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Staffing for Safe and Effective Care

in Scotland

RCN report on the nursing workforce in Scotland

In our third instalment of ‘The Nursing Workforce in Scotland’ report it is evident that Scotland’s nursing workforce crisis is showing little sign of improvement. For the second year in a row, the headline recommendations in the report focus on the importance of the Ministerial led Nursing and Midwifery Taskforce and the need for a fully-funded nursing retention strategy.


Share your views on safe staffing

Scotland’s safe staffing legislation - the Health and Care (Staffing) (Scotland) Act 2019 – came into force last month. We want to understand and measure the impact of the Act.


Safe staffing legislation in Scotland

The Health and Care (Staffing) (Scotland) Act 2019 (‘the Act’) came into force on 1 April 2024. This groundbreaking legislation sets out requirements for safe staffing across all health and care services in Scotland.

The Act was passed in the summer of 2019. In June 2022, following sustained pressure from RCN Scotland and our members, the Scottish Government published a timetable for implementation of the Act.

From the outset, RCN Scotland has strived to positively influence the development and implementation of the Act for the benefit of members and for everyone in Scotland who relies on the safe provision of high-quality health and care services.

The Act places a legal duty on NHS and care providers to make sure there are always suitably qualified staff working in the right numbers for safe and effective care. It also imposes a duty on the Scottish government to ensure there are sufficient numbers of registered nurses, midwives and medical professionals available to enable employers to meet their duty to ensure safe staffing.

We know that the legislation will not immediately address the current acute staff shortages, and we are clear that it will only make a long-term positive difference if services have the nursing establishment they need. It must be accompanied by increased investment in services to enable providers to tackle vacancies and recruit and retain the workforce that Scotland needs.

However, the Act does create new duties that should make an important difference to nursing staff and to patients.

We will be monitoring and evaluating the impact of the Act and are calling for an annual parliamentary debate on safe staffing to ensure ongoing scrutiny of how the duties introduced by the Act are being met.

How can I find out more and get involved?

If you want to find out more about our development and education programme, please contact our RCN Scotland Learning and Development Team by email at

If you want to find out more about our policy work, please contact our RCN Scotland Policy team by email at

Retention strategy for nursing

Read our briefing explaining why the RCN in Scotland is calling on the Scottish Government to urgently develop and implement a nursing retention strategy to tackle the exodus of nursing staff from health and care services

Read our FAQs

Find out more about the Health and Care (Staffing) (Scotland) Act and what Scotland's safe staffing legislation means to you

Read our briefing

Find out why this groundbreaking legislation is needed more badly than ever, and the key differences it will make for our members and those they’re caring for.

Supporting our members

The legislation places a number of duties on Health Boards, care providers and Scottish Ministers. If implemented well, it will ensure that nursing staff can raise concerns about staffing levels without fear of repercussions and have these concerns listened to and recorded. The RCN believes everyone should feel safe and supported when raising concerns about patient care. Find out what to do if you see poor care or feel you are being prevented from providing safe, compassionate care.

Download our overview leaflet

Find out more about what the Act means for you and how the RCN is influencing on your behalf.

Download a workplace poster

Encourage your colleagues to find out more about the Health and Care (Staffing) (Scotland) Act 2019.
three raised hands multicoloured graphic

Raising Concerns

The RCN believes everyone should feel safe and supported when raising concerns about patient care.

Find out what to do if you see poor care or feel you are being prevented from providing safe, compassionate care.

Share your story

The pressure on you and our profession is greater than ever before. As the Voice of Nursing, the RCN wants to hear your story so we can understand the professional and personal impact of today’s pressures and demonstrate to politicians, employers, the public and the media the issues that are affecting the nursing workforce. 
Share your story

How we got here

The Health and Care (Staffing) (Scotland) Act gained Royal Assent on 6 June 2019. It is a ground-breaking piece of legislation as it 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.

You can read about how laws are made here and a summary of the legislation here.

RCN report on the nursing workforce in Scotland

Our updated analysis of nursing workforce statistics and challenges facing workforce planning, RCN Scotland highlights the key trends, implications of the trends and makes recommendations for action to tackle the workforce crisis, including urgent need for a nursing retention strategy.

Your vote is your voice Scotland

Our aim is to ensure that the voice of nursing is well represented throughout this process. We know that this legislation alone will not fix the nursing workforce crisis. It needs to sit alongside fair pay and improved terms, conditions and culture to ensure we can recruit and retain the nursing workforce Scotland needs right now and in decades to come.

The RCN Nursing Workforce Standards, published in May 2021, are closely aligned to the Act and have been created to explicitly set out what must happen within workplaces to ensure the delivery of safe and effective patient care.

Page last updated - 15/05/2024