NHS Scotland crisis: Scotland needs nearly 4,000 nurses as 'demand continues to outstrip supply'

A report released on Wednesday by the Royal College of Nursing (RCN) Scotland has called for a plan to keep nurses in the health service.

“The Scottish Government must develop and implement a fully funded nursing retention strategy that addresses wellbeing, workplace culture, development opportunities, flexible working and career progression by April 2025,” one of the report’s ten recommendations said.

In the year up to December 2023, NHS Scotland figures showed the number of nurses rose from 61,567 whole-time equivalent (WTE) staff to 63,605. However, vacancies in the field have remained high, with 3,961.8 WTE posts still unfilled as of the end of last year.

Scotland, the RCN’s report found, also lagged behind the Organisation for Economic Co-operation and Development (OECD) average of 9.2 nurses per 1,000 of the population, with 7.9. The country was also well behind the figures for Finland, Norway and Ireland, which boasted 18.9, 18.3 and 15.2 respectively.

RCN Scotland board chair Julie Lamberth said the situation was “not sustainable”.

“At no point has NHS Scotland employed the number of nursing staff, it says it needs to deliver safe care and the registered nurse to resident ratio in many care homes makes safe care impossible,” she said.

“At the same time, with the squeeze on budgets, we are hearing reports of nursing roles being axed. The Scottish Government must get serious about the workforce crisis and the long-term implications for the public’s health.

“Nursing vacancies are having a damaging impact on our members’ ability to provide safe and effective care. And on their own wellbeing, when shift after shift they work extra unpaid hours to cover gaps and go home feeling that they are unable to provide the quality of care they want.”

Colin Poolman, the director of RCN Scotland, said: “Nurses and nursing support workers across Scotland are under paid, under-staffed and many are at breaking point. The current service pressures, and staff shortages, have resulted in unsafe conditions being normalised.”

Among the other recommendations were calls for nurses to have “fair pay, good employment terms and safe working conditions”, as well as for the Government to implement a recent review to provide time for training and a shorter working week.

Scottish Labour deputy leader Dame Jackie Baillie said the report showed “SNP incompetence has led to the workforce crisis in our NHS persisting”.

“Almost one in six Scots are on a waiting list, A&E is in chaos and waiting times are rising,” she said. “That the SNP has failed to act to support our NHS by bolstering the nursing workforce is simply unacceptable.

“Scotland’s nurses are working tirelessly to save lives and keep people safe, but it is clear that the SNP Government is not on their side.

“[Health secretary] Neil Gray needs to wake up to the NHS workforce crisis unfolding on his watch and respond to the RCN Scotland’s recommendations, including its call for a comprehensive nursing retention strategy.”

Health secretary Neil Gray said: “We greatly value the vital contribution of our nurses to Scotland’s NHS and I thank them for their continued dedication and compassion. Nurses in Scotland remain the highest paid in the UK and we also provide the highest non-repayable, non-means tested bursaries at £10,000 for eligible nursing and midwifery students – as well as reimbursement of expenses and a range of allowances to support entry to the profession.

“However, I know that more needs to be done to recruit and retain our valuable workforce and that is why I am chair of the Nursing and Midwifery Taskforce, which aims to build on efforts to make Scotland the best place for nurses and midwives to come to work.

“The taskforce brings together stakeholders representing all aspects of nursing and midwifery across Scotland, including HEIs, the RCN and RCM [Royal College of Midwives], working collaboratively to identify recommended actions to form the output of the taskforce. The RCN is fully engaged with this work and will be helping to shape the final recommendations for the taskforce.

“Whilst there is a lot of work already underway to support a sustainable and skilled workforce, the taskforce will help us identify gaps and prioritise work, focusing on tangible outcomes that will futureproof our workforce in light of the ongoing demands that our services face.”