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In February I launched a BMA-wide project to ensure all doctors work in safe environments and all patients receive the best care. It is now widely accepted that years of underfunding has left the NHS chronically understaffed; NHS staff cannot continue to take the blame for system failures and under resourcing.
That’s why the BMA is campaigning for the introduction of laws that mandate the provision of safe staffing levels across the UK. Earlier this year Scotland led the way in passing new legislation, and BMA Scotland was instrumental in securing it.
The Health and Care (Staffing) (Scotland) Act 2019 describes how staffing should be arranged to improve standards and outcomes for patients. Ministers, NHS National Services Scotland and regional health boards must deliver comprehensive services that are decided transparently, take into account patient needs and staff and patient views, respect patient dignity, ensure staff wellbeing, allocate staff efficiently and effectively and promote multi-disciplinary team working.
The Act specifies duties to recruit sufficient numbers of staff, including constantly monitoring staffing levels, implement formal reporting arrangements for staff to raise concerns, address severe and recurrent risks and seek clinical advice in relation to required staffing levels. Compliance will be documented by Health Improvement Scotland and Scottish Parliament will receive annual reports on progress, challenges and future plans to tackle severe and recurrent risk.
The Scottish Government is now working with staff and patient representative groups to develop guidance. There will be 13 chapters and BMA Scotland will be involved in the drafting process.
BMA Wales has called for statutory safe staffing provisions in its response to the stage 1 consultation on the Health and Social Care (Quality and Engagement) (Wales) Bill. We are seeking to discuss our suggestions with the Welsh Government at the earliest opportunity.
In England we are gathering feedback from doctors on the personal impact of unsafe staffing and considering what legislation would look like in all healthcare settings. We’re also planning a stakeholder engagement event in early 2020. A number of other unions, in particular the Royal College of Nursing, are already seeking to clarify accountability for the provision of safe staffing levels in law. We will work alongside them to achieve our ambitions.
We still want to hear about your experiences of working in understaffed environments and any individual or collective efforts to bring about positive change in your place(s) of work. Please share your experiences in this anonymous survey, and encourage your colleagues to do the same.
Despite the huge challenges we are all currently facing, I am convinced that we can turn this situation around, vastly improve working conditions and make doctors’ working days more bearable and safer for patients. This will enable us to do exactly what motivated us all to become healthcare professionals in the first place – provide the best care possible to our patients.