Health boards are facing a growing staffing problem which could threaten Scottish Government proposals for a properly resourced seven-day health service, two leading health professional organisations said today.

The Royal College of Nursing (RCN) and Royal College of Physicians of Edinburgh (RCPE) fully support the recommendations in the consensus statement published following the RCPE UK consensus conference last weekend (15-16 November), including the need for proper seven-day working. However, both organisations believe the whole system of how services are staffed and resourced needs to be reviewed to make sure the right number of staff and beds are in place to safely care for the increasing number of patients seven days a week.

RCN Scotland Director Theresa Fyffe said,

“The latest NHS workforce statistics show that the gap between the number of nurses health boards say they need and staff actually in post is widening. This is at a time when health boards are struggling to cope with increasing demands on services under current ways of working before they are required to provide the same level of service at weekends as well as weekdays.

“We have been saying for long enough that there are not enough nursing staff in post to care for patients safely. Health boards cut nurse numbers too far in recent years, with around 1,800 posts lost between September 2009 and December 2012. So it’s good news for patients that they are recruiting again as the continued modest increase in overall nurse numbers shows. It means that health boards recognise they need more staff to look after the increasing numbers of patients and try to cope with the all-year-round pressures that are now the norm in our NHS.

“But with more than 1,700 nursing posts still vacant, health boards are having to run fast just to stand still. We do have nationally-mandated workforce tools which, if applied properly and combined with professional nursing judgment, tell us just how many staff are needed. But health boards are now struggling to find the staff they say they need. This situation raises concerns about how in the future health boards will be able to staff all the services needed for a seven-day NHS both in hospitals and out in the community, not just doctors and nurses, but physiotherapists, radiographers, porters and cleaning staff as well.”

Dr Neil Dewhurst, President of the Royal College of Physicians of Edinburgh, said,

“The College is committed to working towards a seven-day service for patients, but there is a risk that this will be little more than a lofty ideal without an increase in the medical and nursing workforce.  We have to deal with the problems which currently exist and are impeding progress before we can develop hospital services further. Medical and nursing staff are already under great pressure as we enter the winter, with little capacity to respond to the increased demand which will be experienced at this time. While the Scottish Government has recently signalled its intent to eliminate boarding, temporary increases in bed capacity without an accompanying increase in the appropriate medical and nursing staff to support these additional beds will not assist the delivery of this shared objective. Instead, this will only serve to put further pressure on already over-stretched teams and prolong the practice of boarding which it has been shown can increase the length of stay, rates of readmission to hospital and death rates in patients. It is, therefore, essential that bed and staff capacity are aligned to meet demand and that the medical and nursing workforce is expanded in Scotland.

“In parallel, the working and training environments have to become more attractive to recruit and retain doctors and nurses successfully. Unfortunately, all too often the working pressures are so great that positions remain unfilled. This creates further pressure on staff and the vicious circles continue. By investing in the appropriate staff we can improve the level of care provided to patients, reduce the pressures which exist in our hospitals and work towards the delivery of a genuine and sustainable seven-day service for patients.”

ENDS

For further information or to arrange an interview, please call:

  • RCN - 0131 662 6173 or the out-of-hours press officer on 07962 801005.
  • RCPE – 0131 247 3693 or 07733 263453.

Notes to editors

The Royal College of Nursing (RCN) is the world’s largest professional organisation and trade union for nursing staff, with members in the NHS, independent and voluntary sectors. RCN Scotland promotes patient and nursing interests by campaigning on issues that affect our members, shaping national health policies, representing members on practice and employment issues and providing members with learning and development opportunities.  With around 39,000 members in Scotland, we are the voice of nursing.

The RCPE is a professional membership organisation. We strive to develop standards of medical care and training, and to influence health policy on behalf of physicians and our patients. The RCPE has over 12,000 Fellows and Members, the majority being hospital specialists (both consultants and trainee doctors). www.rcpe.ac.uk

  • The latest workforce figures and data on service activity, published today (26 November), can be found on the ISD website http://www.isdscotland.org/.
  • Vacancy rates are a key indicator that show the difference between the number of staff actually in post and the number of posts health boards say they need. The vacancy rate in June 2012 was 1.7%; in the latest ISD statistical release this has risen to 3.0%.