Associate feature: Getting legislation right is equally important for care homes and the NHS

Written by Theresa Fyffe on 25 March 2019 in Comment

Delivering safe and effective staffing needs to be about more than putting workload and workforce planning tools on a statutory footing

Image credit: Holyrood

Scotland is leading the way in developing proposals to enshrine safe staffing in law and needs to lead by example if other countries are going to follow suit.

Delivering safe and effective staffing in Scotland needs to be about more than putting workload and workforce planning tools on a statutory footing. It is about listening to highly skilled professionals and letting them exercise professional judgment; it is about ensuring that there is the flex in the system to adapt to real time changes in dependency and acuity; and it is about using that live data to plan effectively for the future.

Our members continually flag the issue of poor staffing levels and how it compromises their ability to provide safe and effective care. It is a message we simply can’t ignore - patient safety is being compromised by poor staffing levels. Clearly it is time for change. No matter where people are receiving care, they deserve and have a right to expect care that is high quality, safe and appropriate for their needs.

The Scottish Government’s Health and Care (Staffing) (Scotland) Bill presents an opportunity to make a real difference.  The Bill broken down into three sections. Part 1 sets out the guiding principles, part 2 relates to staffing in the NHS and part 3 to staffing in care services.  Ensuring parity of principle between the NHS and care services is essential if the Bill is to support care homes that provide nursing care, to deliver safe, quality nursing care to residents with increasingly complex health needs. 

People in Scotland are living longer. By 2039 the number of people over 75 is projected to expand by 84 per cent. Where nursing care is required, care home residents deserve to have it provided by the right numbers of nursing staff with the appropriate skills, competencies and education. As Scottish Care recently observed, the reality is that care homes are now often “akin to hospital environments in terms of the levels of need they are supporting.” New health inequalities for people requiring clinical care in care homes for adults would be a serious unintended consequence if this parity of principle is not achieved in the bill.

Many of the amendments made at stage 2 improve and strengthen the Bill and need to be maintained if this legislation is to have an impact. For example, the responsibility for ensuring there are adequate numbers of health care professionals in training to meet demand sits with the Scottish Government.

Health and social care providers cannot be expected to meet staffing standards if there are not enough nurses and doctors being trained. Operationally, senior charge nurses and their equivalents in the community are integral to the daily delivery of safe care and are key to the successful implementation of this legislation. They must be given the time they need to fulfil their clinical leadership role by not being counted in the number of nursing staff required to provide direct patient care. 

The Scottish Government’s Bill before is a unique opportunity to ensure our NHS and care homes have the staff they need. We now need the support of MSPs in the stage 3 debate to secure positive change for staff, patients and residents in care homes. If we get this legislation right it will help to ensure that nursing teams working across sectors have the right staff to provide safe, effective and high quality care and ensure expectations of care can be met in reality.

Theresa Fyffe is director of RCN Scotland

This piece was sponsored by RCN Scotland

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