Health and Care (Staffing) (Scotland) Act 2019: overview

Overview of the Health and Care (Staffing) (Scotland) Act 2019 for those who will be affected by it (health professionals and care service providers) to inform them of their responsibilities and signpost to support available. The provisions in the Act come into force in April 2024.


Health and Care (Staffing) (Scotland) Act 2019 - roles in scope


The Health and Care (Staffing) (Scotland) Act 2019 places duties on the NHS and providers of care services. The Scottish Government have been asked for clarification on who the Act applies to so we have set out our interpretation of this below.

Please note that this list has been designed specifically for use in conjunction with the Health and Care (Staffing) (Scotland) Act 2019 and should not be used for any other purpose.

This list may change as new roles are developed over time.

Health care staff

Section 12IA(1) of the Act states:

“It is the duty of every Health Board and the Agency to ensure that at all times suitably qualified and competent individuals, from such a range of professional disciplines as necessary, are working in such numbers as are appropriate for-

(a) the health, wellbeing and safety of patients,
(b) the provision of safe and high-quality health care, and
(c) in so far as it affects either of those matters, the wellbeing of staff.”

Our opinion is that ‘professional disciplines’ would cover clinical staff and staff who provide clinical advice, comprising:

Allied health professions (All HCPC registrants, all bands, working in all areas)

  • art therapist
  • occupational therapist
  • podiatrist
  • diagnostic radiographer
  • orthoptist
  • prosthetist
  • dietician
  • orthotist
  • speech and language therapist
  • drama therapist
  • paramedic
  • therapeutic radiographer
  • music therapist
  • physiotherapist

Ambulance services roles not covered elsewhere in the list

  • ambulance care assistant
  • ambulance dispatcher
  • ambulance technician
  • emergency call handler
  • paramedic


  • anaesthesia associate


  • dentist
  • dental hygienist
  • dental technician
  • dental therapist
  • dental nurse
  • orthodontic therapist
  • clinical dental technician

Healthcare scientists

  • anatomical pathology technologist
  • audiologist
  • biomedical scientist: blood transfusion
  • biomedical scientist: clinical biochemistry
  • biomedical scientist: reproductive science (embryology & andrology)
  • biomedical scientist: clinical genetics
  • biomedical scientist: clinical immunology
  • biomedical scientist: cytopathology
  • biomedical scientist: haematology
  • biomedical scientist: histocompatibility and Immunogenetics
  • biomedical scientist: histology
  • biomedical scientist: microbiology
  • biomedical scientist: molecular pathology
  • biomedical scientist: virology
  • cervical cytologist
  • clinical perfusionist
  • clinical scientist: audiology
  • clinical scientist: biomedical engineering
  • clinical scientist: blood transfusion
  • clinical scientist: cardiac physiology
  • clinical scientist: clinical biochemistry
  • clinical scientist: clinical bioinformatics and Genomics
  • clinical scientist: clinical engineer
  • clinical scientist: critical care
  • clinical scientist: clinical genetics
  • clinical scientist: clinical immunology
  • clinical scientist: clinical measurement
  • clinical scientist: clinical pharmaceutics
  • clinical scientist: cytopathology
  • clinical scientist: data science and modelling
  • clinical scientist: decontamination and sterile services
  • clinical scientist: gastrointestinal physiology
  • clinical scientist: haematology
  • clinical scientist: health Informatics
  • clinical scientist: histocompatibility and Immunogenetics
  • clinical scientist: histology
  • clinical scientist: imaging with ionising radiation
  • clinical scientist: imaging with non-ionising radiation
  • clinical scientist: medical equipment management
  • clinical scientist: microbiology
  • clinical scientist: molecular pathology
  • clinical scientist: neurophysiology
  • clinical scientist: nuclear medicine physics
  • clinical scientist: ophthalmic science
  • clinical scientist: radiation physics and radiation safety physics
  • clinical scientist: radiotherapy physics
  • clinical scientist: rehabilitation engineering
  • clinical scientist: renal technology
  • clinical scientist: reproductive science (embryology & andrology)
  • clinical scientist: respiratory physiology
  • clinical scientist: sleep physiology
  • clinical scientist: vascular science
  • clinical scientist: vision science
  • clinical scientist: virology
  • clinical technologist: biomedical engineering
  • clinical technologist: DEXA
  • clinical technologist: medical equipment management
  • clinical technologist: nuclear medicine
  • clinical technologist: radiation physics and radiation safety physics
  • clinical technologist: radiotherapy engineering
  • clinical technologist: radiotherapy physics
  • clinical technologist: rehabilitation engineering
  • clinical technologist: renal technology
  • decontamination technician
  • epidemiologist
  • hearing aid therapist
  • medical illustration: clinical photographer
  • medical illustration: graphic designer
  • medical illustration: ophthalmic imaging technician
  • medical illustration: videographer
  • phlebotomist
  • physiologist: cardiac physiology
  • physiologist: gastrointestinal physiology
  • physiologist: neurophysiology
  • physiologist: ophthalmic science
  • physiologist: respiratory physiology
  • physiologist: sleep physiology
  • physiologist: vision science
  • reconstructive scientist

Assistant practitioners, associate practioners, healthcare support workers, maternity care assistants and medical laboratory assistants

  • non-registered staff, all bands in all working areas


  • GMC registered doctors (including doctors in training)

Nursing and midwifery

  • all bands and all parts of the NMC register

NHS24 call handlers



Operating department practitioner




  • dispensing opticians
  • optometrist


  • pharmacists
  • pharmacy technician
  • pharmacy support worker

Physician associate



Public Health roles not covered elsewhere in the list

  • public health consultant
  • public health practitioner
  • public health scientist


  • assistant psychologist
  • clinical associate in applied psychology
  • clinical psychologist
  • counselling psychologist
  • counsellor
  • forensic psychologist
  • health psychologist
  • neuropsychologist

Registered Chaplains



For clarity, within health services, we do not consider housekeeping, administration, maintenance, catering or any volunteers to be subject to the duties within the Act.

Care services

Section 7 of the Act states:

“Any person who provides a care service must ensure that at all times suitably qualified and competent individuals are working in the care service in such numbers as are appropriate for-

(a) the health, wellbeing and safety of service users,
(b) the provision of safe and high-quality care, and
(c) in so far as it affects either of those matters, the wellbeing of staff.”

Care services operate differently to health care services and it is our opinion that ‘suitably qualified and competent individuals’, in a care environment, includes all those involved in the care of the person using the service. This would include, but is not limited to;

  • nursing staff
  • care staff
  • housekeeping
  • catering
  • maintenance
  • volunteers
  • those supporting social activities and engagement in the community

There will be staff who are working for the care service but are not directly involved in the care of the person using the service, such as those in finance and marketing, and these individuals would not be included within the scope of the Act.

This approach is in line with how Regulation 15 of the Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 was interpreted and how the Care Inspectorate also interprets appropriate staffing.

The guiding principles apply to the following services:

  • a support service
  • a care home service
  • a school care accommodation service
  • a nurse agency
  • a childcare agency
  • a secure accommodation service
  • an offender accommodation service
  • an adoption service
  • a fostering service
  • an adult placement service
  • child minding
  • day care of children
  • a housing support service

It has been brought to our attention that social work services were inadvertently included in the list of care services that were within the scope of the Act. This is incorrect and we have subsequently removed it from this list. To confirm, social work services are not within the definition of a ‘care service’ within the Act. (updated 06 October 2023).


Students are referenced in the Act in section 12IK which details the types of health care, locations and employees to which the common staffing method applies. This states that when applying the common staffing method, “employees” does not include students studying to enter the Nursing & Midwifery Council register or the register of medical practitioners maintained by the General Medical Council.

This applies to pre-registration nursing, midwifery and medical students that undertake any defined ‘supernumerary placement’ as part of their learning programme. Staff undertaking training whilst employed or supported on apprenticeships or other ‘earn as you learn’ models, should be included in the definition of a ‘student’ and so be treated as supernumerary, when they are participating in a supernumerary placement or are undertaking protected learning time as detailed within the relevant course outline or conditions of employment.



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