Publication - Corporate report

Transforming Nursing, Midwifery And Health Profession (NMaHP) roles: review of Clinical Nurse Specialist and Nurse Practitioner roles within Scotland

Published: 5 Aug 2021
Chief Nursing Officer Directorate
Part of:
Health and social care

The report of the Short Life Working Group (SLWG) set up by the Chief Nursing Officer (CNO) to review the role of the Clinical Nurse Specialist as part of the Transforming Roles Programme, and improve national consistency in Scotland for Clinical Nurse Specialist and Specialist Practitioner roles.

Transforming Nursing, Midwifery And Health Profession (NMaHP) roles: review of Clinical Nurse Specialist and Nurse Practitioner roles within Scotland
5. National Workforce Reporting

5. National Workforce Reporting

National workforce information demonstrates that there were a total of 1,961.7 WTE Clinical Nurse Specialists employed across NHS Boards in Scotland as at 30 September 2017.[14] Current workforce information is only available for CNS roles within NHS Boards; however, there are also Clinical Nurse Specialists working elsewhere in the public sector as well as within the third and independent sectors in Scotland.

The majority of Clinical Nurse Specialists recorded on the Scottish Workforce Information Standard System (SWISS) are employed between Bands 6 and 8a (see Table 1). There are currently inconsistencies in recording these roles on SWISS. Boards should align the recording of Clinical Nurse Specialist posts on SWISS in line with the new definitions set out in this report.

The process for recording roles on SWISS has until now allowed line managers to make a decision as to whether a nurse fits the current definition and should therefore be recorded as a Clinical Nurse Specialist. Within the Clinical Nurse Specialist classification on SWISS, there are 79 'specialist areas' to select from. However, these categories do not cover all specialty areas and 15% of Clinical Nurse Specialist classifications found to have been labelled as 'unknown' or 'other'. The current list of values for specialist area includes a variety of different classification systems, including medical specialities and sub-specialities, diseases and types or places of care. Accuracy moving forward will be crucial for workforce planning, particularly as recent statistics suggest that approximately half of Clinical Nurse Specialists are aged 50 and over.[15]

Work is underway to consider how the quality and accuracy of reporting CNS roles can be improved. Other workstreams within the Transforming Roles programme are now also developing an approach to improve consistency of recording and coding within ISD. This work is ongoing, with NES now taking the lead on data quality and reporting following the transfer of national workforce data and intelligence functions from 1 October 2019.

Agenda for Change

Table 1: WTE Number of CNS Roles within NHS Boards in Scotland as at 30 September 2017 [16]
Total Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c
1961.7 20.3 790.2 1018.2 99.8 30.2 3.0

It is proposed that following sign-off against competencies, the Level 6 role will equate to Band 6 (Agenda for Change) at a minimum, and the Level 7 role will equate to Band 7 (Agenda for Change) at a minimum.