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Concerns over training burden under Scotland safe staffing bill

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Questions have been raised over where busy healthcare staff in Scotland will find the time to complete training in how to use new workload planning tools, if proposed legislation is introduced. 

A safe staffing bill is currently progressing through parliament and has undergone a first stage review by the country’s health and sport committee.

“We have heard during numerous inquiries staff just do not have the time to access such training”

Health and sport committee

In a report of its findings published this week (see PDF attached below), the committee said it supported the “general principles” of the bill but had “many concerns” that needed be addressed.

The legislation would make it mandatory for health and social care providers to implement workforce planning tools to ensure they have adequate numbers of suitably qualified staff on shift to run safe and high-quality services.

However, the committee raised concerns about the “assumption” that staff would be able to complete the training within the time allocated for continuous professional development.

Giving evidence for the review, the Royal College of Nursing, which has campaigned for the legislation, told the committee that nursing staff already found it challenging to find space in their schedule to do mandatory training such as moving and handling and infection control.

“The report sets out some of the complexities and challenges around the legislation”

Theresa Fyffe

In the report, the committee said: ”We have heard during numerous inquiries staff just do not have the time to access such training, work priorities always take over.

“As the success of the common staffing method relies on the understanding of the tools by staff we ask the Scottish government to reconsider how time is provided for training,” it said.

The committee said it was also worried that predications drawn up by leaders about the cost of training staff in these new tools had been underestimated.

The “majority” of people consulted as part of the stage one review said they were worried the bill was being introduced into a “workforce context under pressure from general recruitment and retention problems nationally”.

The report said: “We recognise the concerns of witnesses about how the outcomes of the bill can be achieved without a link to wider national workforce planning. If there is insufficient labour available nationally to fill vacancies then clearly resolution should lie initially at the national level.”

It added: “We are unclear what the implications for a health board, or social care service, will be if they are unable to meet the requirements of the bill due to circumstances such as above and would welcome information from the Scottish government on how the bill recognises and addresses such a situation.”

The committee said there also needed to be more clarity on where the accountability for the provision of safe staffing in services sat.

It questioned whether there would need to be appointments of “accountable officers” to ensure the blame did not fall to those running the tools day-to-day such as senior charge nurses.

Theresa Fyffe

Theresa Fyffe

Theresa Fyffe

“Whilst the policy memorandum advises it will lie with organisations we believe unless there is a named accountable officer there is a high likelihood, particularly in health board settings, for those at ward level to be held or feel accountable,” the report said.

In addition, the committee said it was “disappointed” that a review of the current workload tools already being used had not been completed before the legislation was put forward for consideration.

While showing its backing for the principles of the bill, the committee said it required answers to the questions raised through the review.

It added: “We look forward to the Scottish government response on these issues which we hope will provide reassurance not just for us but also for staff, stakeholders and service users.”

Theresa Fyffe, director of RCN Scotland, said she was “pleased” to see the committee show its support for the bill’s principles.

“Frontline nursing staff know that the time is right for legislation on staffing levels to provide safe, high quality care,” she said. “The report sets out some of the complexities and challenges around the legislation.

“The RCN looks forward to working with stakeholders to address those, whilst keeping the focus on the need for positive change for staff and patients to make sure that the spirit of the legislation is delivered in practice,” she added.

First minister Nicola Sturgeon first announced the Scottish government’s intention to enshrine safe staffing in law at the RCN congress in 2016.

The Health and Care (Staffing) (Scotland) Bill was introduced into parliament on 23 May 2018 by Shona Robison, then cabinet secretary for health and sport, and was referred to the committee for the first review the following week. 

The bill sets out principles which must be taken into account when considering workforce requirements across services but does not intend to set out minimum staffing levels or fixed ratios.

Wales became the first country in Europe to implement a law on safe staffing in the NHS earlier this year.

As revealed by Nursing Times, health secretary Matt Hancock has since committed to “look into” the possibility of following suit in England. 


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