for advertising new job opportunities
Scottish Rural GP Fellowships
The one-year GP Rural Fellowships represent an opportunity to work in Scotland to develop the generalist skills required to work in some of the most beautiful areas of our country. There are two types of Rural Fellowship - 'Standard' and 'Acute Care'. Up to 12 rural fellowships are available each year.
- The 'standard' GP Rural Fellowship option based on the curriculum for rural practice developed by the Remote and Rural Training Pathways Group (GP sub-group Final Report Sept 2007).
- The newer GP Acute Care Rural Fellowship option based on the, GP Acute Care Competencies work following from the agreement of the Framework for the Sustainability of Services and the Medical Workforce in Remote Acute Care Community Hospitals.
Fellows gain experience by working in remote and/ or rural general practice (for the 'Standard' option) or hospital practice (for the Acute Care option) as well as in a 'base practice' in a rural area. The fellowship year includes 13 weeks of protected time and a generous financial allowance to support a flexible, individually tailored learning programme based on the fellow's individual needs.
The Rural Fellowships are designed for doctors that have reasonably recently completed their General Practice Specialty Training and have an interest in experiencing remote and rural practice.
RCGP Rural Forum
A UK wide forum, with the aim of networking discussion and providing an annual conference for rural GPs.
Being Rural - RCGP Scotland Policy Paper written by the Rural Strategy Group Scotland (Aug 2014) outlines the issues as seen in 2014. Gives recommendations and actions.
Rural GP Association of Scotland (RGPAS)
To represent, progress and act as a forum for the educational and professional needs of rural GPs in Scotland. Also, to represent the interests of rural GP practices and promote access to these learning environments for students and training.
Email network of over 60 rural GPs in Scotland, and a wider reach in terms of engagement with students, trainees and partner agencies
ScotGEM is designed to develop doctors interested in a career as a generalist practitioner within NHS Scotland, with a focus on rural medicine and healthcare improvement. It offers a unique and innovative 4-year graduate entry medical programme tailored to meet the contemporary and future needs of the NHS in Scotland.
The following links may also be of interest:
Supporting Remote and Rural Services
The remote, rural and island Boards in Scotland are clear that high level education support is integral to robust workforce planning and redesign. They need assurance that affordable, accessible education will be in place before investing in new roles and new ways of delivering services.
NHS Education for Scotland (NES) has a key role in this joint workforce planning and education partnership. There is an appreciation that although each of Scotland’s remote, rural and island areas have a range of different needs and ways of working, there are some common areas of need already identified that can guide more effective design and delivery of education and training.
Recruitment and retention issues are the key challenges facing rural general practice and remote and rural healthcare service improvement. There is a need to improve access to ongoing education, increase effective use of technology, and increase rural placements and peer-support to improve recruitment and retention within rural teams.
- MacVicar R, Nicoll Supporting Remote & Rural Health Care, NES Board Paper 2013
- Strasser R. Rural health around the world: challenges and solutions.
- Delivering for Remote and Rural Healthcare: The Final Report of the Remote and Rural Workstreams 2010
- David Oliver: Challenges for rural hospitals—the same but different
- Audit Scotland. NHS Workforce Planning. The clinical workforce in secondary care. July 2017
- Addressing the crisis of GP recruitment and retention: a systematic review
- EU Commission. Recruitment and Retention of the Health Workforce in Europe. 2015
Despite the fact that half the world’s population live in remote and rural areas most health workers live and work in cities. This imbalance is common to almost all countries with large rural geographies and has significant implications for service sustainability and quality improvement.
Additionally, there is a common trend across many countries for the training of medical and healthcare workers within city environments rather than locally closer to remote and rural areas.
However, there is significant international evidence to suggest that increasing recruitment from remote and rural areas has a positive impact on recruitment and retention in the longer term.
- WHO recommendation on recruitment and retention of staff in rural and remote area.
The Remote and Rural Healthcare Education Alliance (RRHEAL)
The Remote and Rural Healthcare Educational Alliance (RRHEAL) is part of NHS Education for Scotland (NES) and helped develop the SRHP. RRHEAL work across all the remote, rural and island areas of Scotland to coordinate remote and rural healthcare education the development and delivery of education and training for the remote, rural and island workforce. Its aims are to increase access to affordable, sustainable education, training and development opportunities and support staff in making best use of available technologies to deliver improved care. RRHEAL works with a large range of partners across Scotland and internationally to help ensure new programmes of education and training are developed in a remote and rural inclusive way in accordance with NES Remote and Rural Inclusive Education Policy.
Nursing and Midwifery
General information can be found at:
- The Scottish Government. Nursing 2030 Vison. 13 July 2017
- The Scottish Government Transforming Nursing, Midwifery and Health Professionals Roles 22 December 2017
As part of a wider suite of work to ensure that Scotland has a sustainable and suitable workforce that will continue to meet the needs of Scotland’s population well into the future, Professor Fiona McQueen, the Chief Nursing Officer (CNO) commissioned Professor Paul Martin CBE - Depute Principal and Depute Vice Chancellor of University of the West of Scotland - to chair a review of routes into the nursing and midwifery professions. The Commission’s Final Report was launched on 7 December.
Nursing and midwifery in the Highlands and Islands
Nursing education in Highlands and Islands
There is long history of nurse education in the Highlands and Islands, more recently nursing students completed their degree with the University of Stirling. From August 2017 the University of the Highlands and Islands became the provider of nurse education in the region with campuses in Inverness and Stornoway. This continues to strengthen the regional provision of adult and mental health nurse education.
- Department of Nursing and Midwifery at the University of the Highlands and Islands
- Department of Nursing and Midwifery - Research
- The University of the Highlands and islands takes over nurse training
- University recognises contribution to nursing provision in the Highlands and Islands
- Nursing Academics to present Inverness lecture
- Leading Health Service research takes Chair at the University of the Highlands and islands
- Opportunities highlighted ahead of international nurses day
Midwifery education in the Highlands
From January 2019, The University of the Highlands and Islands in partnership with regional NHS Boards will offer a pre-registration, post graduate, shortened midwifery programme for qualified nurses, to achieve registration as a Registered Midwife with the Nursing and Midwifery Council (NMC).
Three Higher Education Institutes offer 3 year full time direct entry midwifery courses in Scotland; the University of the West of Scotland, Edinburgh Napier University and Robert Gordon University.
Postgraduate programmes and CPD
Registered nurses, midwives, allied health professionals and social care professional looking to extend their educational qualifications, can access standalone CPD modules, Post graduate Diplomas and Masters Degrees from the University of the Highlands and Islands.
Advanced nurse practitioner/professional practice MSc
Advanced Nurse Practitioners (ANPs) are experienced and highly educated Registered Nurses who manage the complete clinical care for their patient. As part of their core role and function, ANPs work within 4 four pillars of practice:
- Clinical practice
- Facilitation of learning
- Evidence research and development.
Similar pathways for other healthcare professions are available through the Advanced Professional Practice route. The MSc programme supports a range of healthcare professions working across a variety of healthcare settings including remote and rural contexts in hospitals and community.