Implementation of Agenda for Change recommendations
NHS Agenda for Change staff – including nurses, midwives, paramedics, allied health professionals, porters and others – will see a reduction of 30 minutes in their working week from 1st April this year.
The move follows a recommendation from a working group set up to implement a previous commitment to cut the number of working hours as part of the 2023/24 pay deal. It is one of a number of measures to modernise the NHS Scotland Agenda for Change system and has been agreed with trade unions.
If, due to service pressures, safe staffing or wellbeing issues, it is not possible for a staff member to receive their 30 minute reduction they will be recompensed accordingly, until such times as the reduction can be accommodated.
Other measures agreed include:
a consistent approach to Protected Learning Time across all NHS Scotland Boards, and
a defined process for undertaking a review of Band 5 nursing roles with any Band 5 nurse able to self-apply for a review of their role if they believe they meet the criteria.
The changes will support NHS Scotland workforce recruitment, sustainability and retention.
Health Secretary Neil Gray said: “Our Agenda for Change system recognises the value, dedication and hard work of our staff and makes NHS Scotland an employer of choice.
“We expect NHS Boards to work in partnership with trade unions and staff to reduce the working week. This presents an opportunity to modernise how staff are rostered and work, ensuring that NHS Scotland is a leader in flexible and family friendly working practices.
“I am grateful to both Trade Union and Employer representatives for working in partnership with us to develop these reforms to help modernise our service.”
Legislation which will see the introduction of a National Care Service for Scotland (NCS) has passed Stage 1 in Parliament.
MSPs have voted for the general principles of the National Care Service (Scotland) Bill which will ensure greater transparency in the delivery of community health and social care, improve standards, strengthen the role of the workforce and provide better support for unpaid carers.
The proposals include establishing a National Care Service Charter, rights to breaks for carers and provisions to enact Anne’s Law so people in care homes have the right to be visited by their families.
Social Care Minister Maree Todd said: “We need long-term, widespread transformation to fix some of the ingrained issues within the system and ensure sustainability for the future.
“We have spent considerable time working with people with lived experience on how to reform social care for the better. I’m grateful to the thousands of people who have lent their voices and I am determined to ensure the Bill delivers the positive change needed.
“Today’s vote shows that the Scottish Parliament also recognises this and I am grateful to them for bringing us one step closer to this urgent reform.
“This Bill is the biggest public sector reform since devolution and it is our chance to make meaningful change that we all agree is needed to the social care system. I know the people of Scotland will see huge benefits.”
Scotland’s largest trade union bodies have condemned the Scottish Government’s proposed National Care Service Bill as ‘not fit for purpose’ as MSPs approve the legislation at Stage 1.
The Scottish Trades Union Congress (STUC) alongside the three biggest social care unions in Scotland – UNISON, GMB SCOTLAND and UNITE – have written to the Cabinet Secretary for NHS Recovery, Health and Social Care Neil Gray outlining their shared concerns on the Bill.
The letter states that social care workers’ concerns have been ‘widely ignored’ by the Scottish Government and that, at this stage of proceedings, the Bill as drafted remains ‘firmly unacceptable’.
Last week the Scottish Parliament’s Health, Social Care and Sport Committee’s report into Stage 1 drew criticism from trade unions who outlined the ‘glaring deficiencies’ of the proposals on costs and operation of the service.
Commenting, STUC General Secretary Roz Foyer said: “It beggars belief that, despite repeated warnings to the Scottish Government, Scotland’s social care workers are still in the dark on the basic fundamentals of the new National Care Service.
“Our social care sector already suffers from insecure conditions and low pay. We cannot risk those weaknesses being carried over into any new system of nationalised care.
“We must see the Scottish Government take seriously the recommendations of the Health, Social Care and Sport Committee’s report into the Bill. This would include improving pay, terms and conditions for social care staff, including a £15 per hour minimum wage. We also need to see Scottish Government guarantees on Fair Work and sectoral bargaining in addition to full sick pay from day one of employment.
“Our social care staff are the lifeblood of our system. We value their work and it’s high time the Scottish Government does likewise.”
COSLA: “SIGNIFICANT CONCERNS” ON NATIONAL CARE SERVICE PLANS
Speaking ahead of the Stage 1 debate for the National Care Service Bill in the Scottish Parliament on Thursday 29th February, Councillor Paul Kelly, COSLA’s Health & Social Care Spokesperson, commented:“Councils have expressed significant concerns regarding current National Care Service plans and believe there is still work to do to ensure proposals can meet aspirations.
“In particular, Council Leaders are disappointed in the decision of the Scottish Government to continue to push through legislation where a power will be given to Ministers to delegate children and justice services, despite the potential disruption to services and extensive negotiations and concessions from Local Government.
“Council Leaders remain concerned that such a move risks excessive centralisation of decision-making away from local people and areas. Leaders did agree that COSLA should continue to work closely with Scottish Government to address these concerns.
“COSLA welcomes the progress which has been made in reforming some National Care Service proposals, including that local authorities will continue to play a central role in the delivery of, and accountability for care.
“There is a pressing need to improve people’s experiences of accessing and delivering care in Scotland. Although legislative and governance reform may be part of that, the reality is that national funding decisions – including the proposed council tax freeze which has not been fully funded – will further squeeze local care and social work services which are already under incredible pressure.
“Investment in social care must be seen as a priority which can enhance the wellbeing of people, of society and of Scotland.”
Having passed Stage One, the National Care Service (Scotland) Bill moves into Stage 2 where amendments will be considered by the Health, Social Care and Sport Committee before Stage 3, when the full Parliament makes a final vote on whether to pass the Bill.
The Scottish Government needs to develop a clear national strategy for health and social care to address the pressures on services.
Significant changes are needed to ensure the financial sustainability of Scotland’s health service. Growing demand, operational challenges and increasing costs have added to the financial pressures the NHS was already facing. Its longer-term affordability is at risk without reform.
Activity in hospitals and other secondary care settings has increased in the last year, but it remains below pre-pandemic levels and is being outpaced by demand. This pressure is creating operational challenges throughout the whole system and impacting staff, patient experience and patient safety.
There are a range of strategies, plans and policies in place for the future delivery of healthcare, but no overall vision. The absence of a shared national vision, and a clear strategy to deliver it, makes it more difficult for NHS boards to plan for change.
Stephen Boyle, Auditor General for Scotland, said: “Without change, there is a risk Scotland’s NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services.
“To deliver effective reform the Scottish Government needs to lead on the development of a clear national strategy for health and social care.
“It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS. And it should put patients at the centre of future services.”
Responding to the Auditor General’s report on the state of Health and Social Care in Scotland Dr JP Loughrey, Royal College of Emergency Medicine Vice President for Scotland, said: “We welcome this report which addresses many of our recent and ongoing concerns – particularly around a lack of long-term planning and poor Emergency Department performance.
“The Scottish government must do more to address capacity and demand pressures. Hospitals are dangerously overcrowded and do not have the space, staff, or resources to provide safe and timely care for the number of patients who need it.
“There needs to be long term strategies to maintain an adequate baseline in capacity and staffing, and deal with predictable surges in pressure.
“As we have seen time and time again across Scotland, there are simply not enough beds to meet demand and our hospitals are routinely almost fit to burst, with patients enduring long, undignified waits and demoralised staff forced to deliver treatment in inappropriate areas, such as corridors and car parks.
“We urge the government to move away from short-term firefighting towards long term fundamental change to #ResuscitateEmergencyCare in Scotland.”
Victoria Atkins aims to make health and social care system faster, simpler and fairer for patients
Health and Social Care Secretary sets out intention to make the system faster, simpler and fairer for patients
Victoria Atkins thanks staff for a week of delivery, in which two manifesto commitments were met
Health and Social Care Secretary Victoria Atkins has thanked health, social care and research staff for delivering on patients’ priorities, as she set out her commitment to make the health and social care system faster, simpler and fairer for patients.
Her words came days after pharmacies across the country began offering new contraceptive services and additional blood pressure checks, and after a breakthrough in talks to end consultant strikes, which saw the British Medical Association Consultants committee agree to put an offer on contract reform to its members.
Health and Social Care Secretary, Victoria Atkins, said: “Since joining the department, I have been bowled over by the way health and social care staff just keep on delivering for patients. The important milestones we’ve reached this week – reaching 50,000 additional nurses and 50 million more GP appointments – demonstrate real progress.
“I have spent the past few weeks meeting doctors, nurses, GPs, pharmacists and other health workers and heard wonderful stories about how they have gone above and beyond to deliver outstanding care for patients and cut waiting lists.
“But I have also heard about their frustrations and where they feel they are not able to deliver the best possible care or where prevention or early intervention could have made a real difference. That is why I am committed to making health and social care services faster, simpler and fairer.
“We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do. But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”
The Health and Social Care Secretary has committed to making health and social care services:
Faster for patients, by making it easier to get treatment locally, improving A&E performance and cutting waiting lists
Simpler for patients, with joined up, integrated care, and simpler for staff, by reducing bureaucracy and giving them the latest technology to free up their time to care for patients
Fairer, ensuring children are protected from health harms, that health outcomes are not determined by where you live, that government supports older people to maintain their independence for longer, and that government delivers a more productive NHS that is fairer for taxpayers.
She added that she would continue to work with the NHS to manage the ongoing winter pressures. The government prepared for winter earlier than ever before and data released by the NHS on Thursday shows the government is making good progress.
Compared to the same time last year, ambulance handover delays have fallen by 28%, thousands more 111 calls are being answered within 60 seconds, and there were nearly 1,500 more hospital beds available.
The Secretary of State said: “We face a difficult winter ahead. And though our early winter planning is seeing some results we know there is much more to do.
“But having seen what our excellent staff can do I am confident that with the government’s support we can continue to deliver for patients over the coming months.”
The Health and Social Care Secretary was appointed on 13 November. She has now set out her priorities in a week in which the government and NHS hit a number of major delivery milestones:
NHS England data published on Thursday showed there were 51,245 additional nurses in September 2023 compared to 2019 – hitting the government’s manifesto commitment to recruit an additional 50,000 nurses six months early.
NHS England data also showed that for the year to October 2023, there were 51 million additional general practice appointments delivered when compared to October 2019, meeting another manifesto commitment.
On Monday the government announced that it had put forward an offer that will modernise the consultant contract and reform consultants’ pay structure, paving the way to end consultant strikes. The British Medical Association and Hospital Consultants and Specialists Association will put the deal to their memberships in the coming weeks.
On Wednesday the Secretary of State announced funding for a research project to evaluate the rollout of the hugely successful HIV opt-out testing programme to 46 new sites across England.
On Friday 1 December pharmacies across England began offering the new contraceptive services announced recently as part of Pharmacy First. This is part of the NHS and government’s Primary Care Recovery Plan, announced by the head of the NHS and the Prime Minister in May, which committed to making it quicker and easier for millions of people to access healthcare on their high street.
Care matters to us all. We all want good quality cradle to grave care for ourselves and our loved ones (writes TUC’s ABIGAIL HUNT). This is only possible if the workers delivering care services have good pay and conditions.
The global care workforce is huge, totalling at least 381 million workers, two-thirds of whom are women. Worldwide this is 11.5 per cent of total employment and 19.3 per cent of female employment.
In the UK, adult social care jobs alone contribute at least £55.7 billion to the economy and constitute around 6 per cent of total UK employment.
Yet care work is persistently insecure and exploitative. Low and insecure pay, bad employment conditions, violence and harassment, and a limited training and career development are part and parcel of everyday life for care workers.
Recent TUC analysis shows that care workers across the UK are earning below the real living wage and are significantly underpaid relative to pay across the rest of the economy. The median salary of social care workers and childcare practitioners is less than two-thirds of that of all employees nationally.
On 29th October, trade unions, governments, the UN and other social partners will mark the International Day for Care.
This day, initiated by trade unions and recognised in July through a UN General Assembly Resolution, gives visibility to the care economy – and care workers – worldwide and provides an opportunity to build momentum for increased public investment and decent work in the care sector.
Here are three ways that global solidarity and action matter for decent work in the care economy:
The care workforce is global
In recent years ‘global care chains’ have emerged as rising demand for care services has seen migrant workers, largely female, fill care jobs – including childcare, social care and domestic workers as well as nurses, doctors and educators – in turn leaving their own children and relatives in the care of paid workers and family in their home country.
The UK is a key link in the chain, with labour migration increasingly recognised as critical to deliver care services. In 2022 the UK Government expanded the care worker visa scheme to help tackle the ongoing recruitment and retention crisis in social care. This meant that in 2022/23 70,000 international care workers were recruited, up 50,000 from the previous year.
But the TUC has identified that as international recruitment has increased, so has the exploitation and abuse of migrant workers.
This includes wage theft, high recruitment fees with non-permitted repayment clauses and debt bondage as well as abuse of the immigration system by employers to blackmail workers and prevent them seeking other employment.
Therefore the fight for decent care jobs must include the experiences, priorities and needs of international care workers.
The global union movement provides solidarity and support
Global union solidarity and joint action is critical to build care worker movements and support workers.
Sharing insights into working conditions helps unions provide vital workforce support. Trade unions in destination countries have provided information on immigration, employment rights and common labour abuses with migrant care workers via unions in countries of origin. This toolkit produced by unions in Italy is a great example.
Global labour law and policy raise the bar on domestic standards for decent care work
Global and regional labour standards and policy have tackled historic discrimination and exploitation against care workers by setting transnational employment rights floors – and binding governments to act.
Many unions have now turned their attention to getting their government to ratify C.189, including in the UK. From Belgium to Mexico, where it is in force, C.189 has helped extend rights such as paid leave, minimum wages and employment contracts to domestic workers.
In 2015 governments worldwide agreed the UN Sustainable Development Goals, including gender equality (Goal 5) and decent work (Goal 8). This has increased resources and political will, putting care on the policy agenda for the first time ever in many countries.
Important regional initiatives have also emerged. Earlier this year European social partners agreed a social dialogue committee for social services, including adult social care and childcare, covering around 9 million workers across the EU.
Next year will bring important opportunities to reinforce the global framework for care workers’ rights.
In May 2024 governments, trade unions and employers will discuss decent work in the care economy at the International Labour Conference, where unions will seek commitment to a new ILO standard for care jobs.
And we hope to see the UN General Assembly build on this year’s Resolution with a more substantive agreement committing governments to building and financing comprehensive care systems – with decent work and collective bargaining at their heart.
Follow the International Day for Care: #InvestInCare #Care2023
Read more about TUC’s priorities for the care workforce at these links:
£50 million to build Scottish Ambulance Service capacity
A £50 million funding boost for Scottish Ambulance Service (SAS) recruitment and up to £12 million to expand Hospital at Home are among measures to support the health and care system this winter.
The Scottish Government and COSLA’s joint Winter Plan, published today, identifies new funding for SAS to support work already underway to recruit a further 317 frontline staff to help increase capacity to emergency response. It will also see 18 additional clinicians working in the call centre hub who, through additional triage, can offer patients alternative treatment routes in cases which are not time-critical, reducing the number of hospital admissions.
The expansion of Hospital at Home, which enables people to be treated at home rather than on a ward, is intended to deliver at least 380 additional beds this winter – significantly increasing the total service capacity.
The Scottish Government has been working closely with COSLA, Health and Social Care Partnerships, and NHS Boards on a number of further measures to ensure they are prepared for the winter period. This includes a Delayed Discharge Action Plan and improvements to the reporting of data to better identify specific areas for further support or escalation.
Health Secretary Michael Matheson said: “Our highly skilled and committed workforce are the cornerstone of our response every winter, both in health and social care. I am extremely grateful for their continued hard work and dedication in the face of sustained pressure. As we approach the Winter period their efforts will be vital in ensuring we deliver high quality care for the public.
“We are in no doubt that this winter will be extremely challenging for our health and social care system. Our Winter plan builds on the lessons we have learned from previous years and preparations have been on-going since spring. Our whole system approach is based on ensuring people can access the care that is right for them – at the right time and in the right place.
“Our additional investment of up to £12 million to expand the Hospital at Home service will allow people, especially elderly patients, patients with respiratory conditions and children, to receive treatments in the comfort of their own home and will crucially help reduce pressure on our A&E departments this winter.
“As a result our significant investment of over £15 million, an additional 1,000 nurses, midwives and Allied Health Professional from overseas have joined NHS Scotland in the last two years to bolster our existing workforce this winter.
“Our £50 million funding boost for the Scottish Ambulance Service will also help tackle increased demand and support on-going recruitment to drive up capacity for emergency response. This investment will also help reduce the need for people to go to hospital which is a key part of our approach this winter.”
Cllr Paul Kelly, COSLA’s Health and Social Care Spokesperson said: “As key partners in ensuring people and communities are safe and cared for over the winter period, and indeed throughout the year, local authorities have a vital role in enabling people to continue to safely access the care and support they need when they need it.
“We expect the winter to be a very challenging period across the whole health and social care system at a time when the system is already experiencing significant demand pressures and challenges with recruitment and retention.
“That is why COSLA have worked closely with Scottish Government in producing this plan, recognising the importance of the integration of health and social care, and the clear leadership role of Local Government in doing everything we can to maximise capacity across health, social care, and social work, and ensure people get safe and timely access to services during peak winter pressures.”
The Scottish Ambulance Service has welcomed the announcement of £50 million funding by Michael Matheson, Cabinet Secretary for NHS Recovery, Health and Social Care.
Michael Dickson OBE, Chief Executive of the Scottish Ambulance Service said: “This funding will allow us to invest in frontline staff, ambulances, vehicles and our 999 call centre operations. We know that winter will be challenging but the Service, and our committed staff, are working hard to meet those challenges.
“We have a whole range of initiatives which will come into place over winter to help us meet the increased demands on our services, including work to ensure we provide the quickest possible response to our most critically ill patients and we continue to support, where appropriate, less seriously ill patients to be managed at home or in the community, avoiding unnecessary A&E visits.
“Our patients and our staff are our most important priorities, and this investment will ensure we can continue to deliver the very best to our patients whilst supporting our staff who play such a critical role in their care.”
Your Voice Matters in Shaping Health and Social Care!
Ever wanted to put your question to the Cabinet Secretary for NHS Recovery, Health, and Social Care? Here’s your chance!
Michael Matheson MSP will appear before the Health, Social Care and Sport Committee on 12th September, and the Committee want to hear from you.
Whether you’re part of the public or work in health and care, submit your relevant questions on topics such as the NHS recovery from the pandemic and be part of scrutinising the work of government.
Clare Haughey MSP, Convener of the Committee, says, “This is a great opportunity… your suggested questions may help to inform our scrutiny of the Scottish Government’s approach.”
Strachan House in Edinburgh will be opening their doors to the local community for an open door event complete with free refreshments on Saturday 19th August.
Taking place between 10am-4pm guests will be able to enjoy a freshly prepared buffet by the home’s Head Chef whilst taking the opportunity to meet the General Manager Gordon Philp and his fantastic team. Why not allow them to take you on a tour of the home and see everything the home has to offer? In the afternoon visitors will have the opportunity to enjoy a relaxed afternoon tea and ask any questions they may have.
The Strachan House team will be on hand to answer any queries that they may have. A warm welcome awaits every visitor and a free goodie bag upon leaving will ensure that everyone will have a little something to remember their day with us by.
Gordon Philp, General Manager at Strachan House says: “I’m excited about welcoming new visitors and existing friends of the home to our open day.
“Looking for care can be a little bit daunting, but our team here at Strachan House will do all we can to provide all of our guests with the guidance and support they may need, and answer all of their questions, big or small.
“Our open day is a great chance to enjoy everything the home has to offer in a homely and friendly setting- hope to see you all there!”
Our varied life enrichment programme keeps residents active, and provides a daily choice of engaging physical, mental and spiritual activities tailored to residents’ interests and abilities.
Strachan House care home is run by Barchester Healthcare, one of the UK’s largest care providers, which is committed to delivering personalised care across its care homes and hospitals. Strachan House provides residential care, nursing care and dementia care for 83 residents from respite care to long term stays.
We are delighted to welcome our new permanent CEO, Sarah Van Putten, to the LifeCare family.
Sarah joins us as an experienced third sector Chief Executive, with a career in health and social care spanning 3 decades. For the last 6 years, Sarah has been supporting Befriending Networks across the UK, and tackling loneliness and isolation by influencing public policy.
On her appointment, Sarah said: “I am delighted to have joined the LifeCare team as permanent CEO.
“I bring a long track record of working within and managing social care organisations. I knew of LifeCare as my great Aunt was a client and I have always been impressed by the work they do.
“Since taking up post, the commitment and passion of the team has already become evident – with staff continuously going above and beyond for the people they support. I look forward to working closely with staff, our board of trustees and most importantly the clients to identify our priorities for the next 3 years.
“I hope to bring my wider experience of social isolation policy work to help Lifecare amplify the voices of those who use our services, so that we can continue to offer those “extra years of Zest” to the people in our communities that need it most.”
Since moving to Edinburgh to study nursing 10 years ago, Courtney Bennett has long understood the need for attentive, respectful in-home care to meet the growing demand for exceptional services in her community.
After a decade in the care industry, Courtney has recently launched Visiting Angels – a care provider that cares for people in the comfort of their own homes – with the intention of not only providing high-quality in-home care for Edinburgh residents, but also to reward carers for the amazing work they do for others day in, day out.
Before launching Visiting Angels, Courtney graduated from Edinburgh Napier University with a nursing degree, and she felt so at home in the city that she decided to stay and start a life here.
In her years after university, Courtney worked across the care sector in various roles, predominantly with the elderly in nursing homes and in adult social care from the nursing perspective.
After battling through her own health issues, Courtney had to take a step back from clinical nursing, but never lost the passion she had for caring for others. It was this which prompted Courtney to launch Visiting Angels; she was able to provide that high level of care to those who need it most while being able to look after her own health.
“Since finding nursing, I have loved caring for others, particularly for the elderly,” says Courtney, of her motivation for launching the company. “I love the elderly; I feel so comfortable in their company – more than most my own age actually!
“I loved my job as a nurse, but it’s no secret that it comes with its own challenges. Being a caregiver is such a difficult job, one which is not nearly championed enough. Carers deserve to be treated, valued and rewarded properly for the amazing work that they do.
“I found when I was working in care homes that no matter how fantastic the home, the team and the facilities were, there was always something which felt institutionalising and isolating about them.
“I’m a firm believer that people rest better in their own home, and that when carers are given more time for visits and properly compensated for their work, that in-home care becomes something incredibly special.
“When I decided to launch Visiting Angels here in Edinburgh, it was so important for me to think about not just our clients, but our carers as well, which is why we have policies covering minimum one-hour visits, paid-for travel time between visits for staff, and proper rewards for our caregivers’ incredible work.”
Visiting Angels’ ‘carer-centric’ approach sets it apart from other companies in the in-home care sector. Carers working for Visiting Angels feel valued and respected for their commitment to the industry.
Through both financial rewards and opportunities for career development, Courtney and the Visiting Angels team are determined to address issues surrounding the industry, which often leaves carers feeling little –to no appreciation.
Courtney is aiming to have around 20 carers on board by the end of the year. With staff turnover in the care sector at a record high, Courtney is determined to encourage caregivers to stay in the industry, by providing them with a supportive, respectful, rewarding work environment.
More than anything, Courtney wants to change the face of social care for the better, and to make it accessible to every person who needs it.
“It’s so important to get our voices heard and to make a real difference in the community. So much of our local area is underserved and often overlooked when it comes to care, so I’m really excited to be able to bring this level of high-quality, consistent care to the people of East Edinburgh.”
Your Voice Matters in Shaping Health and Social Care!
Consultation is open to all – click the link to submit your question today: 
