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

Part 5: Conclusion

The first year of implementation of the Health and Care (Staffing) (Scotland) Act 2019 has seen Health Boards across Scotland take significant steps to embed the principles and duties of the legislation into their operational and strategic frameworks. The evidence presented in this report demonstrates an ongoing commitment to ensuring safe and high-quality care through appropriate staffing decisions, supported by the implementation of robust governance, professional judgement, and the progressive adoption of digital systems.

Boards have made notable progress in integrating the Common Staffing Method and staffing levels tools into their workforce planning activity. The development of local governance structures, the expansion of eRostering and the associated SafeCare module, and the strengthening of clinical leadership arrangements have all contributed to improved visibility, responsiveness, and assurance in staffing decisions.

Notwithstanding this, since this is the first year of the Act being in place, naturally there are some challenges to full implementation. Whilst they are key enablers and useful tools, rolling out digital systems across Health Boards is complex and takes time. As set out in this report, this challenge and the others mentioned are being addressed both locally and nationally. The reporting responsibilities introduced under the Act ensure transparency and accountability which will further aide in addressing common difficulties.

With this in mind, Health Boards have shown resilience and adaptability, with many actively reviewing their systems and structures to better support the delivery of the Act’s duties. The Scottish Government recognises the importance of these efforts and remains committed to supporting Boards through strategic oversight and continued engagement.

The Scottish Government will continue to work in partnership with Health Boards, Healthcare Improvement Scotland, and other stakeholders to ensure that the principles of the Act are fully embedded in practice. The progress made to date provides a strong foundation for this work, and the Scottish Government remains committed to a sustainable and resilient workforce for the future of healthcare in Scotland.

This report also demonstrates the progress made by Local Authorities, Integration Authorities, and care service providers in embedding the duties of the Health and Care (Staffing) (Scotland) Act 2019 into their planning, commissioning, and delivery of care services.

While there is clear evidence of proactive compliance and innovation across the care sector, persistent challenges remain, particularly around recruitment, retention, training capacity, and financial sustainability.

Considering the information provided within the Authorities reports, it is clear that although staffing level challenges were raised, no Authority reported that they were unable to comply with the duties within the Act. In addition, of the 89.9% of registered care providers who responded to the Care Inspectorate’s 2024 Annual Return, 3.7% self-assessed as not meeting their duties within the Act. Scottish Ministers note the limitations of this self-assessed data, as set out earlier in the report. We expect providers not meeting the duties within the Act will be considered and managed by Local Authorities who commission services, through contract management arrangements.

The Care Inspectorate’s scrutiny and improvement work focuses on outcomes for people. The Care Inspectorate works with services to support improvements for people experiencing care. If they find outcomes and experiences are not being met, they will take action to address this.

While the Scottish Government has overall responsibility for health and social care support policy in Scotland, statutory responsibility for delivering, commissioning, providing appropriate care capacity and charging for services at a local level lies with Local Authorities, NHS boards and Integrated Joint Boards (IJBs), and private providers themselves.

The Scottish Government continues to take steps to support the sector through targeted funding, strategic workforce initiatives, and collaborative policy development. Looking ahead, ensuring a sustainable, skilled, and valued care workforce will be critical to delivering high-quality services and achieving the ambitions set out in the Service Renewal Framework and National Workforce Strategy^[23].