Workforce

The aim of the Health and Care (Staffing) (Scotland) Act 2019 is to ensure that boards will provide appropriate staffing in order to deliver safe high-quality health and social care, which also supports the health and wellbeing of staff.EiC is integral to the application of the Common Staffing Method (CSM) through the provision of workforce and quality data which should be utilised alongside the other components of the CSM to inform workforce planning. This will support health boards ensure that they have the right people, with the right skills, in the right place at the right time to meet the obligations of the Act (5), and the delivery of high-quality, person-centred care.

It is widely accepted that healthcare staffing levels are associated with high-quality care, with inadequate staffing levels consistently associated with adverse patient outcomes (41-43). Lower staffing levels have been linked to higher rates of falls, pressure ulcers, nosocomial infections, longer hospital stay, increased risk of mortality, and other metrics indicative of the quality of care (44-48). This relationship between lower staffing and poorer care quality can be attributed to the increased workload for healthcare professionals and thus a decrease in the level of oversight afforded to patients (49). Additionally, the skill mix of staff within healthcare settings has been proposed as a significant contributor to care quality; whilst the number of staff is an important factor, staff qualifications and competencies also must be considered in relation to patient care needs (50, 51). Thus, in conjunction with the Healthcare Staffing Programme, measures relating to healthcare staff have been included within the CAIR dashboard to enable and encourage the senior healthcare professionals to monitor their staffing levels and inform their workforce development and planning decisions.

The CSM is a framework that supports a triangulated approach to determining the required staffing levels and skill mix. The Health and Care (Staffing) (Scotland) Act 2019 specifically highlights that areas with a staffing tool in place have a duty to follow the CSM. However, in areas that do not have a specific tool, using the key principles of the CSM provides a robust framework to review staffing. The CSM can be used to review and triangulate the outputs from the speciality specific workload and the professional judgement tool, as well as taking into account a number of other factors, including local context and quality measures in order to make a robust and evidence-based decision regarding staffing requirements. Quality is an important aspect of the CSM. The CAIR dashboard provides measures relating to healthcare staff as well as other quality indicators which can all be used to evaluate if the current staffing levels are impacting on the quality of care provided.