Scotland nursing taskforce urged to publish workforce actions
The Scottish Government must publish a series of recommendations and actions from its ministerial Nursing and Midwifery Taskforce by the end of this year, a new report has urged.
The Royal College of Nursing this week published its annual Nursing Workforce in Scotland report, which warned that the country’s workforce crisis “shows little sign of improvement”.
“The picture this year’s report paints is simply not sustainable nor is it in the interests of patients and service users”
Julie Lamberth
It highlighted that nursing vacancies in Scotland remain stubbornly high, staff absences have increased and the number of people applying to study nursing has continued to fall.
While some actions have been taken to address some of these pressing issues, “more is needed”, the RCN argued in its third instalment of this report.
It comes as Audit Scotland warned earlier this year that the NHS and its workforce are now unable to meet the growing demand for health services in the country.
The RCN’s latest report has echoed this, laying bare some of the key workforce issues facing Scotland’s health and care services.
For example it noted that, as of 31 December 2023, nearly 4,000 whole-time equivalent (WTE) nursing posts were vacant in the NHS in Scotland.
Meanwhile, for the second year in a row, the number of applicants and acceptances to nursing undergraduate degree courses in Scotland had decreased significantly.
In 2023, 3,520 applicants were accepted onto undergraduate nursing courses at Scottish universities, compared to 3,950 in 2022 – an 11% decline.
This followed an 8% drop the previous year between 2021 and 2022.
The RCN warned that the number of applicants and acceptances were now lower than pre-pandemic levels.
It said this reduction would “impact on the numbers who can potentially qualify as registered nurses in the years ahead”.
The report noted that between October 2021 and September 2023, the total number of nurses leaving the profession had exceeded the number of joiners, despite an increase in nurses joining who are internationally educated.
In the year to September 2023, nearly one in 10 of all new nurses on the NMC register with an address in Scotland were internationally educated.
Concerningly, the RCN noted that some international joiners to the register in Scotland “were from a range of red list countries”, including Nigeria and Ghana.
‘Red list’ countries are identified by the World Health Organization as places from which the UK must not actively recruit, due to the countries having their own domestic workforce challenges.
Taken together, these trends “demonstrate the extent of the challenges in delivering a sustainable nursing workforce” in Scotland, the RCN said.
As such, it called for “urgent action” to address some of these issues, setting out 10 key recommendations for the Scottish Government.
The first and key recommendation is for Scotland’s ministerial Nursing and Midwifery Taskforce to begin the next phase of its work.
The taskforce, which was established last year, is set to deliver a series of actions that tackle key issues in nursing recruitment and retention in Scotland.
The RCN has called on the Scottish Government to publish an agreed set of recommendations and actions from the taskforce, and to have established an implementation board to oversee the delivery, before the end of 2024.
Meanwhile, the RCN has reiterated calls for the Scottish Government to develop and implement a fully-funded nursing retention strategy by April 2025.
This should address wellbeing, workplace culture, development opportunities, flexible working and career progression, it said.
Other recommendations included fair pay and good employment terms and conditions for all nursing staff, including full implementation of the Agenda for Change review recommendations.
“We want to work with the Scottish Government to ensure the taskforce delivers meaningful and sustainable change”
Colin Poolman
Earlier this year, the Scottish Government agreed to fully implement these recommendations, which include a reduction to the working week, protected learning time and a review of band 5 nursing roles.
Meanwhile, the RCN has called for evaluation of the recently implemented Health and Care (Staffing) (Scotland) Act 2019.
The new law, which came into force last month, has set out requirements for safe staffing levels across health and social care settings.
The RCN has called for an annual parliamentary debate on safe staffing to “ensure ongoing scrutiny” of the legislation.
Other recommendations set out by the RCN included expanding the routes into nursing to grow the domestic workforce, protecting the supernumerary status of nursing students and recognising the role of the registered nurse in community services and care homes.
RCN Scotland board chair, Julie Lamberth, said: “The picture this year’s report paints is simply not sustainable nor is it in the interests of patients and service users.
“At no point has NHS Scotland employed the number of nursing staff it says it needs to deliver safe care and the registered nurse to resident ratio in many care homes makes safe care impossible.”
Ms Lamberth added the Scottish Government must therefore “get serious about the workforce crisis and the long-term implications for the public’s health”.
Meanwhile, RCN Scotland director, Colin Poolman, said: “We have said it before and we will continue to say it – the future looks bleak if the Scottish Government does not grasp with both hands the opportunity for improvement the ministerial Nursing and Midwifery Taskforce and Agenda for Change review present to alleviate the workforce crisis.
“The taskforce has been progressing and we cannot afford for this essential work to be delayed.
“We want to work with the Scottish Government to ensure the taskforce delivers meaningful and sustainable change.”
Responding to the report, Scotland’s health secretary, Michael Matheson, said: “I know that more needs to be done to recruit and retain our valuable workforce and that is why I am chair of the Nursing and Midwifery Taskforce, which aims to build on efforts to make Scotland the best place for nurses and midwives to come to work.
“Whilst there is a lot of work already underway to support a sustainable and skilled workforce, the taskforce will help us identify gaps and prioritise work, focusing on tangible outcomes that will futureproof our workforce in light of the ongoing demands that our services face.”
