Safe and effective staffing in health and social care: analysis of responses

Background

The 'Safe Staffing' Bill will deliver on the Scottish Government's commitment to enshrine in law the principles of safe staffing in the NHS, starting with the nursing and midwifery workforce planning tools. A Nation With Ambition: The Government's Programme for Scotland 2017-18 ^[1] indicated that the Bill would ensure that nationally agreed, evidence-based workload and workforce planning tools are applied in nursing and midwifery settings, and ensure that key principles relating to professional judgement, local context and quality measures underpin workload and workforce planning.

The Scottish Government ran an initial consultation on 'Safe and Effective Staffing in Health and Social Care' on 11 April 2017 ^[2] along with a number of consultation events held across Scotland. An independent analysis of this initial consultation was published on 11 December 2017 ^[3] along with the responses themselves ^[4] (where permission had been granted). In brief, over 80% of the respondents agreed that:

• A statutory requirement to apply evidence based workload and workforce planning methodology and tools will help support consistent application;
• The requirements should apply to organisations providing health and/or social care services;
• Consideration should be given to extending the requirements to apply a similar approach to other settings and/or staff groups in the future.

Responses to the initial consultation highlighted that a focus on achieving better outcomes for service users should be at the heart of the legislation; that workload and workforce planning tools are only one of the components required to achieve high quality care and improved outcomes; and suggested setting out further guiding principles on safe and effective staffing in the Bill.

There was a divergence in responses over whether legislation should span social care, given existing statutory frameworks for these settings. In particular, some Health and Social Care Partnerships (3 of the 5 who responded to the consultation) and some public bodies did not support the inclusion of social care.

Respondents emphasised the importance of ensuring that legislation reflects the context of health and social care integration, while also highlighting the specific context, requirements and current assurance framework in social care.

Respondents also identified the risk of resources being drawn from one service to another if a whole-systems approach is not taken; while the need to extend beyond nursing and midwifery to the wider multi-disciplinary or multi-agency team was a frequently raised theme. These views and comments informed the continued development of the policy underpinning the Bill, and the refreshed legislative proposals were set out in a discussion document published on 22 January 2018 ^[5] .

This further consultation exercise was held over a four week period, closing on 20 February 2018, along with 3 consultation events held in Edinburgh, Glasgow and Aberdeen. We recognised that some stakeholders may not have been aware of the proposal to include social care in the Bill and therefore did not engage with the initial consultation on the legislation. This second consultation was designed to encourage the involvement of stakeholders from across health and social care in the development of this legislation to ensure it delivers the intended aims.

Responses to the second consultation were published (where permission had been granted) on the Scottish Government Consultation Hub ^[6] website on 23 March 2018.