Chamber and committees

We recognise the financial challenges faced by all students, including nursing and midwifery students, and know that this has been exacerbated by the current cost of living crisis.

At this juncture, there are no definitive plans to increase the student nurse bursary, however, following the publication of the Royal College of Nursing’s (RCN) report ‘Nursing Student Finance: the true cost of becoming a nurse’ improvements have been made in response to the recommendations within the report surrounding student clinical placement expenses (which include travel and accommodation costs). Those improvements were taken forward in collaboration with the RCN and further work is planned to review the full package of support for those in receipt of the nursing, midwifery and paramedic student bursary. This work will be taken forward in conjunction with the Nursing and Midwifery Taskforce, which will shortly be making recommendations about the education and development of students and the existing workforce as part of its’ wider remit to make Scotland the best place to be a nurse or midwife.

The Scottish Government package of support for Scottish student nurses and midwives is at its highest level and remains the highest level of support available to nursing and midwifery students across the UK. The annual £10,000 bursary is non-means tested and non-repayable. Eligible pre-registration students also receive free tuition and funding for placement expenses – this includes travel and where appropriate accommodation expenses. Furthermore, uniforms, disclosure checks and health checks are also provided.

Students may also choose to explore registering with the Bank of healthcare workers at local NHS Boards which can provide a variety of paid opportunities, indeed many already take this up to supplement their income and experience. Whilst Bank work does not provide guaranteed work, it allows NHS Boards to offer students employment as and/or when the need arises in their local area. Once a student is registered with the Bank some Boards may also offer students a part time fixed term contract at a maximum of 15 hours per week. The opportunities which are available will vary between Boards, depending on their current and future requirements.

The Scottish Government does not hold the detail of this funding. Local decisions on how to allocate funding is the responsibility of NHS Boards.

The 2024-25 Budget provides funding of over £19.5 billion for NHS recovery, health and social care – giving our NHS a real terms uplift and providing over £14.2 billion investment in our NHS Boards.

This Budget continues to support prevention and early intervention which is critical to addressing system challenges and longer term reform, with key investment including:

• Supporting investment in excess of £10 billion for the NHS paybill to support the workforce including Allied Health Professionals and which has rewarded NHS staff in recent years during the cost of living crisis. The budget for the NHS workforce is not allocated by workforce group.
• £2 billion for social care and integration, an additional £1 billion compared to 2021-22 spend. This delivers on our Programme for Government commitment to increase social care spending by 25% over this Parliament two years ahead of our original target.
• Over £2.1bn for primary care, which includes funding for Allied Health Professionals, to improve preventative care in the community, supporting the development of multidisciplinary teams in general practice, sustaining NHS dental care through enhanced fees and continuing free eye examinations.
• Supporting spend in excess of £1.3 billion to support mental health services, with £290.2 million direct investment – more than doubled since 2020/21 - enabling record numbers of staff in providing more varied support and services to a larger number of people than ever before.
• Sustaining increased funding to address the twin public health emergencies of drugs deaths and the harms from alcohol, by maintaining our commitment to provide an additional £250 million funding over the life of this parliament to address the drugs death emergency.
• Protecting those most at risk with increased investment of over 55% for our routine childhood and adult vaccination programmes.

On 1 March 2024, the Cabinet Secretary for Health confirmed the implementation of the Agenda for Change Review Recommendations including the implementation of a consistent approach to Protected Learning Time across all NHS Scotland Boards. This includes the completion of statutory, mandatory and profession specific mandatory training within working hours, including for Nurses. These changes took effect from 1st April 2024

The Scottish Government presented to the Scottish Workforce and Staff Governance Committee (SWAG) on further work in relation to Protected Learning Time, on 23 April. Following this, it is the intention that SWAG will convene a sub-group to oversee delivery of work to map time requirements for statutory, core mandatory and professional mandatory training.

The Prince of Wales Nursing Cadet Scheme has been successfully piloted in NHS Lanarkshire and NHS Tayside, with evaluations demonstrating positive experiences for both participants and NHS placement staff. Learning and good practice from these pilots has been shared with health boards.

The role of the Nursing Cadet Scheme is being considered by the Nursing and Midwifery Taskforce in anticipation of the Taskforce providing recommendations on, inter alia , opportunities for attracting new entrants into nursing and midwifery careers, to support in building a sustainable and attractive workforce for the future.

As set out in answer S6W-26380 on 16 April 2024, the Nursing and Midwifery Taskforce has held four ministerial led meetings in April, July, December 2023 and March 2024. The Taskforce has also held two official led meetings in June 2023 and March 2024.

Under the Health and Care (Staffing) (Scotland) Act 2019, Health Boards / Special Health Boards / NHS National Services Scotland must follow the common staffing method, which only applies to certain types of health care, provided in certain locations by certain employees (see annex A), at least once every financial year. It must then decide if any changes are needed as a result, both to the staffing establishment, for example an increase or decrease, and the way in which it provides health care, for example service redesign.

Health Boards / Special Health Boards / NHS National Services Scotland are required to publish and submit an annual report to Scottish Ministers on how they have carried out their duties in the Act, with the first report due by 30 April 2025. Scottish Ministers must then present these reports to Parliament with an accompanying statement detailing how the information will be used in designing policies for staffing of the health service.

However, results from the common staffing method are only one factor in providing information on workforce and service delivery and the Scottish Government continues to implement policies for workforce and service reform.

Overall nursing and midwifery staffing is at a record high, up by 17.8% since September 2006, by 10,100.4 WTE to 66,883.6 WTE. Since September 2006, qualified nurses and midwives have increased by 16.3%, by 6,698.7 WTE to 47,724.9 WTE. Initiatives on international recruitment provided around £18m in funding to Boards to recruit 1,250 international nurses, midwives and allied health professionals, with well over 1,000 already in post across Scotland so far and many more arriving in the coming weeks.

Controls were introduced by Boards from 1 April 2023 in order to gradually reduce the number of shifts being filled by nurse agency workers and from 1 June 2023 Boards were no longer using off-framework nurse agencies unless in exceptional circumstances. Boards have reported significant progress in reducing reliance on agency nursing staff as a result of these changes. Further controls were introduced from 1 April 2024, and Boards are no longer using agency workers to fill Health Care Support Worker (HCSW) / unregistered shifts.

The Nursing and Midwifery Taskforce (NMT) was announced in February 2023 at the request of staff side organisations, including the Royal College of Nursing and Royal College of Midwives to understand the challenges facing nurses and midwives across Scotland. The NMT continues to be a Ministerial priority and will recommend a workplan of actions which will seek to improve workplace culture, practice, flexibility, recruitment and retention, alongside the diversification of education and training pathways to support longer-term workforce sustainability. The NMT is making good progress with the development of its recommended actions and will continue to work until members have agreed a comprehensive action plan. We anticipate the publication of a report later in 2024.

Annex A

Types of health care, locations and employees subject to the common staffing method

While the Scottish Government provides the policies, frameworks and resources for high quality healthcare, it is for each individual NHS Board to decide best how to utilise funding, facilities and staff while taking account of national and local priorities to meet local health needs. We expect NHS Boards to plan their facilities and workforce to deliver these services, ensuring the provision of safe, effective and high quality patient care, delivered by the right professional at the right time.