The report, published 06 May, shows that while the gap between planned staffing and actual staffing has reduced, at no point has NHS Scotland employed the number of nursing staff needed to deliver safe and effective care. In social care, the gap is widening as clinical need increases and the number of registered nurses working in care homes continues to decline.

The recommendations in the RCN Scotland report focus on delivery of the actions set out by the Ministerial led Nursing and Midwifery Taskforce and the need to protect and value the nursing contribution. The 10 recommendations also cover areas such as:

• Ensuring fair pay and good employment terms and conditions for nursing staff wherever they work
• The introduction of safety-critical nurse-to-patient ratios in all care settings
• Increasing the student nurse bursary in line with living costs
• Growing the community-based nursing workforce to reduce health inequalities and support the shift in the balance of care.

The long-term trends highlighted in the report show that demand continues to outstrip supply. It highlights the recruitment and retention challenges that employers are facing, the impact this has on patient care and the need to improve the quality of data to inform sustainable workforce planning.

While the number of nursing staff employed by NHS Scotland has increased, so have levels of absence, and nurse agency and bank use remain at unsustainable levels.