Action to make staffing safer

Recent months have brought workforce recruitment issues across health and social care into sharp focus.

The Royal College of Nursing (RCN) has launched an “Ask for More” campaign, highlighting that nursing and midwifery vacancies are the highest ever reported and that one in twenty posts are currently vacant. Meanwhile, more than a third of social care services across Scotland have reported unfilled staff vacancies in the past year (this link will take you away from our website) and the impending threat of Brexit to the workforce has resulted in a Private Members Bill calling for a health and care impact assessment.

Back in 2013, the Francis Report (this link will take you away from our website), which reflected on the crisis at Mid Staffordshire NHS Foundation Trust, called for minimum safe staffing levels to be introduced in the NHS. But its author has subsequently criticised healthcare bosses in England – suggesting that they could reduce planned staffing levels without evidence that staffing levels are safe.

The Scottish Government’s Health and Care (Staffing) (Scotland) Bill (this link will take you away from our website) seeks to avoid similar criticism, aiming to ensure safe and appropriate staffing levels using methods that are clear and evidence-based. Should the Bill pass it will create the opportunity for existing tools, currently inconsistently applied across Scotland, to be mandatory in health and social care settings. Reporting to the Scottish Parliament’s Health and Sport Committee, the Cabinet Secretary for Health and Sport, Jeane Freeman MSP suggested that a consistent approach will allow not only for the right mix of staff in a variety of settings but also for greater transparency, moving staff away from reliance on “subjective assessments” (this link will take you away from our website).

External response to the Bill has been mixed, with the RCN’s Scotland Director Theresa Fyffe noting that “the time is right” but others including the Coalition of Care and Support Providers in Scotland (CCPS) questioned whether it was necessary or proportionate in social care settings “given that the policy objectives are already being met under existing legislation.”

In considering our response, the ALLIANCE directly spoke to individual members in order to find out their views, having often been at the sharp end of decisions about staffing levels in health and social care. They acknowledged that the local context in which health and care services are provided are critical to success, pointing to particular issues they had experienced as a result of recruiting problems in remote and rural areas.

Accountability was also noted as a key failing of the Bill as it stands, calling for more clarity was required in the Bill on what the consequences are for health and social care bodies if they do not meet their obligations under the Act. The Health and Sport Committee agree – calling on the Scottish Government to clarify who will be responsible for ensuring the provision of safe staffing is met across different settings.

Their views have now been quoted in the Health and Sport Committee’s Stage One report (this link will take you away from our website), welcoming the approach taken to date but calling for a greater emphasis to be placed on outcomes for staff and people who use support and services. One way of achieving this is to ensure that coproduction, rather than consultation, is at the heart of the approach taken to developing the new workforce development tools.

MSPs are due to debate the Bill in more detail in the main chamber of the Scottish Parliament on Thursday 6 December 2018.

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