Nursing and Midwifery Taskforce minutes: March 2024

Attendees and apologies

• Lesley Sharkey – Director of Midwifery
• Wilma Brown – Unison
• Jaki Lambert – RCM
• Eileen McKenna – RCN
• Claire Pearce – SEND
• Rrofessor. Patricia Findlay – Scottish Centre for Employment Research
• Colin Poolman – RCN
• James O’Connell – Unite
• Karen Wilson – NES
• Gillian Russell – Director of Health Workforce
• Alex McMahon – Chief Nursing Officer
• Anne Armstrong – Deputy Chief Nursing Officer
• Isabella de Wit – Health Workforce
• Beverley Lamont – Health Workforce
• Jess McPherson – CNOD
• Alison Carmichael - Health Workforce
• Annemieke Bikker - Health Workforce
• Laura Whitelaw - Health Workforce

Virtual attendees:

• Serena Barnett – HR, NSS
• Gillian McCannon – Chair, NHS Western Isles
• Sam Foster - NMC
• Anne Campbell - Vice Principal Ayrshire College
• Professor James Buchan - University of Edinburgh
• June Brown – SEND
• Rachel Dunk – CNOD

Apologies:

• Professor Susan Dawkes - Council of Deans Health
• Fiona Hogg - Chief People Officer
• Liz Airns - GMB
• Professor Aisha Holloway - Chair of Nursing Studies
• Matt McLaughlin - Unison

• Caroline Hiscox - Chief Exec NHS Grampian

• Gavin Fergie - Unite

• Kathleen Carolan - SEND

• Professor Caroline Hollins-Martin - Council of Deans Midwifery

Items and actions

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

Mr Gray welcomed everyone to the fourth ministerial meeting of the Nursing and Midwifery Taskforce (NMT) and thanked members and the subgroups for working at pace, recognising the complexity of the ongoing work. Mr Gray confirmed that this work will help to identify gaps and prioritise work, focusing on tangible outcomes that will futureproof the ongoing demand for services and put nursing and midwifery professions in the best position to overcome the current challenges. He outlined that the aim for the meeting was to discuss the feedback from the Listening Project and emerging recommended actions from subgroups, understanding the subgroups should take time to get the recommended actions right.

Review outstanding actions - Cabinet Secretary for NHS Recovery, Health and Social Care

Mr Gray noted that the minutes of the 6 December 2023 NMT meeting were confirmed as a true and accurate at the official led meeting on the 7 March 2024, the open actions were discussed and updated, there was one outstanding action regarding the data pack. Mr Gray invited Annemieke Bikker to provide an update on this action.

Annemieke Bikker presented the updated data requested at the last meeting showing the ages of nurses and midwives leaving the profession. The data shows an increase in the number of younger nurses and midwives leaving over the last two years. Presentation is available on objective connect.  Mr Gray confirmed the data is showing a clear trend and opened this agenda item for discussion.

Discussion focused on the generational change in attitude toward the NHS being seen as a career for life. With younger generations joining the workforce, there is recognition of the wider choices available and there is not a singular answer to retention, members recognised that this is not an NHS only challenge and the generational change is being seen across many professions, however there is a need to understand the impact on the NHS and how to overcome these challenges.

Discussion then shifted towards capturing data when people leave roles with agreement that there is a need to gather fuller data on why people leave, where they are going and what could be done to bring them back. There is a need to understand and consider flexibility within the career space, making it easier for staff to move internally but also facilitate people who leave the workforce to return at a later point. Members agreed this data would be useful for a better understanding and to help respond to future challenges in a way that is sustainable for the health service.

Action: To understand what data is gathered at board level.

Update on wider systems: Gillian Russell, Director of Health Workforce and Alex McMahon, Chief Nursing Officer

Gillian Russell updated members on the latest workforce statistics that were released on 5 March. They show a mixed picture in relation to nursing and midwifery. Nursing staff have increased 3.3% and Midwifery staff have increased by 3.8% over the last year as at Dec 2023. However, sickness absence rate has increased to 6.2% rate as well as the turnover rate which now stands at 10.4% across nursing and midwifery together.

Regarding the non-pay elements of the Agenda for Change (AfC) review, she confirmed that the Cabinet Secretary had confirmed the implementation of AfC Review Recommendations.

At the official led meeting on 7 March 2024 members discussed the decision-making format of the NMT going forward. It was agreed that subgroups will put forward recommended actions and will break down the steps and costs involved in implementation. Subgroups will assess the risk of implementation as well as the risk of not implementing recommended actions and this work is currently ongoing. Gillian also added that with the emerging issues from the Listening Project that do not fit into subgroups, members have agreed the Policy leads and Co-chairs group will consider and put forward recommended actions to the NMT.

Alex McMahon then provided an overview of the implementation of the Halth and Care (Staffing) (Scotland) Act 2019 which will become law on 1 April 2024. Work is currently ongoing with health boards to help with implementation.

Evidence gathering and Listening Project – Beverley Lamont and Annemieke Bikker, Health Workforce

Beverley Lamont provided an update on the current position of the Listening Project, which has spoken to over 400 staff members in 13 health board areas, with the final in person health board visits being carried out the week beginning 18 March 2024. There will also be virtual events for staff, and these will be shared with members to promote in their organisations. Focus groups with students and academic staff are also now underway. An interim report of key themes emerging from the Listening Project has been shared with members ahead of the meeting.

Beverley confirmed that the Listening Project has compiled an issues log, that will be shared with different areas to ensure all information gathered is passed to the relevant areas. As a final stage, a suitable mechanism will need to be identified to share the findings of the Listening Project and outcomes with staff.

Members noted the outputs of the Listening Project and confirmed that a lot of the themes echo feedback heard previously. A number of members proposed that a culture of defensiveness exists within NHS Scotland that requires understanding and addressing. Members discussed the need for SMART recommended actions for the short, medium- and long-term in order to show the impact that staff voices have had on the process.  Members agreed that a lot of the issues identified in the Listening Project come down to leadership and management and show a need for better training, particularly for those in Band 6 and above. There was agreement that the issues log should be shared with the NMT to ensure accountability and to continue the collaborative and transparent approach to the taskforce. Members noted their thanks for the work carried out to gather the Listening Project feedback.

Action: Listening Project issues log to be shared with NMT members.

Emerging recommended actions – Co-Chairs of subgroups

Mr Gray invited the cochairs of each subgroup to give an update on their current position.

Culture and Leadership will issue a written update to the group shortly. However, with the outputs of the Listening Project there is a need to reconsider some recommended actions with consideration of the new data available.

For wellbeing the draft recommendations align with the outputs of the Listening Project and have been incorporated into the key themes emerging. The sub-group is considering recommendations on areas such as rest breaks, ensuring the working time directive is being upheld and more broadly essential practical needs for staff. Work is underway to cost recommendations on protected time for supervision and reflective practice.  

Attraction is moving into looking at recommended actions around the retention of the workforce, including flexible working. There is a recommended action regarding the need for immediate marketing activity to increase the applications to the undergraduate courses which will be discussed later on the agenda.

Education and Development confirmed they have a draft set of recommended actions which include looking at entry routes in to nursing and midwifery roles which requires scoping to be undertaken on what is currently available and not, such as the infrastructure and IT available for distance learning etc. They are considering the routes for those in bands 2 - 4 to progress and become qualified. They are also having discussions around the career structure. Colleagues have carried out SWAT analysis, and are considering the sequencing needed to influence and tie into other areas in SG that will influence their recommended actions.

Marketing activity and career promotion – Karen Wilson, NES

Karen Wilson provided a short update that informed members of the ongoing work with the Council of Deans and the Centre for Workforce Supply regarding the need for collective marketing. The CWS have an ongoing programme of work to improve the marketing materials available.  They are working with the Council of Deans to pull together resources in a collaborative way to ensure value for money in recruiting students to the undergraduate course, The work will look at the current intake but will focus on overall improvements for the intake for the next academic year to maximise the effort of the currently available channels and they are the quickest way to reach potential students.

Mr Gray confirmed his concerns about the current academic intake and the sustainability of the student pipeline going forward and asked for advice on what can be done in a relatively short period of time and the resource required.

Action: Advice to be provided to the Cabinet Secretary for NHS Recovery, Health and Social Care. This will be shared with colleagues via correspondence given the time sensitivity of this action.

Members discussed how to build sustainability for the future and access students early enough to discuss professions. There is currently work ongoing in this area such as Developing the Young Workforce. NES also have a workstream looking at certain schools with health simulation facilities, which allow practical skills to be taught to students. RCN also have schemes ongoing such as the nursing cadet scheme. Members discussed that marketing activity needs to be targeted to different audiences to ensure effectiveness of any campaigns. 

Next steps - Cabinet Secretary for NHS Recovery, Health and Social Care

Mr Gray advised from a Scottish Government perspective, the priorities for the coming weeks ahead of the next meeting will be to discuss the development of introduction chapter for the NMT report, finalise the findings of the Listening Project and incorporation into NMT report and work with PMO to understand the various milestones and associated costs of the recommended actions by the subgroups to pull together the action plan for the NMT. All subgroups will continue to develop recommended actions, even if full details aren’t known for the 5 June meeting.

AOB and Close - Cabinet Secretary for NHS Recovery, Health and Social Care

Mr Gray thanked members for their attendance and participation in the NMT. He advised discussions are helpful for wider discussions ongoing in government regarding the Health and Social Care landscape. The next meeting will be held on the 05 June 2024.