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INSIDE TRACK: Plot thickens on script to care for elderly patients

I sat down with the Scottish Government's newest NHS workforce plan as though it were the next instalment of a gripping best seller.

I made a cup of tea, I left my smart phone in the kitchen and I went to read it on the sofa. For ages I have wanted to know how the Scottish Government is preparing the NHS workforce to cope with the growing elderly population. Here was the 2020 Workforce Vision Implementation Framework and Plan 2014-15. At last I was going to find out what was planned.

Well, dear reader, I think I can reveal the contents without spoiling the plot. It's the equivalent of a murder mystery that reads: detective works really well with his colleagues and line managers writing a plan to solve the murder, agrees to write a better plan next year at his annual appraisal and promises extra training to his sniffer dog.

It's all very well meaning, but there's little detail about anyone doing anything let alone the satisfaction of "whodunnit". By page eight (more than one-third of the way through), we have reached a table that informs us NHS boards are responsible for "implementing specific actions locally" and the Scottish Government is responsible for "leading on specific national actions and commissioning solutions." Pleased that we got that one cleared up.

The need to solve the murder (or in this case meet the needs of a growing number of elderly patients) is not entirely ignored. The document says "Real, transformational change will be needed," and "will not be achieved through business as usual, compliance and a tick box culture".

Why, then, do we have a plan that does little more than describe planning structures?

It's hard to disagree with many of the points it makes, because most of them are laudable. Of course staff appraisals should be meaningful; and of course NHS boards should carry on improving communication between community and hospital care.

But the Government often says most NHS staff are excellent and I believe that. We don't have to tell them to work well with others, or to be compassionate, and we certainly don't require a new "policy statement setting out the kind of leadership and management needed to deliver the 2020 vision". Good managers know how to be good managers. However, in order to manage the NHS in 2020 and beyond we do need answers to bigger questions. What will budgets be like? How many nurses and doctors will be graduating? What are the likely attrition rates? Will more be trained in elderly care?

Is placing geriatric consultants in the community a good idea? Should we train some? Do social services need more staff to help reduce hospital admissions or is there spare capacity? How well are schemes to prevent admissions working?

The document does call for more training for support workers and it also says the Government will "develop a Scottish Investment Plan to set the strategic direction for investing in the health care workforce now and in the future." Maybe that or another document will give me the vision I crave?

Or am I just dreaming?

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