By Susan Aitkenhead
IT was well recognised that the health and social care workforce was struggling with workforce shortages long before the Covid-19 pandemic. The latest figures show that more than five per cent of NHS Scotland nursing and midwifery posts are vacant and 40% of care home services for older people report nursing vacancies.
Royal College of Nursing Scotland members have repeatedly highlighted the negative impact that poor staffing levels are having on their work, the challenges to allow them to safely care for their patients and the effect on their own health and wellbeing. Previous RCN employment surveys have demonstrated nurses feeling too busy to provide the level of patient care they would like to and last June, in one of our biggest-ever member surveys, 34% of respondents said staffing levels had worsened during the pandemic.
As very publicly witnessed over the last year, nursing is a safety-critical profession, and the pandemic has offered a greater understanding of the realities and complexities of modern nursing and an increased appreciation of the safety critical nature of the work nurses do.
RCN Scotland members across the country remain clear that action is required now to tackle unsafe staffing levels which compromise patient care and safety. Sustainable solutions are needed to ensure that all health and care services have the right staff, with the right skills, in the right place.
Addressing staffing shortages is vital for the retention of experienced nursing staff. In Scotland 38% of members have reported that they are thinking of leaving nursing; when members were asked what would make them feel more valued, three in four said "improved pay" while half identified better staffing levels.
The Health and Care (Staffing) (Scotland) Act is the first legislation within the UK to set out requirements for safe staffing across both health and care services. The Act also requires NHS boards to seek clinical advice when making staffing decisions and to establish a clear process for concerns about unsafe staffing levels to be reported and escalated. Implementation should ensure nursing staff can raise concerns without fear of repercussion and have these concerns heard and responded to. The act also provides the tools to facilitate safe staffing levels in adult social care.
While it is almost two years since the act was passed by the Scottish Parliament, work towards implementation was paused due to the pandemic. However, the reasons for passing this act have been made even clearer by the Covid-19 crisis.
Safe and effective staffing is a fundamental element of remobilising the NHS safely, helping to ensure that Scotland’s care homes can safely deliver care to residents with increasingly complex health needs; and ensuring that those we care for receive a quality service.
That is why, as part of our Protect the Future of Nursing election campaign, RCN Scotland is calling on Scotland’s political parties to commit to implementing the Health and Care (Staffing) (Scotland) Act by the end of 2021.
Susan Aitkenhead is Director, RCN Scotland
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