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A manifesto from the

Royal College of Nursing


Nursing Scotland’s Future –

make a mark, make a difference

A manifesto from the Royal

College of Nursing Scotland
Managing money

RCN Scotland priorities

Nursing Scotland’s Future
As almost one third of current Scottish
A manifesto from the Royal College of Nursing (RCN) Scotland
Government expenditure is on health,
The RCN is the largest professional nursing union in the world and NHS Scotland’s budget will be under
has over 38,500 members in Scotland. It represents nurses and
nursing, promotes excellence in practice and shapes health policies. particular pressure.
Health is almost entirely devolved to the Scottish Parliament so will RCN Scotland wants to see:
always be high on the political agenda. Health and wellbeing has the
largest annual spend of any Scottish Government department and so Financial transparency through the
will be centre stage in the difficult financial decisions ahead. publication of health board plans

Nurses enjoy the support of the public and patients and those who More use of eHealth to improve
aspire to govern should listen to our concerns. With around 1,000 patient care and save money
nurses and health care support workers in each Scottish Parliament
constituency, we will make a difference. A more efficient NHS through
eliminating waste and duplication
This manifesto sets out the issues that RCN Scotland members
believe should be the health priorities for the next Scottish  A reduction in health inequalities
Government. These priorities seek to: by ensuring money is well spent

• manage money better Support for vulnerable communities

• manage the workforce better and so public sector cuts do not hit
• make patient care better them the hardest

The next Scottish Government must listen to us so that,

together, we are Nursing Scotland’s Future.

Eileen Frame
RCN Scotland Board chair
RCN Scotland priorities

RCN Scotland priorities

Managing the Making patient
workforce better care better
Treating staff well and making the Safe and effective high-quality
best use of what they have to offer patient care must be at the heart
is plain common sense. of our health services.

RCN Scotland wants to see: RCN Scotland wants to see:

Guaranteed training and
  Policies to support whistleblowers
development in work time being fully implemented

Improved staff health and well-being

  Dignity in care taken into account
in spending decisions
A review of paperwork and enough
administrative staff Senior charge nurses free to
lead on the ward
Proper workforce planning so that
cuts do not compromise patient care Clinical nurse specialists supported to
do the job they’ve been trained for
Appropriate use of all members
of the nursing team Community nurse leaders as decision
makers, including holding primary
care contracts
Managing money better
…through financial transparency in the NHS …by reducing health inequalities
NHS Scotland will be under financial RCN Scotland calls for the financial People in Scotland are less healthy RCN Scotland calls on the next
pressure in the future and this plans and reports of health boards and die sooner than people Scottish Government to undertake
will mean tough and sometimes to be more transparent and made elsewhere in the UK. Lifestyle – and promote significant research into
unpopular choices. New ways to public so that difficult funding smoking, drinking, diet, exercise the Scottish Effect, so that effective
deliver safe and effective services choices can be fully understood – and poverty are important factors, decisions can be taken and future
with less money must be found. This and debated. but do not fully explain the higher spending targeted more effectively.
can only be done successfully if levels of poor health and early death
health boards are transparent in their in Scotland. There appears to remain
finance and efficiency plans and in a ‘Scottish Effect’ not explained by
the decisions they make to save and traditional factors and the causes
re-allocate funding. of this must be understood to save
money in the long term.

…by supporting vulnerable communities

…through more use of eHealth
We should all be able to enjoy access RCN Scotland calls on the next Scottish
to appropriate, quality services at Government to audit and report on the eHealth, including telehealth and RCN Scotland calls on the next
the right time; participate in decision socio-economic impact of its budgets telecare, improves patient care and Scottish Government to implement
making about our care; and have the and spending decisions; consider at the same time saves the NHS and fund a national eHealth
independence to lead a full, healthy the full range of NHS and non-NHS money, but progress with eHealth is programme to ensure the continued
life, at home wherever possible. services needed for the most excluded patchy across Scotland. Greater use development and use of eHealth
At a time of public sector cuts, the members of our society to improve of eHealth improves communication, across Scotland. Nurses, midwives
most vulnerable and excluded in our their health; and ensure that decisions improves records and supports and allied health professionals must
society must not be hit hardest. to reconfigure services take account of decision-making, helps support be fully involved in these decisions.
the impact on the most excluded. people in their homes and increases
access to specialist services.

…through a more efficient NHS

As a result of inf lation and pressures RCN Scotland calls on the next
on the Scottish Government’s Scottish Government to ensure that
finances, patient services and NHS health boards identify unnecessary
jobs are already on the line. But there waste, inefficiency and duplication
are still too many examples of waste in spending and eradicate them as
and inefficiency in the NHS, and these a matter of urgency. Complexity,
must be eradicated before staff or personal preference and preserving
services are cut. the status quo cannot be excuses
for wasting precious NHS resources.
Managing the workforce better
…through guaranteed training and development …through less paperwork
To ensure safe and effective patient RCN Scotland calls on the next Nurses should spend their working RCN Scotland calls on the next
care, nurses and healthcare support Scottish Government to ensure time caring for patients, but an Scottish Government to ensure
workers must undertake training, clarification as to what constitutes RCN survey shows an increase in that enough admin staff are
some of which is required by law. mandatory training within healthcare. paperwork is preventing this. Some employed, and to carry out
They must also have access to In addition, nurses must get 45 clinical paperwork is essential, but far a review of what constitutes
ongoing development and training in hours per year for their continuing too much non-essential paperwork is essential paperwork.
their role to ensure a motivated, skilled professional development and all being done by nurses. Time could be
and experienced workforce. However, training must be done in work time, saved by better use of technology,
too often training is not happening or with cover provided. employing ward clerks and admin
nurses have to undertake it in their staff and by ending duplication of data
own time. entry between systems.

…by taking care of staff …through proper planning

NHS Scotland staff are committed RCN Scotland calls on the next Workforce planning has been a RCN Scotland calls on the next
professionals, but have relatively Scottish Government to implement success, with big reductions in Scottish Government to ensure that
high levels of sickness absence, the findings of the Boorman review expenditure on agency and bank health boards use nationally agreed
particularly with back problems and in Scotland, which recognises nurses in recent years. But some nursing workforce and workload
stress. Overstretched and stressed the link between staff health and health boards are stepping back tools, and produce detailed clinical
staff run the risk of not speaking out wellbeing and the overall ability of from proper workforce tools and risk assessment plans before any
about poor practice. the NHS to provide high levels of plans. ‘Slash and burn’ cuts are changes to the nursing workforce are
patient care. Successful projects short-sighted, and risk adversely made. These plans must be agreed
from the Health, Work & Wellbeing affecting the services received locally with trade unions.
Challenge Fund should go national. by patients.

…by using all members of the nursing team

An effective nursing team depends RCN Scotland calls on the next Scottish
on the use of the different skills of all Government to create a culture in
its members. Healthcare employers which the nursing contribution is
must make appropriate use of the valued and staff fulfil their potential.
full range and expertise of members Barriers to career development
of the nursing team, from healthcare opportunities for all members of the
support workers to staff nurses to nursing team must be removed and
advanced nurse practitioners. investment in such development
must not be wasted by using staff
Making patient care better
…by backing whistleblowers …by freeing up senior charge nurses
Nurses are required by their RCN Scotland calls on the next The national framework for senior RCN Scotland calls on the next
professional codes of conduct Scottish Government to make sure charge nurses (SCNs) has a Scottish Government to ensure
to report concerns about the that healthcare employers put in welcome focus on their role as that SCNs are not counted in ward
care and treatment of patients place whistleblowing policies and clinical leaders on wards. Having a staffing numbers and are free from
to their employer. Concerns implement them fully. They must clinical caseload and unnecessary clinical caseloads and non-essential
have been expressed however, hold a register of staff concerns admin impacts their ability to fulfil paperwork, to allow them to fulfil
about the atmosphere for such raised through whistleblowing this role: SCNs must be visible and their leadership role.
‘whistleblowers’ in NHS Scotland. procedures, report these to their accessible to patients and staff as
boards and demonstrate compliance guardians of high quality patient care.
as part of the Annual Review
Process. The same standards must
apply in the independent sector. …by supporting clinical nurse specialists
Clinical nurse specialists (CNSs) RCN Scotland calls on the next
…by ensuring dignity improve patient care, support Scottish Government to ensure that
achievement of targets and save the CNS numbers are maintained and
Nurses want to treat patients RCN Scotland calls on the next NHS money. However, some health that CNSs are not redeployed to non-
with dignity, i.e. with respect, Scottish Government to help health boards seek to use CNSs to cover specialist duties because of ward
compassion and sensitivity. boards analyse the impact of capital, staff shortages on the wards, cutting staffing shortfalls.
However, sometimes the physical refurbishment and maintenance back on the time they spend with the
environment in which they work funding decisions on the ability patients they are trained to support.
can get in the way of this, for of patients to receive dignified
example, when a lack of space care. This should incorporate new
in buildings or poor facilities duties arising from the UK Equality …by backing community nursing
lead to a lack of privacy. Act. Senior nursing staff must also
be involved in such decisions to Community nursing is at a crossroads RCN Scotland calls on the next
ensure that the impact of physical about the way forward, yet the majority Scottish Government to give
environment on the delivery of of patient care is delivered in the strategic direction and provide
dignified care is fully considered. community. That’s why the RCN has investment in community nursing.
developed clear statements of the way Community nurse leaders should
forward for community nursing and be formally engaged in decision
has a key role in the Modernising making at board level, and
Community Nursing Board. It was regulations should be laid before the
set up in 2009 by the Scottish Scottish Parliament to enable nurses
Government to ensure high quality and other healthcare professionals to
and effective care is provided within hold primary care contracts.
a team-based approach.
For more information or to talk to
RCN Scotland members in your area,
please contact the RCN Scotland
parliamentary office at:

RCN Scotland
42 South Oswald Road, Edinburgh
t 0131 662 6173