1. Paediatric medical workforce Catherine Calderwood Obstetrician and Gynaecologist Medical advisor for Women and Childrens Health

2. Staffing of rotas Difficulties in staffing rotas at all levels Especially middle grade rota In one Board 2/3 of middle grade rota NOT filled In small hospitals even absence of 1 person can make big difference

3. Consultants Middle grade rotas being staffed by consultants Knock on effects on day time work Expensive Not sustainable long term

4. Why? 3 key factors which have come together at the same time Female: male ratio 80:20 in trainees Tier 2 visa restrictions introduced thus limiting numbers of doctors from eg Indian subcontinent who can work in UK National contract for locum pay which pays less to locum doctors working in Scotland than England

5. Female:male ratio LTFT working Maternity leave Attrition rate of 6% per year over 8 year programme

6. Solutions Maintain current level of trainees- not reduce, agreed by Cabinet Secretary Work with NES and Specialty Training Board Recruitment and retention LTFT working which provides sustainable service Link up potential post availability with appropriate specialty training for trainees

7. Tier 2 visas UK Border Agency issue Lobbying by SG workforce and other colleagues for change to this Highlighting exemptions clause Successful in all cases so far if business case is made robustly Rapid turnaround time – 1 week Letter sent to medical directors

8. NSS national contract Value for money for NHS Scotland In reality doctors have left Scotland to earn higher salaries in England Added to already difficult situation with rotas Letter sent by Malcolm Wright, Deirdre Evans to NSS Work with agencies to ensure adequate fill of paed locum posts NHS staff locum bank

9. National event –early 2011 Share good ideas/solutions Increased role of ANP/ANNPs Creative job plans International fellowship recruitment Out of hours service from those not currently undertaking this