Professional voices: practical solutions
a manifesto for 2016
Nurses and health care support
workers work with individuals and
communities in all their diversity.
They work tirelessly to support,
empower and comfort those in their
care. They believe in team work and
innovation; in providing quality care
to all without prejudice, condition or
complaint; they treat patients with
compassion, dignity and respect.
As a nursing team they work around
the clock, often managing with skeleton staff and only minimal
services. It is physically and emotionally challenging.
They celebrate lives getting longer, but care for the
consequences, supporting people living with multiple conditions
and complex needs. They see first-hand health inequalities
widening in vulnerable communities across Scotland.
Things have become more challenging for them, the teams they
work in, and for their patients as budgets get tighter and demand
on services grows. They feel that their work is undervalued by
those that take decisions, although cherished by those in their
care. They have less time than they want to care for their patients,
they have fewer resources and the pressure under which they work
is ever increasing.
Individuals standing for election to the Scottish Parliament have
difficult choices to take, but they have the opportunity to build a
better health and care system for Scotland. A system which values
nursing wherever care is delivered; organisations which strive to
improve patient care, and a country which invests fully in health.
I know that our members, the nurses and health care support
workers on the frontline, are ready to take their place to help
Scotland’s elected representatives to achieve that vision.
That’s why we asked them to tell us what they felt needed
to change.
Nursing Scotland’s Future is their answer.
Michael Brown,
Chair of RCN Council and RCN Scotland Board
Decisions are made to shape
health and care for generations
to come, rather than focussing
on short-term goals
We hear a lot about the pressures on
Scotland’s health care services. In fact,
we hear the messages so often that it’s
easy to become immune to the warnings.
But nurses and health care support
workers tell us that the way in which
health care services in Scotland are
delivered must change, and quickly.
Work has started to re-shape services.
We have seen the shift towards integrated
health and social care and more
discussion around care in community and
home settings instead of hospitals. We
must continue to think about the long
term, and what needs to change to ensure
that decisions made in the fifth session
of the Scottish Parliament are felt for
generations to come.
As a country we need to do more to
make our NHS sustainable and to address
the fact that people’s health is too often
determined by where they live. That means
us all rising to the challenge of thinking
differently, thinking about the long term,
and coming together to agree a new set of
principles to guide the decisions our new
MSPs will take on our behalf.
How you can support our
members’ vision:
•Work with your MSP colleagues,
regardless of the party they
represent, to agree a new approach
to health care targets by the end
of 2016. This new approach must
help our health care services to be
sustainable in the long term and must
improve the clinical outcomes for all
of our patients.
•Support the creation of a set of
clear, consistent and transparent
criteria to be used when MSPs or
government take any decision on
health care funding. The new Scottish
Government should hold a public
consultation to decide these principles
with the Parliament agreeing them
before the first Budget is debated.
Having a shared set of principles on
which to base funding decisions will
support MSPs to make the difficult
but necessary choices, and allow for
rigorous scrutiny.
A government-led workforce and
skills impact assessment is carried
out each time a new health or
social care policy is proposed
Scotland’s health care services are
constantly evolving to meet the growing
demands being placed upon them and to
ensure that patients receive the best care.
Those who look after us in hospital, at
home or in our local area are the ones who
spearhead transformation and make any
policy come to life.
Since 2011 there have been numerous
government-led reviews, working groups
and taskforces looking at different
aspects of health care. Too often their
recommendations pull our health care
professionals in different directions,
asking them to change the way that they
work without considering the additional
skills and knowledge they need to do so.
Those making decisions must have a
comprehensive and unambiguous view
of how their recommendations will affect
Scotland’s health care workforce. By
working together to fully understand the
impact of any proposed changes we can
ensure that Scotland has the right people
with the right skills in the right place ready
to treat and care for patients no matter
their illness or where they ask for help.
How you can support our
members’ vision:
• Work with us to ensure that the next
Scottish Government commits to
long-term workforce planning across
all health care services whenever a
new health or social care policy is put
forward. This will help to guarantee
that multidisciplinary teams have the
right number of staff, with the skills
and knowledge they need to deliver
for patients.
• Stand up for protected time for
continuous professional development
for each and every member of the
multidisciplinary health care team. It
is crucial that those delivering patient
treatment and care receive cuttingedge training and development so
that they are equipped to deal with
the increasing complexities that they
face every day.
Digital technologies are used to open
up new, smarter ways of working for
health care teams, especially those
operating in the community
The availability of new technology has
revolutionised the way that we all live,
work and communicate. In the health
care sector having the right technology
in the right place has enormous potential
for both staff and patients. It can
make it easier to share knowledge and
information with patients and peers.
When used appropriately technology can
help to deliver better, safer care.
Projects which have been tested
and rolled out are already making a
real difference to health care staff and
patients. But our members, particularly
those who work in remote and rural
areas, are frustrated with the limitations
of IT systems and connectivity: something
as simple as calling a colleague for advice
is impossible without a mobile signal.
Others say that they need additional
knowledge and skills to use new
technologies safely and effectively and
to support their patients to do the same.
To make the most of the technologies
available to support better health and
better care we must work together to
address these challenges.
How you can support our
members’ vision:
•Engage with your local health board
and integration joint board to ensure
that by 2020 all health care staff in
your area have access to, and are
able to use with confidence, the
technology they need to deliver safe
and consistent care.
•Commit to supporting continued
digital infrastructure development
in your local area, and campaign for
improvements where there are gaps.
Scotland-wide connectivity is key if
we are to use technology to its full
potential to support health care. Work
is already underway, but it will take
service providers, local residents,
professionals from across a variety
of sectors, elected representatives
and governments working together
to achieve the vision.
The pivotal role of senior charge nurses
in leading safe, effective, patientcentred care is recognised, respected
and properly remunerated
Senior charge nurses are essential to our
health care system. Whether on a hospital
ward, in a mental health team, or out in
the community, these nurses lead and
support the teams who look after us and
our loved ones. Their experience and
expertise must be valued.
Scotland’s senior charge nurses are
responsible for everything that happens
within their team, whether it relates to
patient care, safety or staff performance.
They are the guardians of clinical standards.
Their role is essential in ensuring that
patients receive safe, effective care.
On top of their leadership, management
and mentoring responsibilities, these
nurses are expected to cover dayto-day nursing duties if their team is
short staffed. These highly-skilled and
experienced professionals are under
intolerable pressure. It is no longer a role
which many of our members aspire to
because of the ever-increasing burden
being placed upon senior charge nurses.
Things must change, because these senior
nurses hold a pivotal role across our
health services.
How you can support our
members’ vision:
•Back our call to ensure that in every
health board senior charge nurses
have the time to lead their teams.
They should be ‘supernumerary’ –
that is, not counted in the number
of staff needed to provide safe and
effective care – giving them the time
they need to assure both excellent
care and clinical standards.
•Campaign with us for all senior
charge nurses to be paid at a level
appropriate to their responsibility.
The accountability which comes
with the role, and the experience
and expertise which a nurse must
have to be working at this level,
should be recognised and properly
remunerated.
Scotland’s politicians champion
better pay, terms and conditions for
members of nursing teams, no matter
their grade or where they work
Nursing teams work incredibly hard in the
most challenging of circumstances. They
are dedicated to their patients and they
want to give the best care possible. But
their dedication does them a disservice
when it comes to fighting for the pay and
conditions which they deserve.
These individuals are educated,
skilled and knowledgeable in their
field. Day in and day out we, and our
families and friends, trust them with
our lives. Many of them are struggling
financially because of pay awards well
below inflation in the public sector. Those
working in the care home sector are
feeling the squeeze because of the cuts
in local council budgets; and the stagnant
pay in the independent and third sector
is affecting those who support patients
outside our NHS.
Scotland’s nursing teams deserve
better. They should be valued as
integral members of the multidisciplinary
teams we need to deliver care now
and rewarded appropriately for their
skills, education and knowledge.
How you can support our
members’ vision:
•Commit to upholding and recognising
the independence of the NHS Pay
Review Body. It is vital that the NHS
Pay Review Body is able to carry
out its assessment of pay free from
political interference and that its
recommendations are upheld.
•Work with us to preserve terms and
conditions for our members. We
want to work with you to ensure
that nurses and health care support
workers are paid fairly, and do not
have their terms and conditions
eroded. We welcome the fact that
trade unions are seen as a positive
force for change in Scotland, and we
want to work in partnership with you
to ensure that continues.
What matters most to RCN Scotland members
Clarity development
continuity
respect
care
focus
services
safety
leadership
colleagues service self-management
funding
education
individual
investment
knowledge
time
staff
patients valued
listening
professionalism
safe workforce advocate
support
prevention compassion
dignity
empathy
systems
training
planning
resources outcomes
teamwork confidence
supervision
direction
patient
quality
wellbeing patient-centred
empowering communication
consent people
excellence
pay
twitter@RCNScot #nursing16
I support
Signed
www.rcn.org.uk/scotland
VALUE
NURSES
IMPROVE
PATIENT CARE
INVEST
IN HEALTH AND CARE
The Royal College of Nursing (RCN) is the
world’s largest professional organisation and
trade union for nursing staff, with members
in the NHS, independent and voluntary
sectors. RCN Scotland promotes patient and
nursing interests by campaigning on issues
that affect our members, shaping national
health policies, representing members on
practice and employment issues and providing
members with learning and development
opportunities. With around 40,000 members
in Scotland, we are the voice of nursing.
www.rcn.org.uk/scotland
twitter@RCNScot
#nursing16
RCN Scotland
42 South Oswald Road
Edinburgh EH9 2HH
January 2016