Scottish nurses face staff and funding 'perfect storm' says RCN
Budget cuts, Brexit and growing patient demand are all leading to a "perfect storm" for nursing staff in Scotland, a new report has warned.
The Royal College of Nursing (RCN) said the Scottish government needed to take action now to avert a staffing crisis.
They said rising demand and insufficient nursing staff were putting patient care at risk.
The Scottish government said the number of nurses and midwives had risen by 5.2% since 2006.
According to the RCN, a "boom and bust" approach to staffing had led to many health boards cutting nursing staff to balance their books, then later scrambling to recruit as demand increased.
They said despite the vacancy rate for nurses rising to 4.2% in June, the number of available staff only went up by 1% in 2015.
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They also said the workforce was facing added pressure as the age profile of nurses increased. The RCN said that in 2006, 43% of nursing and midwifery staff were aged 45 or over; in 2015 that figure had risen to 54%.
The union said that although nurses had been awarded a salary increase recommended by the NHS Pay Review Body, pay restraint had led to a real-terms fall of about 14% in salaries since 2010. They said this was adding to recruitment and retention problems.
RCN Scotland Director Theresa Fyffe said: "Scotland's population is getting older and more and more people are living with more complex conditions.
"Demand for health care is going through the roof. And you only have to look at the latest NHS vacancy rate - which went up from 3.7% to 4.2% in June 2016 - to know that the very modest increase in staff is just not keeping pace with demand, with a number of health boards really struggling to recruit enough nursing staff."
She added: "All these factors, as well as the as yet unknown impact of Brexit on international recruitment - particularly in the care home sector in Scotland are contributing to a 'perfect storm' for our nursing workforce and, as today's report says without sufficient nursing staff and exponentially rising demand, patient care is being put at risk."
Health Secretary Shona Robison said that under the Scottish government, the number of staff working in the NHS had increased by more than 11,000 - including more than 2,100 nurses and midwives, a rise of 5.2%, since 2006.
She said: "Rises in nursing and midwifery vacancies are due to the creation of new posts in health boards, mainly as a result of information from our innovative workload and workforce planning tools which help health boards to plan for the number of staff they require.
"We are committed to training and retaining our nursing staff and we will increase the number of trainee nurses and midwives by 5.6% for 2016-17 - a fourth successive rise."
Ms Robison also said the Scottish government was committed to retaining the nursing and midwifery bursary and free tuition fees in Scotland.
Scottish Labour health spokesman Anas Sarwar said: "The SNP government has ignored previous warnings from staff and that can't be allowed to happen again."
Donald Cameron, for the Scottish Conservatives, said the government must "explain why it hasn't created more student places when it knew the workforce was ageing, and why hiring patterns have been so erratic".