With MSPs debating proposed legislation to support safe staffing in Scotland, QNIS spoke to Eileen McKenna, Associate Director at RCN Scotland, to shed light on what this will mean for community nursing.
What is the proposed legislation and how did it get to this stage?
At the 2016 RCN Congress in Glasgow, the First Minister Nicola Sturgeon announced that she would bring forward legislation to guarantee safe staffing, this has resulted in The Health and Care (Staffing) (Scotland) Bill being introduced into the Scottish Parliament in May this year. Ensuring safe levels of nursing and midwifery staffing across all health and social care settings is a key objective of the RCN and QNIS. Colleagues in RCN Wales have successfully worked on a safe staffing bill which came into force in 2018, albeit the scope was different to the Scottish Bill.
What does safe staffing mean?
For us, staffing for safe and effective care means having the right number of staff, with the right skills, in the right place, at the right time. At RCN Scotland, we worked with the Scottish Government prior to the publication of the Bill and they have incorporated a number of our demands such as provisions on including professional judgement and a focus on guiding principles for setting nursing and midwifery establishments (the number of staff required to deliver care in that setting). However, we would like to see the Bill strengthened in a number of areas as it moves through Parliament.
How will this legislation support community nurses to ensure there are sufficient staff to deliver high quality, person-centred care each day?
Most aspects of community nursing are covered by the Bill. The Bill places a general duty on NHS Boards to ensure appropriate staffing in all settings. It also places a specific duty on NHS Boards to follow a common staffing method in most healthcare settings, including community adult and community children’s nursing. We will be pushing to ensure that Healthcare Improvement Scotland develops workforce tools and methodologies in areas where these don’t yet exist, including community mental health nursing. We are also asking that existing tools and methodologies are reviewed to ensure they continue to be contemporary taking account of the growing body of relevant evidence. The Bill also places a duty on those delivering social care to ensure appropriate staffing levels and explicitly points to the development of methodologies for care homes, which the RCN supports.
What work is still to be done?
It is important that the Bill does not just focus on the workforce tools and the RCN has worked with Scottish Government to ensure that the Bill takes account of professional judgement. The Bill also stipulates that boards must take account of the local context and current staffing levels and vacancy rates. We’re very clear that there is much more to determining safe staffing levels than just running workforce tools. Setting the establishment might be a process that only takes place on an annual basis, but there must be mechanisms to assess, mitigate and escalate concerns in real time. We are actively working to influence amendments to the Bill at Stage 2 which will set out the responsibilities on NHS Boards to resolve staffing issues.
What happens next?
For now, we are focussed on ensuring that MSPs support the principles of the Bill. They’ve taken evidence from stakeholders and a report was published last week which was debated at Holyrood on 6th December 2018. Please support the RCN’s Ask For More campaign and contact your MSP to tell them what difference this legislation would make to you and to encourage your MSP to ensure the Bill is as robust as possible. Hearing from clinical nurses makes it very real for politicians – they need to hear what challenges you face in your day to day work.