NHSScotland Staff Governance Standard (4th Edition)

1 Introduction

Since the publication of the 3rd edition of the Staff Governance Standard for NHSScotland Employees in 2007, there have been many developments impacting upon NHSScotland and its staff. Key amongst these is the Healthcare Quality Strategy for Scotland (the Quality Strategy), published in May 2010 and the Strategic Narrative and 20:20 Vision of what healthcare will look like. The Quality Strategy sets the policy direction for the delivery of healthcare services in Scotland now and for the future.

The Quality Strategy aim:
To deliver the highest quality healthcare services to people in Scotland, and, through this, to ensure that NHSScotland is recognised through its measurable improvement as amongst the best in the world.

The Quality Strategy is based on shared knowledge of what works well and builds on the range of excellent progress and work already underway at local, regional and national levels. The Quality Strategy is about a change in culture across Scotland in the way we deliver and engage in our healthcare. It weaves through everything we are already doing, and will be supported by the refocusing, alignment and integration of our work. NHSScotland is now focused on the pursuit of realising the three Quality Ambitions for healthcare in Scotland which are mutually exclusive:

• Person-centred - Mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values and which demonstrate compassion, continuity, clear communications and shared decision-making.
• Safe - There will be no avoidable injury or harm to people from healthcare they receive, and an appropriate clean and safe environment will be provided for the delivery of healthcare services at all times.
• Effective - The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.

The Quality Strategy recognises that our staff are the greatest resource and we must ensure that they are enabled and supported to use their knowledge and skills to best effect to deliver the best service they can provide, consistently. Staff need to have the confidence and be empowered to make the changes needed to provide the highest quality, compassionate and clinically effective healthcare and feel that they do, and continue to enjoy doing, what they came into the NHS to do. This requires strong leadership, good staff governance and effective partnership working. Involving and empowering staff in decisions relating to their work has been demonstrated to deliver a better quality of outcome which will ultimately result in the delivery of high quality, safe, effective and person-centred healthcare services.

The challenging economic environment, coupled with changing demography and technological advances, will require NHSScotland and individual Boards to make some difficult decisions about the design and delivery of services and the workforce required to deliver them. The Strategic Narrative and the 20:20 Vision for healthcare services identify what we are working towards in the future.

Our '20:20 Vision'
Our vision is that by 2020 everyone is able to live longer, healthier lives at home or in a homely setting.
We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

As the Quality Strategy recognises, we need "to balance the drive for quality, productivity and efficiency with the support and development for staff to feel engaged, valued and empowered in leading and driving quality in their communities, services, wards and departments."^[1] While such circumstances will inevitably put a strain on employee relations, strong and effective staff governance mechanisms, together with partnership arrangements, will ensure that these relationships are maintained and used positively. This should lead to good decision making and encourage continuous improvements in the quality of service which will benefit both patient care and staff experience.

It is against this background that the most recent review of the Staff Governance Standard has taken place. The review was conducted by a review group comprising representatives from the Scottish Government, NHSScotland employers, trade unions and professional organisations - full membership details are provided at Appendix 2.

The review group was charged with reviewing the current Standard to ensure that it remained fit for purpose in the light of the Quality Strategy, the Strategic Narrative and other recent developments. The review group was also tasked with considering the extent to which a revised Staff Governance Standard should include both rights and responsibilities in line with the language and commitments promoted within the Quality Strategy. The review group also took account of other developments and issues, including work on promoting professionalism, the Dignity at Work toolkit, the healthcare principles within the Patient Rights Act, and Equality and Diversity initiatives.

This document sets out:

• the strategic framework surrounding staff governance;
• the definition of staff governance and the specific elements which make up the Staff Governance Standard;
• how the Framework will be monitored; and
• the roles and responsibilities of all who are involved.