Opinion: Reimagining post-pandemic health and social care services in Scotland

It is critical to remember that health and social care services were under pressure before the pandemic and will continue to be when the pandemic is over.

Our National Health Service delivered an unprecedented service delivery transformation during the last eighteen months in response to Covid-19. Rapid implementation of change ensured staff and patient safety while also trying to ensure that services continued where appropriate, and promptly remobilised where this was not possible.

These changes were driven by the pandemic, which will pass. However, health inequalities, geographical challenges, an ageing population, increasing obesity, and consequently other associated health problems all put pressure on our health and social care services—and will continue to do so. The pandemic has also prompted us to question the current configuration of health services and how health services interface with the public. There are undoubtedly lessons to be learned that will shape the NHS differently as we move forward, some of which is also influenced by the availability of a skilled workforce.

There has been a shift in policy to encourage every individual in Scotland to consider their role in maintaining their own health, and this has become even more important during the pandemic. This shift away from using healthcare services towards ‘keeping well’ in order to manage our medical problems and ill health will take time to embed and maintain. This means we must continue to reimagine how services can be provided to ensure we continue optimal care for Scotland’s population, while making the most effective use of our finite fiscal resources.

People are adapting to online consultations, through such technological mediums as “Near Me”, instead of attending clinic appointments. They are now realising the benefits of such an approach. This, along with the other changes implemented at speed (due to necessity in response to the pandemic), provides the impetus to continue driving change forward. However, such strategic changes, if they are to be successful in the longer term, need careful thought and planning.

Within health and social care, there is recognition of the need to skill the workforce in strategic reimagining of services. Suitably equipped staff will be able to imagine creative and sustainable solutions for continued delivery of high-quality services for Scotland’s growing and ageing population. However, the role of strategic planning requires a diverse range of skills and knowledge, ranging from understanding of finance to epidemiology, data analytics, workforce challenges, developing technological advances, and the basics of building design as well as creative thinking and skills in organisational change.

The NHS had a tendency to rely on a relatively small pool of external service planning consultants. This comes at a cost. With limited financial resources, this cannot be considered a long-term sustainable solution for NHS Scotland’s Health Boards. Building internal capability to undertake service planning provides Boards with the flexibility of using their own “in-house” intelligence to navigate the rapidly changing health and social care agenda, at a time that suits the Board while coming at a much-reduced cost.

Robert Gordon University has a long history of working with the NHS to co-create demand-led courses, upskilling individuals to the benefit of the sector and its service users. The University’s innovative new master’s course, in Strategic Service Planning and Delivery in Health and Social Care, was developed in close partnership with key staff from NHS Grampian who recognise the need to “grow their own” talented service planning staff.

Despite being only in its second year of running, students in their first year are already reporting a difference in how they are approaching challenges in the workplace. They can see how knowledge and an understanding of areas such as epidemiology, public health and data analytics need to influence the decisions being made.

The growing pressures on our health and social care services are not dormant. They swell under the skin of the pandemic and will outlast its scars. We must strategically upskill enough people with influential and broad knowledge today to affordably plan ahead of Scotland’s healthcare demands that expand with each tomorrow.