Health and social care: safe and effective staffing consultation

Title of Proposal

Safe and Effective Staffing: Consultation on proposals to enshrine safe staffing in law, starting with the nursing and midwifery workload and workforce planning tools.

Purpose and intended effect

Background

• Nursing and midwifery workload and workforce tools have been developed and mandated for use in NHS Boards since April 2013. A suite of 12 tools is now available covering 98% of service areas helping to plan for the number of nurses and midwives they require to provide the best possible care for patients. One multi-disciplinary tool has also been developed for use in Emergency Department/Emergency Medicine Settings.

Objective

• The objective of the Safe and Effective Staffing legislation will be to:
  • Ensure safe staffing levels, reflecting patient and service needs
  • Enshrining key principles of triangulation
  • Enable consideration of service delivery models
  • Enable public and staff assurance (and reassurance).

Rationale for Government intervention

• The link between safe and sustainable staffing levels and high quality care is well established. It is vital to have the right number of staff in place, with the right skills. Scotland has led in the UK in developing mandatory nursing and midwifery workload and workforce planning tools that help NHS Boards to plan for the number of staff they require to provide the best possible care for patients in a variety of specialities.
• It will contribute to two of the 16 national outcomes:
  • We live longer, healthier lives.
  • Our public services are high quality, continually improving, efficient and responsive to local people's needs.

Consultation

The legislation will be developed in a collaborative way involving colleagues from across and outwith the Scottish Government.

Within Government

• We are working with colleagues across the Scottish Government to develop this legislation. This includes, but is not restricted to the following teams:
  • Workforce and Strategic Change.
  • Person Centred and Quality Unit.
  • Integration.
  • Health Performance Delivery.
• This will ensure that current Scottish Government policy is reflected in the on-going development of this legislation and will ensure that all appropriate stakeholders and stakeholder groups can offer comment of these proposals.

Public Consultation

• The formal consultation will run for a period of 12 weeks from 12 ^th April 2017 until 5 July 2017.
• The consultation material will be available on the Scottish Government's website and will be sent to a wide range of stakeholders. We will also use social media to provide updates.

Business

• We will identify relevant organisations to meet with during the consultation period and update this section at Final BRIA stage.

Options

Option 1 - Do Nothing

Under Option 1, the situation would remain as it is at present. The tools are currently mandated for by NHS Boards and are more widely used but there is scope to ensure they are more consistently applied and reviewed within NHS Boards across Scotland.

Option 2 - Introduce Safe and Effective Staffing Legislation

This will create a statutory duty on organisations providing health and social care to apply the workforce tools, starting with the nursing and midwifery tools on a consistent basis.

The full consultation document covering the proposed legislative measures that will be developed is published in conjunction with this partial BRIA.

Sectors and groups affected

The legislation would apply to organisations providing health and social care and be applicable only in settings and in staff groups where a nationally agreed methodology and tools exist.

The legislation would apply to all providers of health and social care services.

Benefits

Option 1: there would be no action and therefore no additional benefits.
Option 2: the introduction of these requirements are intended to further ensure - and assure - safe and effective staffing and strengthen and enhance the arrangements already in place to support continuous improvements in workforce planning and employment practice across Scotland.

Costs

Option 1: there would be no action and therefore no net additional costs to government or to providers of health and social care services.

Option 2: The legislation should not create sizeable additional costs or liabilities for government.

The Scottish Government and NHS Boards would need to consider if it was necessary to introduce any additional training on application of the use of the tools and consider the costs and resources which would be required.

Scottish Firms Impact Test

The proposal is designed to reinforce a culture of safety and quality for patients in Scotland in all health and social care settings. There have been no consultations with Scottish firms who may be affected. The consultation which this document accompanies actively seeks the views of businesses who may be affected by these proposals and who the consultation document has been forwarded to.

Competition Assessment

Will the proposal directly limit the number or range of suppliers?
The proposal will not directly affect the number or range of suppliers of health and/or social care. The legislation will apply to all health and social care settings.

Will the proposal indirectly limit the number or range of suppliers?
The proposal will not indirectly affect the number or range of suppliers of health and/or social care. The legislation will apply to all health and social care settings.

Will the proposal limit the ability of suppliers to compete?
The legislation will apply to all health and social care settings. It will have no impact on competition within the health and social care settings.

Will the proposal reduce suppliers' incentives to compete vigorously?
The legislation will apply to all health and social care settings.

Will the proposals limit the choices and information available to consumers?
The legislation will apply to all health and/or social care settings. It will have no impact on the choices and information available to consumers.

Test run of business forms

No new forms for business are anticipated.

Legal Aid Impact Test

As part of the legislative development process we will liaise with the Scottish Government Access to Justice Team to gauge whether any proposed legislation will affect Legal Aid. This will be detailed within the final BRIA.

Enforcement, sanctions and monitoring

The enforcement, sanctioning for non-compliance and monitoring of any proposed legislation will be detailed within the full BRIA.

Implementation and delivery plan

12 April 2017 - launch of consultation process.

Post-implementation review

A review process will be considered as the legislation is developed.

Summary and recommendation

Option 2 is the option on which the Scottish Government wishes to consult.

Summary costs and benefits table

This will be detailed in the full BRIA, following consultation and accompanying documents.

Declaration and publication

I have read the Business and Regulatory Impact Assessment and I am satisfied that, given the available evidence, it represents a reasonable view of the likely costs, benefits and impact of the leading options. I am satisfied that business impact has been assessed with the support of businesses in Scotland.

Signed:

Date: 30 March 2017

Minister's name Shona Robison MSP
Minister's title Cabinet Secretary for Health and Sport

Scottish Government Contact point: Dawn Sungu, Chief Nursing Officer Directorate