Health and Care (Staffing) (Scotland) Act 2019: statutory guidance

10. Staff Training and Engagement

10.1 Which sections of the Act is this chapter about?

This chapter provides further detail on the following sections of the 1978 Act, each of which are inserted by section 4 of the Act:

• section 12IC(2)(d), (e) and (f): raising awareness, encouraging and enabling staff and training associated with the duty to have real-time staffing assessment in place;
• section 12ID(2)(h) and (i): raising awareness and training associated with the duty to have risk escalation in place;
• section 12II: duty to ensure appropriate staffing: training of staff; and
• section 12IL: training and consultation of staff (in relation to the use of the common staffing method).

There are other links to useful information embedded in this chapter; these are denoted in blue text.

It is noted that duties explained in this chapter relate both to training about the Act itself and to training required for individuals to be able to perform their role within the organisation.

10.2 Who does this chapter apply to?

The following organisations must comply with the duties contained in this chapter:

• All geographical Health Boards;
• NHS National Services Scotland (referred to in the Act as the “Agency”); and
• Special Health Boards who deliver direct patient care, i.e., NHS 24, the Scottish Ambulance Service Board, the State Hospitals Board for Scotland and the National Waiting Times Centre Board.

These are referred to as “relevant organisations” in this chapter.

10.3 In what settings and to which staff does this chapter apply?

Section 12IC(2)(f) requires that individuals with lead professional responsibility (whether clinical or non-clinical) for particular types of health care are trained in implementing the arrangements put in place under section 12IC – the procedures for the identification, notification and mitigation of risk and raising awareness among, and enabling and encouraging use by, staff of these procedures. This training requirement applies to all individuals with lead professional responsibility, whether they are clinical or non-clinical. Chapter 7 provides further information on who “an individual with lead professional responsibility (clinical or non-clinical)” is.

Sections 12IC(2)(d) and (e) also require relevant organisations to raise awareness amongst staff of the procedures for identification, notification and mitigation of risk, and encourage and enable staff to use these. This applies to all staff covered by the Act (chapter 2, introduction provides more details on professional disciplines covered by the Act) in all NHS functions.

Section 12ID(2)(i) requires that those with lead professional responsibility (whether clinical or non-clinical) for particular types of health care and other senior decision-makers are trained in how to implement the arrangements put in place by the organisation under the section 12ID duty to have risk escalation process in place. This training requirement applies to all individuals with lead professional responsibility, whether they are clinical or non-clinical, as well as to senior decision-makers. Chapter 7 provides further information on who is “an individual with lead professional responsibility (clinical or non-clinical)” and also a senior decision-maker.

Section 12ID(2)(h) requires the arrangements put in place by relevant organisations under the section 12ID duty to have risk escalation process in place to include raising awareness of these procedures amongst staff. This applies to all staff covered by the Act (chapter 2, introduction provides more details on professional disciplines covered by the Act) in all NHS functions.

Section 12II requires relevant organisations to ensure that, in complying with the duty imposed by section 12IA (the duty to ensure appropriate staffing), employees receive appropriate and relevant training This is to ensure that suitability qualified and competent individuals from such a range of professional disciplines, as necessary, are working in such numbers as are appropriate for the health, wellbeing and safety of patients and the provision of safe and high-quality health care. Section 12II also requires that adequate time and resource is provided to undertake that training.

This applies to employees in all professional disciplines covered by the Act (chapter 2, introduction provides more details on professional disciplines covered by the Act) in all NHS functions. It would also apply to non-clinical disciplines such as those in management who have responsibilities in relation to risk escalation and staffing decisions.

Section 12II only applies to employees of the relevant organisation. Employee is defined in section 12IO of the Act as:

“an individual in paid employment by, as the case may be, a Health Board, the Agency or (where an integration scheme under Part 1 of the Public Bodies (Joint Working) (Scotland) Act 2014 applies) a local authority, whether under a contract of service or apprenticeship or under a contract for services”

Section 12IL requires that staff who are expected to use the common staffing method are trained in its use; this would include any part of the common staffing method, e.g. use of staffing level tools, providing clinical advice, identifying or mitigating risks or making decisions as a result of its use. This requirement only applies to the health care types, locations and employees covered by 12IJ duty to follow the common staffing method. Further information about this requirement can be found in that chapter 11.

Section 12IL also requires relevant organisations to encourage and support employees to give their views on its staffing arrangements, and to take into account and use those views to identify best practice and areas for improvement. This applies to all types of health care, locations and employees covered by the common staffing method – those listed in section 12IK. Again, more information is provided in chapter 11.

Accountability for all the duties covered in this chapter remains with the relevant organisation and not with individuals who may be charged with carrying out certain actions.

10.4 What is this chapter about?

This chapter sets out the requirements to train and engage with staff in health care settings. The requirements should be considered within the context of existing staff governance, education and training strategies, and regulatory frameworks’ rules and standards.

The purpose of requirements of the provisions detailed above is to ensure that relevant organisations provide staff with appropriate information and training to enable the organisation to implement the duties in the Act effectively. It is also to ensure that staff are suitably qualified and are able to maintain competence to provide safe, high-quality, person-centred care in their role.

The Act sets out provision around quarterly reporting by individuals with lead clinical professional responsibility for a particular type of health care to members of the relevant organisation’s board under the section 12IF duty to seek clinical advice on staffing, on the extent to which that individual considers that the relevant organisation is complying with various duties introduced by the Act (see chapter 8 for further information). This would include compliance with the relevant duties relating to staff training and engagement. Relevant organisations will also have to include an assessment on how they have carried out these under section 12IM reporting on staffing (see chapter 12 for further details).

10.5 What information and training is required?

In relation to sections 12IC, 12ID and 12IL:

• Dependent on an individual’s role, and their knowledge and skills, training requirements should be identified through existing Personal Development Plan (PDP) and job planning / appraisal processes;
• Training in these sections will apply to non-clinical staff as well as clinical staff, where their role requires involvement in decisions relating to staffing and / or risk escalation;
• Training required for section 12IL will be dependent on the individual’s involvement in the use of the common staffing method;
• National learning resources are available to support training (Health and care staffing in Scotland : a knowledge and skills framework);
• A range of training methods could be used, which might include but not be restricted to:
  • Being informed of the process and protocols;
  • Written briefings/newsletters;
  • Briefing sessions;
  • Formal training sessions; and
  • Informal training, e.g. work shadowing and observing practice.

The duty to train relevant staff is not time limited. As such, a rolling programme of training, including refresher training, will be required to keep both existing and new staff up to date. Levels of knowledge and skill required by any individual member of staff may move between informed, skilled, enhanced and expert depending on their role at any given point in their career.

In relation to section 12II:

• This will be dependent on individual circumstances but should include training to ensure employees can continue to discharge the role for which they are employed.
• Training requirements will form part of the PDP and appraisal processes.
• Training offered will be informed and prioritised using existing local education and training plans and existing regulatory professional requirements.
• When individual members of staff are released for training should be considered in the context of the ability to maintain services, existing contractual arrangements and staffing models. For example, the ability or inability to release multiple staff for training at the same time.
• Staff must be afforded adequate time and resources to undertake appropriate and relevant training.

Section 12IC duty to have real-time staffing assessment in place requires relevant organisations to have a procedure for the identification, by any member of staff, of any risks caused by staffing levels to the health, wellbeing and safety of patients, the provision of safe and high-quality health care or, in so far as it affects either of those matters, the wellbeing of staff. If an inability to meet the requirements for provision of training for an employee(s) is considered a risk, then this procedure for risk identification should be followed and, where appropriate, procedures to escalate the risk under section 12ID and procedures under section 12IE (duty to have arrangements to address severe and recurrent risks).

10.6 What could a relevant organisation use to evidence compliance?

It would be for the relevant organisation to decide how they could evidence compliance, however examples of evidence that could be used could include:

• a training strategy and governance structure for individuals within the scope of the Act;
• Monitoring cancellation / postponement of training;
• Providing assurance that all individuals are up to date with mandatory / essential training;
• Personal development activity report which identifies if training plans have been achieved; and
• Record of training activity.

10.7 Other relevant guidance and legislation

Note that this statutory guidance relates to staff training and engagement requirements under the Act. It does not replace any other requirements or guidance regarding education and training for the health and social care workforce.

Other guidance can be found at:

Health and Care (Staffing) (Scotland) Act 2019: overview - gov.scot (www.gov.scot)

Healthcare Staffing Programme – Healthcare Improvement Scotland

Health and Care Staffing in Scotland | Turas | Learn (nhs.scot)

Health and Care (Staffing) (Scotland) Act 2019 (cloud.microsoft)

Staff Governance Standard — NHS Scotland Staff Governance

NHS Education for Scotland | NES