Safe and effective staffing in health and social care: analysis of responses
An analysis of responses received to the discussion document on safe and effective staffing in health and social care.
Consultation Events
In parallel to the written consultation, three public engagement events were held in Edinburgh, Glasgow and Aberdeen to seek feedback from stakeholders. Attendees were asked to work in groups with a mix of health and social care participants and discuss 4 questions regarding the proposals for the Bill.
The number of attendees and groups at each event is presented below:
| Event | No. of attendees | No. of groups |
|---|---|---|
| Aberdeen | 54 | 7 |
| Edinburgh | 68 | 9 |
| Glasgow | 60 | 10 |
A wide range of viewpoints were expressed by the attendees, some supportive and some that raised challenges to the proposals being discussed. Presented below is a summary of each question and the high level themes that were identified by each group. Responses may have covered multiple themes therefore the total responses may be less than the total themes.
Feedback was recorded from the group discussion by the groups themselves. Groups were not asked to reach a consensus, rather to simply capture the themes that were discussed within their group.
Question 1 – Discuss if you think it is important to have a coherent legislative framework across health and social care to underpin workforce planning and appropriate staffing in health and social care.
There were a total of 25 group responses to this question. The most common themes were identified as:
| Theme | No. of responses | Percentage |
|---|---|---|
| Consideration of the impact on resources and funding | 13 | 52% |
| The importance of flexibility and being able to respond to unforeseen demands | 9 | 36% |
| Awareness of recruitment and retention challenges | 9 | 36% |
| The importance of staff training, professional development and engagement | 9 | 36% |
In addition to the above, respondents also highlighted issues surrounding clarity of governance and accountability and where this would lie, the need for a focus on outcomes rather than processes and the importance of taking into account the skill mix of teams.
There were 6 group responses (24%) that did not believe legislation was necessary in this area.
Question 2 – What do you think of the proposal that there should be guiding 'safe staffing' principles to provide NHS Boards and care service providers with a foundation on which to base their staffing considerations? What might these key principles cover?
There were a total of 23 group responses to this question. The responses received were limited to what respondents thought guiding principles would need to cover and the common themes were identified as:
| Theme | No. of responses | Percentage |
|---|---|---|
| Staff support and training | 12 | 52% |
| A focus on positive outcomes and avoiding 'box ticking' | 10 | 43% |
| A flexible approach that can respond to unforeseen demands | 9 | 39% |
| A focus on the service users and outcomes that benefit them | 9 | 39% |
Other themes that emerged from the responses included ensuring a focus on safety and managing risk, recognition of the challenges of staff recruitment and retention, clear definitions of terms such as 'safe' and timeframes.
Question 3 – What are your views on the proposed requirements for Health Boards and what key issues need to be considered?
There were a total of 23 group responses to this question. The most common themes were identified as:
| Theme | No. of responses | Percentage |
|---|---|---|
| Awareness of funding and resource challenges | 13 | 57% |
| The importance of staff engagement and training | 12 | 52% |
| Importance of clear and transparent communication from Health Boards on the decisions made when using the tools | 7 | 30% |
| A focus on positive outcomes over process adherence | 7 | 30% |
Other themes that emerged from the responses included taking account of local context and needs, avoiding the creation of a 'tick box' exercise, ensuring service re-design and improvement is enabled and consistent application of the requirements placed upon Health Boards.
Question 4 – What are your views on the proposed role for the Care Inspectorate in monitoring application of the duty and principles and, where there is an identified need, leading work, with the social care sector, to develop workforce planning tools for application in specified settings? What questions do we need to address?
There were a total of 24 group responses to this question. The most common themes were identified as:
| Theme | No. of responses | Percentage |
|---|---|---|
| Engagement with stakeholders and clear communication on the development of tools and methodologies | 7 | 29% |
| Ensure funding and resources are made available to develop tools and methodologies | 7 | 29% |
| Where does the governance and accountability lie in the development process? | 7 | 29% |
| Awareness of integration and ensuring this is taken into account when developing tools and methodologies | 5 | 21% |
Across all three events, six groups specifically mentioned that the Care Inspectorate is the most appropriate body to undertake the role of monitoring application of the duty and principles within the Social Care sector. One group disagreed stating that although the Care Inspectorate should be involved, work should be done alongside sector partners such as Social Work Scotland, Scottish Social Services Council and COSLA.
Other comments made in relation to the role of the Care Inspectorate included:
- The Care Inspectorate should have a role in validating tools but development should be delegated to an independent academic institution
- The Care Inspectorate should oversee the development of tools rather than actually develop them.
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