The Royal College of Nursing (RCN) Scotland is calling on the government to deliver a nursing retention strategy, as it reports ongoing staff pressures and rising vacancies amidst the workforce crisis.

Just a week after many NHS Scotland health boards marked International Nurses Day, RCN Scotland’s latest nursing workforce report reveals that staff continue to struggle.

Publishing its latest instalment of ‘The Nursing Workforce in Scotland’ report today, the nursing union highlights that demand continues to outstrip supply in NHS Scotland.

For the second year in a row, the report’s headline recommendations focus on the importance of the Ministerial-led Nursing and Midwifery Taskforce, established as part of the government’s efforts to inform and address the workforce crisis through voices of experience.

The report also highlights the need for a fully-funded nursing retention strategy that addresses wellbeing, workplace culture, development opportunities, flexible working and career progression.

The Scottish government should also publicly publish recommendations made by the Taskforce and establish an implementation board to oversee the delivery by the end of this year, according to the report.

Commenting on the report’s publication, Julie Lamberth, RCN Scotland Board Chair, 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.

“At the same time, with the squeeze on budgets, we are hearing reports of nursing roles being axed.

“The Scottish government must get serious about the workforce crisis and the long-term implications for the public’s health. Nursing vacancies are having a damaging impact on our members ability to provide safe and effective care.

“And on their own wellbeing when shift after shift they work extra unpaid hours to cover gaps and go home feeling that they are unable to provide the quality of care they want.”

A full implementation of the government’s agreed NHS Agenda for Change review recommendations to improve pay and work conditions is also called for in the report.

These recommendations include a 30-minute reduction in the working week, reviewing band 5 nursing roles, and implementing protected time for statutory, mandatory and profession-specific learning.

It also calls for an evaluation of Health and Care (Staffing) (Scotland) Act 2019, including an annual parliamentary debate on safe staffing.

The new report is published ahead of a roundtable of RCN members with Scotland’s politicians and senior nurse leaders today focusing on valuing the nursing workforce.

Colin Poolman, RCN Scotland Director, said:

“Nurses and nursing support workers across Scotland are under paid, under-staffed and many are at breaking point. The current service pressures and staff shortages have resulted in unsafe conditions being normalised.

“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 new report reflects that despite the increased number of nursing staff employed by NHS Scotland, the number of vacancies remains ‘stubbornly high’, while staff turnover and absences have increased.

Moreover, the number of registered nurses employed in social care – particularly adult care homes declined further while clinical need continues to rise.

The report also highlights the need to improve the quality of data to inform sustainable workforce planning.

A global comparison shows that the number of nurses per 1,000 population in Scotland (7.9) is below the OCED average of 9.2 and significantly below Ireland (15.2).

For the third year in a row, the number of people applying and accepted to study nursing has fallen in Scotland.

Meanwhile, the workforce crisis has permeated to nursing students too, with student nurses meeting MSPs last year to share their experience of financial hardship and staff shortages.

Responding to the news, Scottish Labour Health Spokesperson Jackie Baillie MSP said:

“[Scotland’s Health Secretary] Neil Gray needs to wake up to the NHS workforce crisis unfolding on his watch and respond to the RCN Scotland’s recommendations, including its call for a comprehensive nursing retention strategy and clear evidence of progress from the Ministerial Nursing and Midwifery Taskforce.”

RCN Scotland’s Director has added the government cannot afford to delay delivering on the recommendations of the Taskforce:

“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.

“In addition, Ministers must now move swiftly to open negotiations for the 2024-25 NHS Scotland pay award.”

Read more: Snapshot of NHS recovery revealed; Urgent workforce reforms needed for Scotland's NHS; Public health leaders call for ‘systemic change'; Cancer workforce “not going in right trajectory”; ‘Bleak picture': health leaders react to NHS review; Unpaid hours highlighting midwife shortage; Watchdog: ‘No overall vision' for NHS

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