Scottish authorities ‘should not be complacent’, according to the Royal College of Nursing (RCN), despite a report from the Nuffield Trust comparing the country’s NHS favourably over the rest of the UK.
Learning from Scotland’s NHS is a report put together by the trust to analyse what advantages Scotland holds over the other countries’ healthcare systems. Particular praise was given to the country’s methods of seeking improvement to quality and safety.
The Scottish Patient Safety Programme (SPSP), introduced in 2008, was highlighted as ‘exemplary and the keystone of quality improvement’ for the way it directly involves clinicians and managers. It has recently expanded into mental health, primary care and maternity, bringing with it ‘highly specific’ interventions and targets for improvement.
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Lead author Mark Dayan said: ‘Scotland’s well thought-through system of improving patient safety and quality of care works by engaging frontline staff in the process, and importantly the country has stuck with that approach rather than chopping and changing every couple of years.
‘The dark cloud on the horizon threatening these strengths is potentially serious financial problems. Scotland’s NHS has the same resource constraints as England and Wales, but doesn’t yet have a medium-term plan for dealing with them – and in a harsh political environment, open debate and difficult decisions can seem impossible.’
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Worries that funding deficiencies could see Scotland’s pioneering work diminished in the near future were highlighted in the report. Scotland currently has a 4% nurse vacancy rate, compared to 9% across the UK – though this is expected to change if the pay cap remains in force and once Brexit takes place.
The report praised advanced nurse practitioners (ANPs) who work on the Scottish islands – highlighting a health centre in Lerwick on the Shetland Mainland where ANPs may take on 60% of total appointments. RCN Scotland highlighted the ‘untapped potential’ of ANPs to lead further development of healthcare provision.
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Director for RCN Scotland Theresa Fyffe said: ‘Retention and recruitment of nursing staff is a real challenge in Scotland, and the Scottish government and others should not be complacent about the impact that current vacancies have on the quality of patient care.
‘The RCN in Scotland has, for a long time, warned of the impact that workforce and workload pressures are having on the morale and well-being of nursing staff.
‘While Scotland should not be seen as having all of the answers, positive partnership working does help to keep employers, staff representatives and government talking about and working to address challenges in a largely positive and proactive way.’