Ministerial Scottish Nursing and Midwifery Taskforce: report and recommended actions
The final report of the Scottish Ministerial led Nursing and Midwifery Taskforce which makes a number of recommended actions that aim to make Scotland the best place for nurses and midwives to work.
Annex 2: Recommended actions and subgroup origin
Nursing and Midwifery Taskforce
Recommended actions and subgroup origin
Recommended action: Employers must have appropriate staffing levels and the systems or mechanisms in place so staff are able to take contractual and statutory breaks to which they are entitled. This will include a review of the mechanisms by which breaks are effected (such as rota design and associated workforce planning tools).
Subgroup: Wellbeing
Recommended action: Scottish Government will develop mechanisms/a toolkit to ensure staff have all their essential needs met whilst at work. This will consider core aspects of need such as physical needs, physical safety, emotional safety and psychological safety.
Subgroup: Wellbeing
Recommended action: At a national level, the Scottish Government, NHS employers and trade unions and professional organisations will review and update the definition of what flexible working means in the context of nursing and midwifery rostered environments. Following this review, flexible working practices will be promoted and implemented for both nursing and midwifery professions to ensure flexible
Subgroup: Attraction
Recommended action: The Scottish Government, NHS employers and trade unions and professional organisations will develop national rostering and e-rostering guidance and training to ensure it promotes a culture of flexibility and shared decision making, including team-based rostering to improve the work life balance of nursing and midwifery staff.
Subgroup: Attraction
Recommended action: The Scottish Government, NHS employers and trade unions and professional organisations will systematically identify effective approaches to team-based rostering and give support for progressive implementation across the whole system, to promote a culture that embraces flexibility and work life balance. The review should include (a) establish what shift patterns and rota designs and on call provisions are currently used and to what extent and (b) understand the impact on staff wellbeing and safe and effective care, in order to identify if changes to shift patterns and rota design and on call provisions for nurses and midwives are necessary.
Subgroup: Attraction
Recommended action: The Scottish Government will explore with relevant partners and stakeholders, including regulators, the benefits and challenges of introducing regulation and standardised education in Scotland for nursing support worker roles. This will include considering all the available evidence regarding substitution, deployment, scope of role, increasing widening participation and suitable education programs that can enable progression to the Registered Nurse role.
Subgroup: Education and Development
Recommended action: NES with relevant stakeholders will review the education of maternity care assistants with the aim of understanding the potential benefits and challenges of standardised education, aligned with the level 2-4 Maternity & Neonatal Education & Development framework to increase widening participation and suitable education programs that can enable progression to earn as you learn models for midwifery education.
Subgroup: Education and Development
Recommended action: The Scottish Government with relevant partners and stakeholders will commission a comprehensive review of practice learning to:
- identify potential gaps in education provision, supervision, and IT infrastructures.
- understand the future requirements of pre- and post-registration learners, and educators aligning where appropriate with the national NMC review of practice learning and the Nurses, Midwives, and Allied Health Professionals (NMAHP) framework.
- identify gaps and the actions required to enable new learning routes, learning opportunities and CPD to be effective.
- ensure capacity, capability and opportunity within the system including options such as regional approaches to placement provision.
Subgroup: Education and Development
Recommended action: The Scottish Government will work with relevant partners and key stakeholders such as Higher Education Institutions, NHS Boards, Scottish Funding Council, Scottish Qualifications Authority (SQA) and others to develop alternative sustainable pre-registration degree education delivery and funding models that will lead to NMC approved programmes for nursing and midwifery that are structured in a more contemporary and progressive way.
This will include:
- blended and distance learning, with these programmes becoming available.
- As a priority these developments will focus on hard to recruit fields and respond to the demographic and regional challenges across Scotland for midwifery and nursing.
Subgroup: Education and Development
Recommended action: NES and employers will embed the refreshed NMAHP career framework as a tool to enable a structured approach to staff learning and development, including career planning conversations, across all four pillars.
Subgroup: Education and Development
Recommended action: Employers will ensure leadership, finance, educational programmes, and processes are in place and visible to support all nursing and midwifery learners, levels 2-9, to access relevant education provision to develop their individual career aspirations.
Subgroup: Education and Development
Recommended action: NES with relevant partners will address where there are gaps in education provision.
Subgroup: Education and Development
Recommended action: In collaboration with the Chief Nursing Officer (CNO) Research Advisory Group, and with cognisance of their recent work, agree the development of a structured approach to integrated clinical, academic and research appointments with clearer career pathways and job descriptions including clinical academic roles. This work should consider all drivers, include funding mechanisms, to bridge the gap in HEI/Board salaries and to enable expansion of opportunities for staff to be supported to develop at MSc level and beyond.
Subgroup: Education and Development
Recommended action: The Scottish Government will conduct a mapping exercise of the current digital landscape and will act on the findings to come up with areas for improvement around the opportunities for nursing and midwifery staff to be involved in digital transformation.
Subgroup: Attraction
Recommended action: The Scottish Government will commission a review of data inputting and paperwork requirements within all nursing and midwifery roles to establish which:
1) are duplication of other inputs and requirements and
2) are non-essential either legally or for the purposes of patient safety. It will identify which ones can be removed
As part of the review, to reduce the administrative burden on nurses and midwives it will consider the effectiveness of current business systems and administrative processes and the Scottish Government will act on the findings to allow nurses and midwives to focus their time on direct clinical patient care.
Subgroup: Attraction & Wellbeing
Recommended action: The Scottish Government will review the predicted absence allowance in the staffing level tools used by NHS Scotland to ensure it is fully reflective of the non-clinical aspects of nursing and midwifery roles and realistic levels of absence; where the relevant duties under the Health and Social Care (Staffing) (Scotland) Act 2019 apply and applied in a consistent manner across NHS Scotland. This will support employers in meeting their duties under this Act. Where the Act does not apply to encourage adoption of this approach as best practice.
Subgroup: Wellbeing
Recommended action: The Scottish Government will give consideration for future-proofing, centrally led system commissioning for interconnected communication across healthcare in Scotland.
Subgroup: Wellbeing
Recommended action: Employers will put in place a fair, consistent and transparent process to deciding which staff are moved to other areas based on their skills, knowledge and experience
Subgroup: Attraction
Recommended action: When staff are moved, the receiving area will give an adequate handover, orientation and resources to undertake role to ensure that patient and service user outcomes and staff wellbeing are not compromised.
Subgroup: Attraction
Recommended action: When staff are given temporary responsibility for additional cases, employers will put in place a clear process of prioritisation based on dynamic risk assessment and identified mitigations to ensure workload remains manageable.
Subgroup: Attraction
Recommended action: Employers will ensure a clear route of escalation is available to staff members who are moved and or given additional temporary responsibility and feel that client/patient safety and outcomes are negatively impacted as a result, or who consequently feel unable to provide safe client/patient care
Subgroup: Attraction
Recommended action: Building on existing good practice and evidence and through collaborative design, the Scottish Government, partners and stakeholders will develop a culture assessment tool for all teams to use in a psychologically safe way, across all health and care settings.
Subgroup: Culture and Leadership
Recommended action: Employers will test and refine the culture assessment tool with nursing and midwifery teams.
Subgroup: Culture and Leadership
Recommended action: Employers will implement the tool across multi-disciplinary teams to develop a consistent approach to improve organisational culture at a local level.
Subgroup: Culture and Leadership
Recommended action: The Scottish Government, partners and stakeholders will develop a pathway to enable teams to:
1) access appropriate support for the assessment process, and
2) access support to implement required improvements.
Subgroup: Culture and Leadership
Recommended action: Employers will ensure that nurses and midwives are fully supported and have appropriate opportunities to reflect and analyse traumatic and difficult situations they have experienced through responsive and well publicised local support channels.
Subgroup: Wellbeing
Recommended action: The Scottish Government will explore a consistent approach to capturing information to allow for a better understanding of why nurses and midwives choose to leave their professions.
Subgroup: Attraction
Recommended action: The Scottish Government, partners and stakeholders will ensure nurses and midwives can access sustainable and progressive opportunities to influence policy, practice, national and local strategy to achieve change.
Subgroup: Culture and Leadership
Recommended action: The Scottish Government, partners and stakeholders will enable practicing nurses and midwives to participate in leadership teams across all settings to allow direct input to strategy, decision making and planning.
Subgroup: Culture and Leadership
Recommended action: Employers, the Scottish Government, and leadership will support staff to act with autonomy, within their scope of practice, maximising their knowledge, skills and competence to influence and participate in local and national decision making on all issues that impact on their effectiveness.
Subgroup: Culture and Leadership
Recommended action: Organisations and employers will commit to sustaining compassionate leadership, which evidence shows must be a critical component of every nurse and midwife’s role.
Subgroup: Culture and Leadership
Recommended action: The Scottish Government, partners and stakeholders will support employers to establish sustainable leadership learning and development pathways and support NMW leadership development from the beginning of career across all healthcare settings.
Subgroup: Culture and Leadership
Recommended action: Employers will promote development of leadership capacity and capability, and a talent management and succession planning approach covering all roles.
Subgroup: Culture and Leadership
Recommended action: NES and employers will ensure a safe and supportive environment is in place in all health and care settings which empowers all nurses and midwives to develop and demonstrate compassionate leadership skills.
Establish and implement robust processes to ensure staff can access and develop their leadership skills that build on existing policy and guidance.
Subgroup: Culture and Leadership
Recommended action: An employer commitment for nursing and midwifery staff to have protected time for a model of supervision which meets the individual’s needs.
This should include (but is not limited to)
- restorative supervision,
- peer support, and
- reflective practice.
The model should incorporate provision for this to be in a safe space and at a time that is right for them; particularly following traumatic events.
Subgroup: Wellbeing
Recommended action: The Scottish Government with relevant partners and stakeholders will build a sustainable nursing and midwifery workforce that supports and maximises existing pre and post registration programmes. Integral to this will be the development of sustainable alternative entry routes into nursing and midwifery, including part-time routes, earn as you learn, apprenticeship models and fast track routes from relevant degree- educated pools.
Subgroup: Education & Development
Recommended action: The Scottish Government with relevant partners and stakeholders will develop new entry routes with dedicated funding available to support them. This should prioritise adding to, and not replacing, traditional undergraduate routes.
Subgroup: Education & Development
Recommended action: The Scottish Government with relevant partners and stakeholders will ensure continued widening participation and that the demographic of the future nursing and midwifery workforce mirrors the population and communities it serves.
Subgroup: Education & Development
Recommended action: Widening participation must therefore go beyond SIMD (Scottish Index of Multiple Deprivation), be diverse and inclusive and respond to remote and rural needs.
Subgroup: Education & Development
Recommended action: The Scottish Government will commission research and labour market analysis that identifies current dynamics and trends in levels of interest in nursing and midwifery careers, taking account of regional variations and any differences between fields of nursing and professions. This work will be used to identify how any future marketing activity should be shaped and targeted.
Subgroup: Attraction
Recommended action: The Scottish Government will commission evidence-based and evaluated career marketing activity that accurately represents and promotes the roles and range of career opportunities that reflect the key pillars of clinical practice, leadership, research and education to attract and retain a diverse range of talent in nursing and midwifery.
Subgroup: Attraction
Recommended action: The Scottish Government will work with relevant partners and stakeholders to ensure nurses and midwives are supported and encouraged to share their passion for their role and career with others, to support attraction and retention, based on their own experience of the challenges and opportunities.
Subgroup: Attraction
Recommended action: The Scottish Government will work with relevant partners and stakeholders to ensure the consistent, sustainable provision of a range of taster schemes across health and social care that enable people from various backgrounds to experience nursing & midwifery and, on completion, participants are guided and supported to access careers in health & social care.
Subgroup: Attraction
Recommended action: The Scottish Government will identify the barriers and enablers to attracting a diverse range of suitable candidates and develop a costed action plan to address barriers. This would include a review of the package of student financial support to ensure that nursing and midwifery students receive the right support to complete their studies.
Subgroup: Attraction
Contact
Email: nmtlisteningproject@gov.scot
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