Staffing for safe and effective care

The Health and Care (Staffing) (Scotland) Act gained Royal Assent on 6 June 2019

This is a ground-breaking piece of legislation. The Act is the first in the UK to set out requirements for safe staffing across both health and care services and most clinical professions.
The RCN's  ‘Ask for More’ campaign was instrumental in shaping the Act, with the majority of our asks being included.
Over 5,000 people pledged their support and the RCN would like to thank everyone who took action during our Ask for More campaign.

  • Positive outcomes - positive outcomes for people and staff must be at the heart of decision making.
  • Informed decision making - all decisions about staffing for nursing teams must be based on data and evidence, which is robust, up to date, and used appropriately.
  • A strong professional voice - nursing leaders, whether at a ward, team or governance level, should be able to exercise their professional judgement about whether there are the right number of nursing staff with the right knowledge, skills and experience, in the right place and at the right time.
  • Responsibility, accountability, real-time action and long-term planning - organisations must take responsibility for providing the right number of nursing staff. Staff should have the right knowledge, skills and experience and be deployed in the right place and at the right time to provide safe, high quality care to patients.
  • Scrutiny and sanction - there must be public scrutiny of staffing for safe and effective care and sanction if the law is not met.
  • Staff to care for people across Scotland - this legislation is a starting point. Work must continue to ensure that Scotland has the health and care staff it needs across nursing and other disciplines. The Scottish Government must take responsibility for ensuring a supply of nursing staff that meets demand.
The passing of the Act is the starting point for the next phase of the RCN’s work to ensure effective legislation for staffing for safe and effective care in Scotland.
There is a long road to navigate before the legislation comes into force – statutory guidance still needs to be written and organisations and staff have to prepare for change. This will not be a quick process, and there are also many other issues the RCN has to influence alongside the Act – from student numbers to workplace culture. The engagement of members will be key to getting this right. 
The Cabinet Secretary for Health and Sport committed to developing the guidance in collaboration. The RCN will continue to engage in this process, taking every opportunity to influence and shape how the Act will impact on the day-to-day running of the health and care services. Work will also continue on the review of existing and the development of new workforce planning methodologies and tools.
Check back on this page for updates in the near future.
You can find out more about how laws are made here.

Find out more about what the RCN has been doing

If you want to know more about the RCN's work on staffing for safe and effective care you can contact the team at

Page last updated - 06/04/2021