But it’s a relief that an approach that has been talked about behind the scenes for some time is now out in the open. To date, there has been a lack of transparency surrounding the sub-national planning approach that has been unhelpful. This must improve in the future.

It’s also notable, albeit coincidental, that the announcement comes on the same day figures are released showing record numbers of patients are facing delayed discharge.

Behind every set of statistics are personal stories of individuals who could and should be cared for or recovering in their own homes. But, lack of investment in the correct areas, means patients are languishing in hospitals across Scotland. While this situation is extremely stressful for individual patients and their families, it is also emblematic of the problems facing our health and care services.

So I doubt anybody working in the NHS would deny that reform is needed. In fact, from hard-pressed nursing staff’s point of view, it’s long overdue.

The RCN does not hold strong views about the number or make up of NHS boards, but we have a number of principles that we believe must underpin any reform.

Major structural reform carries significant risk, including diverting resources and attention away from immediate operational pressures. Given the pressures on the system and given the nursing workforce, despite increases in numbers in recent years, has at no point reached the levels NHS Scotland says are needed to deliver safe and effective care, any reform must be adequately resourced and those delivering services properly supported. The nursing workforce must not be left to bear the burden of both an already creaking system and major reform at the same time.

A comprehensive, robust and long-term workforce plan, which addresses retention and recruitment challenges, must be a priority for reform. This plan must include ways to tackle the persistent culture problems in the NHS and wider health and care services. These problems too often prevent nursing staff from providing the quality of care they want to, leading to burnout and nurses leaving their jobs. Without ways to solve these problems, the Scottish government will not be able to build the sustainable nursing workforce it needs to see reform through.

Staff must be meaningfully involved in co-designing, testing and evaluating reform proposals. Early engagement involving both trade unions and professional bodies, as well as staff themselves, is necessary to ensure unintended consequences are avoided.

The discussions about local government reform, flagged by the First Minister, must also include the social care workforce. Registered nurse numbers in care homes have decreased over the last decade, at the same time that, as evidence shows, clinical need is increasing. Without this, the Scottish government’s aim of shifting care into the community will remain a pipe dream.

Nursing must be recognised as an investment, rather than a cost. Staffing decisions related to the Programme for Government and reform of the NHS structure must be based on need, not affordability.

Some of the solutions we believe are needed are already available. The Nursing and Midwifery Taskforce set out 44 recommendations to address the ongoing nursing retention and recruitment crisis and improve the working culture and environment. Yet, almost two years later, implementation has barely gotten underway, and the Taskforce is yet to make any meaningful difference to nursing staff. Urgent, fully-funded implementation of the recommendations would be a sensible prelude to much-needed reform.

This blog originally appeared as a comment piece in The Times