Nursing and Midwifery Shifts - FOI Response Register

1. Confirmation that when nursing and midwifery shifts are not fully staffed, it is recorded by the board.
2. The number of nursing and midwifery shifts recognised and recorded as not being fully staffed in the current financial year 2024/25.

3. Please also provide the number of nursing and midwifery shifts recognised as not being fully staffed in the last six financial years (2018/2019, 2019/20, 2020/21, 2021/22, 2022/23, 2023/24).
4. Confirmation that the board has a definition of ‘safe staffing numbers’ for wards and shift patterns and that these numbers are communicated to staff.

Clarification: Safe staffing numbers refers to a standard by which the board measures the safety and wellbeing of patients according to the number of staff working on the ward.

There is no set safe staffing level for our hospital. This will depend on various factors including: case load, skill mix, demand and professional judgement in real time.

The Health and Care (Staffing) (Scotland) Act 2019 came into force on the 1 April 2024.  The Act makes provision about staffing in the NHS and care services to ensure that safe, high quality care and improved outcomes can be delivered for people experiencing care.

The Act builds on existing legislation, policy, local practice and guiding principles to ensure safe staffing and to protect the wellbeing of patients and staff.

Whilst the Act applies to ALL Clinical Staff & Senior Leaders within ALL Healthcare Professions e.g. Nursing & Midwifery, AHP, Medical, Dental, Pharmacy, Psychology, Healthcare Scientists etc. the Act does not prescribe staffing levels for departments nor hospitals but provides a range of resources, eg staffing level tools & Professional Judgement Tool, the output of which can be used as part of the Common Staffing Method to inform future staffing models.

The Act does not seek to prescribe a uniform approach to workload or workforce planning. It allows the development of suitable approaches for different professions and care settings.

In order to ensure compliance with the Act, NHS Shetland has the following in place:

Healthcare staffing programme Board to oversee implementation of the Act;

Promotional materials to increase awareness of the Act for patients and staff eg posters, briefings;

Educational resources via TURAS learn – all staff to undertake the Informed Level training – Fundamentals of Health and care staffing, further targeted training for individuals with specific roles.

Compliance with requirement to undertake staffing level tool runs as per Act Specification ie minimum of once per annum in all services with a speciality specific tool;

Use of Common Staffing Method as a Framework to inform workforce planning within services as part of the annual workforce/service/financial planning cycle;

Real time staffing risk assessment with consideration of severe and recurrent risks – utilising organisational systems to both mitigate and escalate risk to senior decision makers.

Further information can be found at Healthcare Staffing Programme – Healthcare Improvement Scotland

5. The number of instances in 2024/25 in which nursing and midwifery shifts were recognised as being below safe staffing numbers.
6. Please also provide the number of nursing and midwifery shifts recognised as not being fully staffed in the last six financial years (2018/2109, 2019/20, 2020/21, 2021/22, 2022/23, 2023/24).