This is UNISON Scotland’s response to the Scottish Parliament’s Health, Social Care and Sport Committee’s call for evidence[1] for the short inquiry into winter preparedness and planning within health and social care.
Background
The Committee asked respondents about “how successful the Scottish Government has been in implementing actions from its eight priorities to support winter resilience across health and care systems”. The Committee also sought opinions on what can be done to improve upon winter planning for the coming winter.
This is against a backdrop of the NHS in Scotland experiencing its worst winter on record, with hospitals in several health board areas on a number of occasions under extreme pressures, with overflowing accident and emergency departments, ambulances queued up, beds blocked, patients’ lives put at risk and horrendous stress on hard working and dedicated staff. UNISON is greatly concerned about the impact of these on patient care and on the human cost of shockingly inadequate winter planning. We have been warning for years about the issues currently causing such pressures in hospitals.
“Queen Elizabeth University Hospital staff ‘ask’ for major incident amid safety fears.”
“NHS on brink of collapse as hospital bosses urged to declare critical incident.”
“First minister says Scotland’s hospitals are ‘almost completely full’ as she announces measures to ease pressure.”
Those are just a sample of headlines[1] that will bring back difficult memories for the general public, as well as overworked staff, already traumatised from their pandemic experiences, yet expected to deal with crisis after crisis on understaffed wards. Lessons must be learned, including ensuring proper integrated social care systems to prevent bed blocking.
Our key areas of concern are for effective NHS workforce planning over the long-term, and for social care to receive the proper investment needed to ensure quality decent jobs delivering the high-quality care service that our elderly and vulnerable relatives deserve. UNISON Scotland’s vision for a National Care Service is very different from the Scottish Government’s NCS Bill, as our document of comparisons shows[2]. And while we have cautiously welcomed the announcement that social care staff will continue to be employed by local authorities, and councils will still be responsible for assets like buildings and the delivery of services, there are still considerable concerns about the Scottish Government’s plans and much that can be done to immediately act to improve social care[3].
Another priority for UNISON is the wellbeing of NHS and social care staff. This has a direct impact of course on staff shortages and retention of workers – and therefore on patient care when understaffing hits hard. In November 2021 when the Committee was considering winter preparedness, our then Head of Social Care John Mooney gave oral evidence and warned of a “burnout pandemic”[4]. But staff were under yet further pressures a year later, during last winter. And UNISON Scotland’s survey of nurses published in May 2023 found chronic understaffing across the NHS[5], but, cruelly, workers have no time to report this.
Wilma Brown, an NHS nurse and chair of UNISON Scotland’s health committee, said: “This survey makes clear that NHS staff don’t have time to properly report the effect of chronic under-staffing across the NHS and the impact it is having on patients. It’s vital that staff can report the true picture, so NHS leaders can make the changes needed. The situation on the ground is desperate, there are just too few nurses to be able to do the job properly and staff are struggling to provide patients with the care they deserve. Ministers are failing in their duty of care to both patients and staff, and we need urgent action to provide a long-term solution to this crisis.”
Earlier this month the NHS marked its 75th anniversary, but while it is much loved and celebrations were held, most accept that the NHS is in crisis and needs concerted action to address multiple problems. UNISON head of health Matt McLaughlin made some suggestions in an article in The Herald[6], pointing out that an enormous £500m was spent last year on bank and agency clinical staff and noting that “survey after survey identifies short staffing as a major pressure on service delivery and staff wellbeing”. Matt also commented on the NHS workforce report last month, noting that there are “just too few nurses to be able to do the job properly and staff are struggling to provide patients with the care they deserve.” Wilma said: “UNISON Scotland has warned of the crisis for over a decade. There has been a collective failure by the Scottish government to respond properly to the identifiable pressures in the NHS in Scotland. The current problems caused by the failure to invest in social care, an ageing workforce, stagnating pay, and delays in filling vacancies were all predicted by UNISON.” [7]
Staff who have been through so much during the pandemic and last year’s very difficult winter need reassurance that they will not be expected to cope with the same unacceptable pressures again this winter.
UNISON health branches responded to a survey considering the Committee’s various questions. Our response concentrates on a broad overview of the experiences of our members working in health and social care.
[1] https://www.heraldscotland.com/politics/23221328.nhs-scotland-qeuh-staff-ask-major-incident-amid-safety-fears/
https://www.dailyrecord.co.uk/news/nhs-brink-collapse-hospital-bossed-28894475
[2] https://unison-scotland.org/national-care-service-the-one-we-need-and-the-one-on-offer/
[3] https://unison-scotland.org/unison-comment-on-the-scottish-government-national-care-service-partnership-announcement/
[4] https://www.scotsman.com/health/act-now-on-social-care-or-risk-patient-deaths-due-to-staff-shortages-msps-told-3451122
[5] https://news.stv.tv/scotland/almost-three-quarters-of-nurses-deal-with-daily-staff-shortages-unison-survey-suggests
[6] https://www.heraldscotland.com/politics/viewpoint/23633581.nhs-75-five-ways-fix-health-care-services/ https://unison-scotland.org/nhs-at-75-a-suitable-case-for-treatment/
[7] https://unison-scotland.org/unison-scotland-response-to-nhs-workforce-report-2023/
[1] https://yourviews.parliament.scot/health/winter_planning/