RCN Scotland calls for urgent action to stop nurses fleeing profession as healthcare crisis at 'breaking point'

A Scottish nursing union is calling for urgent action to stop nurses who are “at breaking point” from fleeing the profession.

Royal College of Nursing Scotland said the nursing workforce crisis is showing little sign of improvement after publishing the third instalment of The Nursing Workforce in Scotland report.

In the year up to December 2023, NHS Scotland figures showed the number of nurses rose from 61,567 whole time equivalent (WTE) staff to 63,605.

But vacancies in the field still remain high, with 3,961.8 WTE posts still unfilled as of the end of last year – a drop from the peak of more than 6,500 in December 2021, but still higher than before the pandemic.

For the second year in a row, the report focuses on the the importance of the Nursing Midwifery Taskforce and the need for a fully-funded nursing retention strategy.

They say that the Scottish Government “must” develop and implement a fully-funded nursing retention strategy that addresses wellbeing, workplace culture, development opportunities, flexible working and career progression.

They add that the government should establish an implementation board to ensure the changes are delivered by the end of this year.

The RCN recommended ten areas of concern including fair pay, good employment terms and conditions as well as the evaluation of the Health and Care (Staffing) (Scotland) Act 2019, including an annual parliamentary debate on safe staffing.

The report found that while the number of nursing staff employed by NHS Scotland has increased, the number of vacancies remains high adding that staff turnover and absences have increased.

It comes as the number of people applying and accepted to study nursing falling for the third year in a row.

Within social care, the number of registered nurses employed declined further despite increasing clinical need.

A global comparison shows that the number of nurses per 1,000 population in Scotland (7.9) is below the OCED average of 9.2 and significantly below Ireland (15.2), Norway (18.3) and Finland (18.9) who have some of the highest numbers of nurses per 1,000 population.

Commenting on the report’s publication, Julie Lamberth, RCN Scotland board chair, said that the reports findings are “not sustainable”.

“At no point has NHS Scotland employed the number of nursing staff it says it needs to deliver safe care and the registered nurse to resident ratio in many care homes makes safe care impossible.

“At the same time, with the squeeze on budgets, we are hearing reports of nursing roles being axed.

“The Scottish government must get serious about the workforce crisis and the long-term implications for the public’s health.

“Nursing vacancies are having a damaging impact on our members ability to provide safe and effective care. And on their own wellbeing when shift after shift they work extra unpaid hours to cover gaps and go home feeling that they are unable to provide the quality of care they want,” she said.

Colin Poolman, RCN Scotland director, echoed this adding that the nursing workforce in Scotland are “under paid, under-staffed and many are at breaking point”.

“The current service pressures and staff shortages have resulted in unsafe conditions being normalised.

“We have said it before and we will continue to say it – the future looks bleak if the Scottish government does not grasp with both hands the opportunity for improvement the Ministerial Nursing and Midwifery Taskforce and Agenda for Change review present to alleviate the workforce crisis.

“The Taskforce has been progressing and we cannot afford for this essential work to be delayed.

“We want to work with the Scottish government to ensure the Taskforce delivers meaningful and sustainable change.

“In addition, Ministers must now move swiftly to open negotiations for the 2024-25 NHS Scotland pay award,” he said.