New flagship laws to underpin “safe” numbers of doctors and nurses in Scottish hospitals will not be enough to guarantee patient care, medical leaders have warned MSPs.
There is even the prospect of “unintended consequences” which could work against the quality of care under the Health and Care (Staffing) (Scotland) Bill. Medical organisations have broadly welcomed the move to enshrine the need for adequate levels of staffing in the NHS in statute.
MSPs will take evidence on the Bill this week but there has been a mixed response, with concerns that “staffing models” alone will not tackle problems with staff recruitment and retention.
“Improving the working environment by ensuring adequate hospital and social care resources will also mitigate this problem,” the Royal College of Emergency Departments states in its submission to MSPs.
It says patient safety is down to more than just staffing and includes appropriate resources in the system.
“If there are not enough hospital beds, social care capacity or public health facilities, some patients will still not receive safe, dignified or timely care.”
It warns that patients are robbed of “dignity, respect and high-quality care” in some cases when they are forced to spend up to 12 hours on a trolley. Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy, warns of “fundamental weaknesses” in the legislation and says the body will not support it.
Staff may be shifted from other areas of the NHS to acute care just to meet the requirements of the legislation.
Prof Middleton also warns that it will not tackle the nurse staffing shortages. “These shortages stem from problems in strategic workforce planning and recruitment and retention in the nursing professions, which the legislation will not address.”
The Royal College of Nursing has backed the Bill but warns that it will need “significant amendments” to meet its aims.
However, the RCN questions whether the Bill can be “implemented fully without significant investment – particularly in the workforce – and without recognition of the reality of current workforce pressures, and with the likely future increased demand on services”.
The need to use tools to assess staffing could “stifle innovation” and new ways of working to meet the changing demands of the NHS, according to the Chief Officers Group Health and Social Care.
“There is also a risk that a focus on the use of specific tools results in a ‘tick box’ culture focused on processes and detracts from focusing on outcomes,” it adds in a submission.