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Scotland’s health and care safe staffing legislation has come into effect, five years after the law was passed in the Scottish Parliament.
Nurse leaders in Scotland have welcomed the move, but have urged for greater investment in the nursing workforce, as vacancy rates in the country remain high.
“Implementation must be accompanied by investment, innovation and continued scrutiny”
Colin Poolman
The Health and Care (Staffing) (Scotland) Act was first passed in Holyrood in 2019 but had its implementation delayed for five years, largely due to the Covid-19 pandemic.
The landmark legislation has set out requirements for safe staffing levels across both health and social care settings.
The Act places a legal duty on NHS and social care providers to ensure that there are always suitably qualified staff working in the right numbers for safe and effective care.
Meanwhile, the law also imposes a duty on the Scottish Government to ensure that there are enough registered nurses, midwives and medical professionals available to enable employers to meet their duty.
Healthcare Improvement Scotland and the Care Inspectorate will be responsible for monitoring compliance with the Act in the health and social care sectors respectively.
Scotland’s cabinet secretary for NHS recovery, health and social care, Neil Gray, said the law would ensure services were “more effective, efficient and sustainable”.
He added: “It will help put in place systems and processes to allow real-time assessments of staffing levels, meaning resources can be managed more easily, and that people can get the right care, at the right time, in the right place.
“The Act will also help to embed a culture of openness, so workers are informed about decisions relating to staffing and feel able to raise any concerns.”
The legislation states that any providers of a healthcare service must ensure that individuals working within that service receive appropriate training for the work they will perform.
This includes normal day-to-day training to do their job properly, but also training on the new safe staffing regulations, which are outlined in the Act.
Additionally, the law states that any individuals who may have to undertake new duties as part of the Act must also be trained how to do so.
This is most notable for nurse leaders who may be tasked with duties such as assessing staffing in real time, identifying and mitigating risks and ensuring adequate time is given to those with staffing responsibilities.
The Royal College of Nursing (RCN) in Scotland, which helped shape the legislation, has welcomed implementation of the law but has highlighted the need for further investment in the nursing workforce.
The union noted that the legislation had come into force while nursing vacancy rates in Scotland remain high and staff shortages continue to impact the healthcare workforce across the country.
It comes as latest workforce data revealed that there were 4,096 nursing and midwifery vacancies in Scotland’s NHS.
In addition, recent data from the Universities and Colleges Admissions Service (UCAS) showed that applications to study a nursing course in Scotland in 2024-25 fell by 8% compared to the previous year.
Meanwhile, a new poll carried out on behalf of RCN Scotland revealed that 84% of the public believed there are not enough nursing staff across healthcare services to provide safe and effective care.
The poll, which was carried out between 20-22 March, also found that over 90% of the public said more should be done to protect the wellbeing of nursing staff, while 84% said nursing staff should be paid more for what they do.
Colin Poolman, director of RCN Scotland, said: “Given the role we played, we must welcome the implementation of this important legislation and remain hopeful that this, along with the Ministerial Nursing and Midwifery Taskforce, will provide the environment for positive change.”
Mr Poolman noted the results of the recent poll and said the Scottish public were “experiencing first-hand the impact of record waiting times and staff shortages”.
He added: “Today marks an important milestone but implementation must be accompanied by investment, innovation and continued scrutiny, if we are to retain existing nursing staff and establish a sustainable nursing workforce for the future.”
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