Nursing 'crisis' in Scotland's NHS as record number quits, says Royal College of Nursing

Nursing in Scotland’s health service is in “crisis”, a union has warned, as it urged the Scottish Government to come up with a plan to keep more nurses in the profession as the numbers quitting reached a decade high.

The Royal College of Nursing Scotland (RCN) called for the retention strategy among a series of other recommendations as part of its second annual Nursing Workforce in Scotland report, which was released on Wednesday.

Julie Lamberth, RCN Scotland board chairwoman, said: “This report lays bare the full scale of the challenges facing the Scottish Government and employers to scale the nursing workforce crisis”.

She added: “Our highly skilled and dedicated nursing workforce deserve better and the Scottish Government must bring forward sustainable domestic recruitment and retention planning that will turn the tide of persistent nursing shortages.”

As part of the 36-page report, which was released ahead of a roundtable of union members with politicians and nursing leaders, it called for the retention strategy to focus on elements like career progression, flexible working and better support to enable more nursing students to complete their nursing course.

The report made 10 recommendations to the Scottish Government and, as well as improving retention, its demands included taking steps to grow the number of nurses by increasing student places and expanding the routes into the job.

The recommendations come as the RCN found the number of registered nurses leaving the NHS in Scotland increased to 4,238 in the year to March 2022, which it said was the highest number of registered nurse leavers in one year over the past decade.

And, in 2022, some 8% fewer applicants were accepted onto an undergraduate nursing course at a Scottish university compared to 2021, it said.

There were nearly 600 fewer nursing students starting university in autumn 2022 than the Scottish Government’s recommended intake target of 4,536, the report found.

Ms Lamberth said: “With the NHS vacancy rate running between 8% and 9% throughout 2022, with the number of nurses leaving the profession reaching the highest level for 10 years, and with ever more numbers of care homes reporting nursing vacancies, it’s no wonder that our health and care services are under severe pressure.

“As worrying is the decrease in the number of people applying to universities to study nursing. In addition, millions are being spent on temporary staff to try to fill the gaps.”

The report also called for the Scottish Government to “deliver on its commitment to review Agenda for Change to support recruitment, sustainability and retention”.

Colin Poolman, RCN Scotland’s director, said the review into the pay band scale “must not be kicked into the long grass”.

“Our nursing staff need the Cabinet Secretary for NHS Recovery, Health and Social Care and Scottish Government to be focused fully on the task in hand,” he said.

“It’s only a year until the Safe Staffing Act comes into force and we still have near-record nursing vacancies.

“The clock is ticking for the Scottish Government to find effective solutions to the nursing workforce crisis.”

Health secretary Michael Matheson said the Government “value the work of our nursing staff” and workers on the Agenda for Change scale had a “pay deal worth more than £1 billion over the last two years – ensuring nurses in Scotland remain the best paid in the UK”.

He said: “We have also set up a Nursing and Midwifery Taskforce which includes the RCN and RCM (Royal College of Midwives) as well as recognised nursing and midwifery workforce experts, alongside academia, NHS and Scottish Government representatives. This taskforce, which I am chairing, held its first meeting on April 6.

“It will build on efforts to make Scotland the best place for nurses and midwives to come and work by developing plans for the retention of the existing nursing workforce, as well as looking at recruitment. We aim to make our nurses the best paid in the UK, as well as also having the best conditions and career opportunities.”