Douglas Fraser
Scotland business & economy editor

The NHS has turned 70, well past the age of having its own bus pass.

While most others can retire at that age, the National Health Service is still working. Indeed, it's having to work flat out, and it's feeling the strain.

Some of that strain comes from more demands being placed on it. Expectations of what it can achieve are completely different to 1948.

Image source, Getty Images

And it has to put up with patients, many of whom do a poor job at looking after themselves. A lot of the strain comes from budgets that keep rising but struggle to keep up with numbers of patients and expectations of what can be done.

But even with lots more money, there's a shortage of people to do the jobs necessary. So-called workforce planning is one of its biggest headaches. I've been looking at many different facets to that workforce planning challenge.

Read Douglas Fraser's analysis.

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Kim Hartley Kean, representing the Allied Health Professions Federation Scotland, says the focus of the bill is on nursing staff rather than the staff mix that is required.

Patricia Cassidy points out the Integration Joint Boards are working very closely with colleagues in the council and the health service to jointly create a workforce plan.

Ms White asks whose responsibility it is to ensure there is an adequate workforce.

Ms Cassidy replies IJBs and health boards would share that responsibility.

Dr Gosling insists there is not a workforce plan for allied health professionals and argues a multidisciplinary approach looking at the correct skill mix is required.

SNP MSP Sandra White asks about a possible effect on the integration of health and social care if the bill is not altered.

It could drive resources to focus on being compliant with the bill's requirements which could divert it from frontline care, warns Patricia Cassidy.

Kim Hartley Kean from AHPFS echoes concerns about resources, highlighting vacancy levels already impacting AHP pathways.

Dr Sally Gosling from the Chartered Society of physiotherapy says there is a risk of appearing tio provide a solution without actually doing so.

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Patricia Cassidy, representing the Chief Officers Group for Health and Social Care Scotland, insists she is cautious about a legislative approach for a number of reasons.

Ms Cassidy points out it could create another layer of bureaucracy and there are concerns about impeding the ability to respond to local needs.

There are also worries around the stifling of innovation through the legislation she adds.

Any tool developed must be flexible and dynamic enough to allow local need to be addressed, Ms Cassidy says.

She concludes arguing the bill does not have clear enough guidance on NHS staffing and adds the "one size fits all approach to workforce planning simply won't work".

Dr Sally Gosling of the Chartered Society of Physiotherapy agrees with many of the previous points.

A multi-disciplinary team approach must be taken on staffing levels, she argues.

The bill assumes that looking at staffing levels in isolation will improve patient safety, but this risks not looking at outcomes for patients, Dr Gosling says.

"The legislation risks being a distraction and risks creating a bureaucracy."

She warns the bill may lock on rigidity, a lack of flexibility and unresponsiveness.

Committee convener Lewis Macdonald kicks off with a question about concerns and considerations about the Health and Care (Staffing) (Scotland) Bill, external.

Kim Hartley Kean from the Allied Health Professions Federation Scotland (AHPFS) suggests the bill does not achieve its objective and her organisation does not support the bill as it stands.

She states only the right staffing team can lead to the right outcomes, but the bill is not outcomes-focused or future-focused.

Ms Hartley Kean warns the bill plays to an old silo model of care.

The bill is also not needs based, focusing solely on doctors and nurses rather than the wider range of AHPs, she argues.

Concerns are raised about limited funding for AHPs in comparison to other medical professions.

"There's a sense the we have been forgotten," Ms Hartley Kean states.

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The Health and Care (Staffing) (Scotland) Bill seeks to place an existing workforce planning tool onto a statutory footing.

It will also see staff planning methods be used on social care settings, such as care homes.

Health boards are responsible for assessing the needs of their own populations using a set of 12 tools, which have existed since 2004. These are focused on nursing and midwifery.

Should the legislation pass, the tools will become mandatory for health boards and social care providers to use - though it is not yet clear what would happen if they did not meet their duties.

Read more about the bill in the SPICe briefing. , external

In the first part of the committee, we will hear from:

• Dr Sally Gosling from the Chartered Society of Physiotherapy, external
• Kim Hartley Kean, representing the Allied Health Professions Federation Scotland, external
• Patricia Cassidy, representing the Chief Officers Group for Health and Social Care Scotland, external

The committee elects SNP MSP Emma Harper as deputy convener.

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The Health and Sport Committee, external is this morning taking evidence on the Health and Care (Staffing) (Scotland) Bill.

It is planning on hosting three sessions with stakeholders before hearing from the cabinet secretary in early October.

The committee papers are available here. , external

You can also read written submissions on the bill here. , external

Image source, Getty Images

Welcome to Holyrood Live on Tuesday 11 September 2018.

We begin the week looking at NHS staffing levels with a host of doctors, nurses and health professionals giving evidence on the Health and Care (Staffing) (Scotland) Bill.

Image source, Getty/PA

After topical questions, there will be a ministerial statement on Brexit from Mike Russell, this time entitled ‘Preparations for EU Exit’.

The rest of the afternoon in the chamber will be devoted to the Social Enterprise World Forum which has gotten underway in Edinburgh today.

Image source, Forestry Commission/SPL

Finally, Labour MSP Claire Baker will use her member’s debate to celebrate the 20th anniversary of the Ecology Centre at Kinghorn.