Nursing and Midwifery Taskforce minutes: December 2023

Attendees and apologies

• Colin Poolman, RCN
• Eileen Mckenna, RCN 
• Jaki Lambert, RCM
• Gavin Fergie, Unite 
• Wilma Brown, Unison 
• Professor Susan Dawkes, Council of Deans Health 
• Fiona Hogg, Chief People Officer 
• Alex McMahon, Chief Nursing Officer
• Gillian Russel, Director of Health Workforce 
• Justine Craig, Chief Midwifery Officer 
• Isabella de Wit, Health Workforce Directorate (IDW)
• Beverley Lamont, Health Workforce Directorate (BL)
• Annemieke Bikker, Health Workforce Directorate (AB)
• Jessica McPherson, Chief Nursing officer Directorate (JMcP)
• Alison Carmichael, Health Workforce Directorate (AC)
• Kirsty Merriman, Health Workforce Directorate (KW)
• Laura Whitelaw, Health Workforce Directorate (LW)

• Remotely:

• Sam Foster, NMC
• Lesley Sharkey, MD Tayside 
• Jackie Mitchell, RCM 
• Anne Campbell, Vice Principal Ayrshire College 
• Professor Caroline Hollins-Martin, Council of Deans Midwifery 
• Gillian McCannon, Chair NHS Western Isles 
• Prof. Patricia Findlay, Scottish Centre for Employment

• Apologies:

• Liz Airns, GMB
• Karen Wilson, NHS NES
• Professor Aisha Holloway, Chair of Nursing Studies
• Professor James Buchan, University of Edinburgh
• Serena Barnatt, HRD GJNH
• Matt McLaughlin, Unison
• Caroline Hiscox, Chief Exec NHS Grampian
• Claire Pearce, ND Tayside
• June Brown, ND Grampian
• Richard McCallum, Director of Health Finance
• Angie Wood, Interim Director, Social Care Resilience and Improvement
• Rachael Dunk, Chief Nursing officer Directorate
• Fiona Davies, IJB Chief Officer

Items and actions

Welcome and introductions – Cabinet Secretary for NHS Recovery, Health and Social Care – Mr Michael Matheson

MM welcomed everyone, including online members to the third ministerial led meeting of the Nursing and Midwifery Taskforce (NMT). Mr Matheson noted that he was pleased with the progress that has been made by subgroups and highlighted that considering the challenging financial situation it will be important to fully understand and cost recommendations ahead of a prioritisation exercise that will take place once all recommendations are known.

Minutes and actions from previous meeting 28 August 2023 - Cabinet Secretary for NHS Recovery, Health and Social Care – Mr Michael Matheson

MM asked members if they had any comments or amendments to the previous meeting minutes. No amendments were put forward and members unanimously agreed to the previous meeting minutes to be a true and accurate record of the meeting.

There were two actions noted from the previous taskforce meeting.

• members to review the asks in paper 1: Context and Landscape Mapping and to email policy colleagues with any comments they have

Update: Action has been closed. No further comments from members were received and the final version was sent to members on 22 August 2023.

• policy colleagues to consider external scrutiny of data to ensure there are no gaps. Ensuring conclusions drawn are based in quality evidence and data

Update: Action is ongoing and will be discussed in agenda item 3

Evidence gathering and Listening Project – Isabella de Wit and Beverley Lamont

IDW presented updated workforce data that has been gathered. Presentation is attached.

Following the presentation, members discussed the importance of ensuring that the data accurately reflects the realities of the workforce, and goes further than top line numbers, to ensure an accurate representation. Members also suggested a further breakdown such as age profiles, turnover by age etc. This has been noted as an action and the data pack will be amended (Action 1). Members then highlighted the challenges in international recruitment, with discussion focusing on recruiting from red list countries. It was confirmed by Scottish Government staff that recruitment by NHS Scotland Health boards is in line with the Scottish Code of Practice for ethical recruitment and are not actively recruiting from red list countries.

MM – closed this agenda item, highlighting some further work around the data will be needed and reinforced the importance of how we report the data, to ensure we have good data to underpin the recommendations.

MM- Invited Beverley Lamont to provide an update on the Listening Project.

BL – presented the preliminary finding from the pulse poll and the in-person engagement events. The presentation is attached below.

There was discussion regarding the positives of the Listening Project, to understand the issues facing the workforce and how the taskforce tackles these challenges. Members highlighted that they recognised the preliminary findings as challenges they have faced or heard from their respective areas of the workforce. There was importance placed on having in person visits across Scotland in various locations to ensure that the Listening Project reaches all staff across the four pillars of practice and gives then the opportunity to be involved, especially remote and rural areas, given the complexity of challenges faced due to their location. Discussion then progressed to the reflection of our changing society and how this could be increasing some of the issues faced, more specifically around the perception of Nursing and Midwifery careers.

In addition, the Nursing and Midwifery Council are looking at 1. What’s the global picture in terms of picture and infrastructure around students, and 2. What is the state of undergraduate education. Highlighted by the worry about indefinite approval and self-assessment and how this has led to a difficult position of finding funding. NMC will look for an independent chair in new year to look at starting pilot incentives. (Action 2)

Recommendations – Cabinet Secretary for NHS Recovery, Health and Social Care – Mr Michael Matheson

MM – Introduced agenda item 4 and invited cochairs to provide an update on their subgroups.

Wellbeing: The subgroup is progressing well, with good engagement from members. Discussions have focused on the importance of people taking breaks, make sure staff understand each other’s needs to have a break and hydration and having access to water etc and to ensure consistency across health boards in Scotland. Which reflects the early discussions heard by the Listening Project, in which staff have highlighted the importance of wellbeing initiatives improving their day-to-day experience. Members have highlighted the link between the Wellbeing Subgroup and the Culture and Leadership group and will ensure alignment and joint recommendations regarding how staff are treated in work and the effects on wellbeing.

Education and Development: After a number of meetings, the subgroup has a set of draft recommendations, which are included in the attached paper. Members are using an iterative process, and these will be amended as the subgroup continue to develop their recommendations. The recommendations focus on increasing routes to the professions, widening access, how easy we make it for people to join, how we get them in and retain, the delivery model of education, different to the traditional routes used currently by universities and what the infrastructure would look like to achieve and  sustain these. They are also looking at post registration and after graduation, how to support lifelong learning, what career opportunities and pathways and the opportunities across the four pillars of practice.

Culture and Leadership: They have met three times and will be meeting again in January to look at the Listening Project as this will give more information to move on. Current themes are around pressures and how we create time and space for people to think about own development, how do leaders make themselves visible. This group will also build on the outcomes of the Listening Project. However, an early recommendation is to map leadership offers, how we can promote and give people the information they need, and how we support people.

Attraction: The attraction subgroup had an initial focus on attraction, members agreed to look at retention next, which will be informed by the findings from the Listening Project. The initial priority is to improve the attractiveness and general awareness of nursing and midwifery careers across the four pillars of practice and the routes to move between those. The first recommendations focus on national market research to take stock of current landscape. This uncovered an immediate action required, around the urgency of encouraging the population to apply to higher education to fill vacancies. A task and finish group is now in place to support this ask for the current undergraduate cycle. Following on from the market research there is a recommendation to the delivery of the marketing activity advertising the breadth of opportunity withing Nursing and Midwifery.

MM – Highlighted that it is important to have preliminary recommendations and that work now needs to take place to understand the steps and costs involved in undertaking the work. Keen for subgroups to think about prioritisation, as well as early, intermediate, and longer-term actions.

Next steps: Cabinet Secretary for NHS Recovery, Health and Social Care – Mr Michael Matheson

MM advised the next steps are delving deeper into the recommendations, alongside the Listening Project and the views of our Nursing and Midwifery Workforce, the data and where the trends are. We are now starting to move into considering actions and the priority to give to each of these. We will meet again in February to discuss.  

A short discussion regarding prioritisation and funding heard members wishing for a health economist view to look at costs of recommendations but also cost of not doing the recommendations, so when decisions are made, that would help to make decisions in a balanced way (Action 3).

Closing remarks - Cabinet Secretary for NHS Recovery, Health and Social Care – Mr Michael Matheson

MM thanked everyone for attending and brought the meeting to a close.