Health and Care (Staffing) (Scotland) Act 2019 2024/25 Ministerial Annual Report

Foreword

The Health and Care (Staffing) (Scotland) Act 2019 (“the Act”) is the UK’s first multidisciplinary staffing legislation and Scotland became world leading by enshrining such legislation which applies across our entire health and care system. This legislative step reflected our unwavering commitment to delivering high-quality care and improving outcomes for service users.

The core aim of the Act, to enable better care through appropriate staffing, has been the subject of much focus in its first year of implementation. Early evidence indicates that the Act is fostering greater transparency in staffing decisions and cultivating a culture of openness and honesty. Staff are increasingly empowered to participate in decision-making processes and to raise concerns safely and constructively. This engagement is not only vital for maintaining adequate staffing levels but also for aiding in more robust staffing decisions.

Health Boards, Local Authorities and Integration Joint Boards commissioning are services required to publish and submit annual reports to Scottish Ministers detailing how they have carried out their statutory duties under the Act. This Ministerial report provides a comprehensive summary and analysis of the findings from those annual reports, alongside data from the regulators of care services, highlighting the progress made, areas of success, and areas for further development when implementing the Act across Scotland’s health and care services. It also describes the practical steps the Scottish Government is taking to satisfy its legal obligations under the Act.

For health services, the majority of Boards indicated either reasonable or substantial assurance in terms of their compliance with the duties contained in the Act in the first year following commencement. The Common Staffing Method and real-time staffing assessment are recognised features of the way we plan for services and a range of other governance structures, systems and processes have also been introduced to ensure staff are supported to deliver high quality treatment.

We are supporting Health Boards in their compliance through active collaboration and support. Through our expansion of medical undergraduate places and specialty training roles we are building capacity across our medical workforce to ensure it is able to meet the future demands we face. In support of Nursing and Midwifery we are working to implement Phase Two of the Nursing & Midwifery Taskforce (NMT) and the package of support we provide for Scottish Nursing and Midwifery students is at its highest level, unmatched across the UK. In addition, In October the formation of a new Scottish Maternity and Neonatal Taskforce was announced which will provide strategic and national leadership over issues reported in these services.

For care services, all Local and Integration Authorities set out the structured and proactive steps they have taken to embed the Act’s requirements into their processes in their annual reports, to demonstrate compliance with the Act’s duties following implementation in April 2024.

With regard to care services, in 2021, we committed to increasing social care spending by 25% (over £800 million) by 2026–27. This target was achieved two years ahead of schedule, as confirmed in April 2024, with the Scottish Budget for 2024–25 delivering the full uplift.

Programmes such as the Joint Social Services Taskforce, Earn and Learn Blueprint, Programme for Scotland’s Childminding Future, and the National Induction Framework are helping to attract, retain and develop a skilled workforce.

These targeted steps should be viewed alongside broader plans to reform our health and social care system in order to ensure our services and the people who deliver them are well placed to meet the future demands we face.

Through our Public Service Reform strategy, we have set out the way in which all public services must evolve if they are to meet our future needs. Our Service Renewal Framework (SRF) describes how we will give effect to these ambitions for health and social care.

The SRF recognises that our workforce will be deployed differently in the future to achieve improved outcomes for the people of Scotland. We will work with partners to strengthen workforce planning for services which will be increasingly designed based on population needs. The day-to-day experience of the workforce in delivering those services will also improve through better use of digital systems to streamline support and reduce the administrative workload, freeing up capacity so staff can spend more time with individual patients and people, supporting us to deliver the aspirations of the Act. Our efforts in this space will be shaped by the feedback we are gathering through our Future Medical Workforce project which will be considered alongside the outputs of the NMT. We will also explore further opportunities to support our workforce through the establishment of NHS Delivery, a new national organisation tasked with driving innovation and delivering more on a Once for Scotland basis

While the full impact of the Act will be realised gradually, the foundations laid in its inaugural year are promising. The annual reports submitted by health and care providers offer valuable insights into how the legislation is being embedded in practice and highlight areas of success and ongoing development

The Scottish Government remains committed to working collaboratively with health and care providers, Local and Integration Authorities, professional bodies and Trade Unions, Health Improvement Scotland and the Care Inspectorate to build on this momentum. Together, we will ensure that the principles of the Act continue to be upheld and strengthened, year on year, delivering lasting benefits for both staff and service users across Scotland’s health and care system.