The report, published today (6 May 2025) ahead of the Scottish government’s Programme for Government, highlights 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 Scottish government has committed to ‘protecting, strengthening and renewing our National Health Service’ but this cannot be achieved without leadership, investment and effective workforce planning. The same applies within social care where nursing staff continue to report feeling undervalued and overlooked.

Our 10 recommendations 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. They 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.

Within care homes for adults, the number of registered nurses employed has declined further despite the complexity of clinical need increasing. And for the fourth year in a row Scotland has failed to fill the number of student nurse places set out in Scottish government targets.

RCN Scotland members will have an opportunity to meet with key politicians and senior nurse leaders to discuss the report’s findings, the current challenges facing services and the key role of nursing in addressing these challenges at a roundtable event in Edinburgh tomorrow morning.

Colin Poolman, Director, RCN Scotland, said: “In setting out its programme for government today, the Scottish Government must recognise the key role that health and social care staff will play in service reform and commit to implementing the recommendations from the Nursing and Midwifery Taskforce.

“Delivering and supporting a sustainable nursing workforce will be key to delivering improvements and shifting the balance of care. Our report demonstrates the challenges that need to be overcome. Our recommendations reflect the need for the Scottish government to follow through on its existing commitments and to take the action to allow the nursing profession to grow, develop and maximise its contribution to the health and wellbeing of the nation.”