Foreword by the Chief Nursing Officer
Ensuring that there are sufficient numbers of nursing staff with the right skills and competencies to deliver the high quality of care people in Scotland demand of their NHS is part and parcel of the day-to-day life of operational managers and nurse leaders throughout the country.
Their primary resource in meeting this demand is the nurses employed within the substantive workforce of NHS boards. When short- or longer-term deficiencies in supply of nurses from the substantive workforce occur, they turn to what is termed "supplementary staffing" resources - nurses employed through the nurse bank.
Nurse banks consist of groups of nurses employed to work on a flexible as-and-when-required basis to cover for planned and unplanned shortfalls in the nurse staffing establishment. Bank nurses can work across all the clinical services provided by NHS boards in hospital and community settings, depending on their skills, competencies and experience.
The Nationally Co-ordinated Nurse Bank Arrangements report, published in 2005, analysed the pattern of usage of bank nurses in NHSScotland at that time. While the report found much to be admired in the way supplementary staffing was being handled within the NHS, it also highlighted areas in which a different approach would provide better standards of care for service users and better value for money for the service.
It is fair to say that the management and deployment of supplementary staff in NHS boards in Scotland has come a long way since that time, with significant improvements in appropriate use of bank nurses rather than more expensive options. But nurse bank managers across Scotland feel there is still more that can be done to improve the situation.
Nurse bank managers have been putting forward a clear message that they can help their local NHS boards to manage the supply of supplementary staffing, but that their sphere of influence does not extend to managing the demand for supplementary staff - a responsibility that lies with managers in direct care settings. As a result, nurse bank managers across Scotland have developed this Good Practice Guide for frontline staff and managers.
It is a practical guide that will help them review and improve their role and responsibilities in the management of nurse staffing and which sets out the qualities substantive staff can expect to see in bank nurses. It also provides helpful support to nurse bank managers in the running of nurse banks by setting out what works well (and why it works well) from the perspectives of people who have significant experience in managing a supplementary staffing service.
The Guide also helps to promote the importance of nurse banks to nurses' professional development. Providing services via a nurse bank is becoming increasingly recognised as an important point in a nurse's career. It is not the end-point of that career - a "winding down" towards retirement - but is a stage in a career development profile that fits with individuals' lifestyles and in which nurses can gain excellent experience that will position them well to attain substantive posts in the NHS when the time is right for them.
But the most important thing is to emphasise the ultimate end-point of a nurse bank service - the delivery of a high quality service for patients and clients. Bank nurses make a significant contribution to frontline services in the NHS, and the better trained, developed and supported they are, the higher the quality of care they will deliver to patients and clients.
This Good Practice Guide will, I believe, help managers and frontline staff in NHSScotland put together the diverse elements that make up an excellent nurse bank service, resulting in significant clinical benefits for patients and clients, significant professional benefits for bank nurses, and significant cost savings for the NHS.
Paul Martin
Chief Nursing Officer