'Worrying' fall in nursing applicants as milestone SNP Government report makes 44 recommendations

The report from a taskforce set up by the Scottish Government has made 44 recommendations for change. These have already been accepted by Health Secretary Neil Gray, who hailed the report as an “important milestone”.

It comes after the Government established the Nursing and Midwifery Taskforce in 2023, with the group set up to consider how to “make Scotland the best place for midwives and nurses to thrive at work”.

The recommendations include ensuring there are “appropriate staffing levels” in place to allow nurses and midwives to take their statutory breaks, and a review of flexible working practices, with this coming after a listening project involving more than 4,000 nurses, midwives and others was told “work/life balance just isn’t there”.

To help with an “increased workload” that can lead to “burn-out” and “compassion fatigue”, a review will seek to reduce paperwork and administration in a bid to allow staff to spend more time focused on patient care.

The report was published as Universities and Colleges Admissions Service (UCAS) figures showed 4,560 people had applied to study nursing in Scotland by last month’s deadline - a 2 per cent fall on the 4,650 who applied last year.

It is the fourth successive year where numbers have fallen and is the lowest figure for seven years. The number of applicants in Scotland remains below pre-pandemic levels. The sharpest fall over the period was a 8.3 per cent drop between 2023 and 2024.

Colin Poolman, Scotland director of the Royal College of Nursing (RCN), said: “On the day the Ministerial Nursing and Midwifery Taskforce report is launched, these figures are a reminder of how important fully funded implementation of the report’s 44 recommendations is to the future of nursing.

“The report’s recommendations are ambitious and, if implemented well, will help develop a sustainable nursing workforce for the future. But these figures show just how badly nursing needs investment.

“We say every year that nursing remains a fantastic career, but these figures suggest getting that message across to potential applicants is proving harder. While the drop in applicants between last year and this is lower than in previous years, we need to stop the extremely worrying overall trend as soon as possible.”

Mr Poolman added: “Implementation of the recommendations will take time and investment. We look forward to playing a key role in the implementation board to ensure delivery and enable Scottish Government to meet its aspiration of making Scotland the best place for nurses and midwives to work.”

Anne Armstrong, Scotland’s interim chief nursing officer, and chief midwifery officer Justine Craig said implementing the recommendations would lead to a “happier, healthier and better equipped workforce”.

There were 51,572 nurses and 3,173 midwives employed by the health service in Scotland as of September last year, making up 41.7 per cent of all NHS staff.

But the report also showed that in the year to March 2024, there was a 5.5 per cent increase in the number of nurses leaving the Nursing and Midwifery Council’s register of staff. The document also noted “trends over time”, which show “more nurses and midwives are leaving their careers at an earlier point than previously”.

This, the report added, could create “potential gaps in the skill mix now and in the future”.

Work is to now begin on a detailed plan for implementation of the report, which will include timescales as well as financial details.

Mr Gray said the report was a “very honest assessment of what it’s like to be a nurse and a midwife”, setting out the “challenges” facing the profession.

Asked about a recommendation that nurses should always have breaks, the Health Secretary said: “We want to make sure we provide consistency and we make sure the elements of a nurse or midwife’s contract are being honoured.

“We recognise there are pressures in this job and there are pressures being faced across the health service and some people are going above and beyond, but we can’t expect them to be doing that all the time.

“That’s why we need to make sure we listen, as we have done to those 4,000 nurses and midwives who helped to contribute to the listening project, and we get it right for them.”

Mr Gray, who will chair the implementation board, also declared he wanted 2025 to be the year the Government turned the corner on improving delayed discharge in Scotland’s hospitals. He said he also wanted to see A&E waiting time performance get better.

Opposition parties have regularly attacked the SNP on delayed discharge rates, saying successive ministers have failed to eradicate the problem and allowed pressure to build up in the NHS.

The SNP minister said he had been co-chairing weekly meetings with local government body Cosla on improving delayed discharge, without which “the position would have been much worse than what it is right now”.

Mr Gray said he is determined to improve the situation, saying there were roughly 2,000 patients across Scotland who are delayed in hospital when they should not be.

Pressed on whether he will turn a corner on the issue in 2025, he said: “I certainly want that to be the case.”

But Scottish Tories health spokesman Dr Sandesh Gulhane said: “Neil Gray should be embarrassed at his level of ambition for Scotland’s NHS. A decade ago his colleague Shona Robison promised to eradicate delayed discharge in our hospitals, yet he only wants to turn the corner on it.

“And merely looking to improve A&E waiting times will be cold comfort to the thousands of patients suffering deadly delays every single week on his watch.”

Labour health spokesperson Dame Jackie Baillie said: “At the root of the dangerous crisis in our NHS is a workforce crisis created by the SNP.”

While Dame Jackie said the nursing and midwifery report was welcome, she added: “It must kick-start a genuine change in direction by the Scottish Government. Without a real plan for delivery, no report is worth the paper it’s written on and this SNP Government has a long history of failing to deliver.

“The SNP must work with nurses and midwives to act on these recommendations, deliver a real workforce plan, and properly support our fantastic NHS staff.”

Scottish Liberal Democrat leader Alex Cole-Hamilton said NHS staff were reporting being “dangerously understaffed” and that “every shift can be a pressure cooker”.

Accusing the Scottish Government of having “let staff down time and time again”, Mr Cole-Hamilton added: “I’m pleased to see frontline nurses and midwives have been consulted, but that needs to be turned into action.

“Ministers must set out a clear timeline for delivering these recommendations and properly supporting our hard-working NHS staff.”