IT is hard to disagree with the Audit Scotland Report. The issues and challenges which they describe were all predicted many years ago. Indeed the challenges facing NHS Scotland have been well documented in previous reports, with solutions and mechanisms to profile workforce risk proposed.

Therefore the real question has to be; why the inertia and reluctance to build sustainable solutions, and a modern workforce profile which meets the predicted challenges? The answer is entrenched in traditional ways of planning, professional protectionism, lack of bravery and a fear of hearing the truth.

Young people today have a plethora of career choices available to them, so why choose healthcare? Healthcare can be very rewarding but it is also demanding, at times distressing, anti-social, and emotionally and physically demanding.

People are also likely to have 50 years careers now so how do we keep them interesting, rewarding and prevent burn-out? The challenges are multiple, but the solution of more staff is old hat, unachievable and frankly unattainable both in terms of finance and supply.

There is always talk of the circa 30 per cent who are over 50 years, but what of the remaining 70 per cent who are not going to retire in the next 10 or so years? How are their careers being developed and shaped to meet the skills and knowledge to deliver modern and advancing healthcare.

Will Labour's new workforce commission look to capitalise on, and open up, new labour markets? Care is more technical and scientific. Are there roles for science graduates, technicians, IT specialists?

Workforce planning continues to be planned in professional silos that further narrow the thinking. Workforce planning must be based on skill profiling at all levels in each department, and then building a correctly skilled team matched to demand, environment and population group.

The information and intelligence needed to predict health and social care demand is available, the current problems were known. Available labour markets are being by passed, the classic is those exiting our Colleges with HNC and HND qualifications. Advances in care are continuing a pace, but our workforce deployment patterns are changed little from the 1980’s.

Demand is not just changing with and ageing population, more neonates and children are now surviving previously life limiting conditions, there are higher levels early diagnosis and more people are surviving illness as a result of medical advances. Change will continue and demand will increase with every modern advance, its time to take the blinkers of and meet these demands head on with a workforce skilled to deliver them.

Professor Alan Boyter is a former HR director at NHS Lothian and now director of Dignity HR Solutions