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The tools are there as guides for local decision makers in ensuring that there are safe staffing levels. As I said, they are intended to be dynamic and flexible to respond to local need and clinical demand. As Christopher Thompson set out, HIS is working on developing the tools to ensure that they are responsive—the tools are works in progress. As a result of the legislation and the work that the Government is doing with boards on supplementary staffing, significant work is on-going to ensure that establishment staffing levels are appropriate. A considerable benefit is coming through as a result of the legislation and the on-going work that is being done by HIS and by boards.

Obviously, we will keep under review what we publish. We have to publish the board’s responses, which we will get at the end of next month. We will keep under review and consideration the data that is published alongside that.

As we are setting out the tools and seeing the act being implemented in local areas, and as we see the response that comes back from boards on how they are reviewing and ensuring that they have safe staffing levels, of course we keep under review areas such as those that have been suggested by the Royal College of Nursing. The process is dynamic and flexible—it is not a one-size-fits-all approach—so that we can deal with potential elements that need to be worked on as the legislation is implemented. We keep under review concerns such as those from the Royal College of Nursing that Mr Gulhane has raised.

I thank Emma Harper for that question, because she has illustrated what I was setting out in response to Sandesh Gulhane about the processes that are in play in all environments, in both health and social care, and what must be taken into consideration in order to understand what will be a safe staffing level for a particular shift.

Emma Harper rightly points to the fact that a number of factors will be dynamic and have to be flexible. In the example that she provided, the number of people who are intubated or in intensive care and requiring ventilation would change depending on the number of patients who are in that particular unit at that time. There is an understanding of that. The safe staffing legislation provides transparency around the tools that are used, the way in which the safe staffing level is determined, and ensuring that we comply with that across the NHS and social care estate. That is essentially what the legislation is designed to do.

We will see what the reports from boards say. I have not had sight of those, and they are not due to arrive with us until 30 April. Challenges remain across the system in ensuring that we have sufficient staffing levels. I will not shy away from that, but I think that this, alongside some of our work with the nursing and midwifery task force, our work on GP attraction and retention and our work with the royal colleges and others on attracting and retaining staff in all disciplines, will help us to build towards ensuring that we continue to have the high-quality and safe clinical environments that people expect.

I am not going to pretend that, on every shift in every ward, staffing is at appropriate levels, because I know that we are sometimes short. However, this is about ensuring that we get to that point. Improvements in that respect will have been made over the past year, and I am looking forward to the reports demonstrating that.

Thank you for giving me the opportunity to speak to the committee. I will briefly set out the reasons for the amendments to the National Health Service (Common Staffing Method) (Scotland) Regulations.

The amendments, which are relatively technical in nature, largely take account of changes that are linked to the implementation of the reduced working week for agenda for change staff. The first half-hour reduction in the working week for those staff was implemented on 1 April last year. It is clearly important that the staffing tools that are provided for under the Health and Care (Staffing) (Scotland) Act 2019 are adjusted to reflect the new definition of whole-time equivalent working hours. Further amendments will be required at the point at which we deliver the 36-hour working week, on 1 April 2026.

I reiterate for the avoidance of any doubt that the Scottish Government is delivering on its commitment to implement the reduced working week by 1 April 2026. I look forward to staff feeling the full benefit of that change. A clear delivery plan is being set out to give confidence regarding its delivery.

As part of the Health and Care (Staffing) (Scotland) Act 2019, the common staffing method sets out a process, including the use of tools and the consideration of a range of other factors, to determine appropriate staffing levels. Those tools will need to be updated and supplemented periodically, and corresponding updates to secondary legislation will be required. The tools provide a useful source of information to support local decision making, and they form part of a wider set of systems and processes that were introduced by the 2019 act to support effective workforce planning.

To be clear, the intention is not to prescribe what staffing numbers are appropriate or to set recommended ratios at the national level. Such an approach would lack the flexibility to account for local circumstances and would fail to take account of the dynamic nature of healthcare services and the care that they are required to deliver. Instead, the approach is designed to support robust and transparent local decision making.

It is important to recognise that this is the first year following the commencement of the 2019 act and that, as more resources become available and learning takes place in the years to come, we will naturally see incremental improvements in the approach that is taken to compliance. That is not to say that some benefits are not already being felt. I am aware of work that is being done across the system to review staffing establishments as part of broader efforts to ensure that our services are fit for purpose and able to respond to the demands that we can reasonably anticipate. The act has added impetus to those efforts, and we will learn more about health boards’ experience of implementing the legislation when we receive their annual reports in the coming weeks.

I will re-engage with the Parliament later this year to give an update on the Scottish Government’s plans in the light of the evidence that continues to emerge. I will, of course, be happy to take questions from committee members.

No. I will bring in Christopher Thompson in a second. The tools are there to help to inform different parts of the system to ensure that staffing levels are appropriate. There is a duty on local boards to report to ministers on their staffing levels. Ministers must lay those reports and respond to them, which I will do later this year.

Christopher can correct me if I am wrong, but I do not believe that we have had any concerns expressed.

Of course. It has to be. That is why it is important that it is done at a local level, to respond to local need and the local environment, and to the various factors that Emma Harper will be familiar with, given her previous practice, in arriving at what will be required and what a risk assessment would arrive at as the best requirement for that particular shift, or for a longer period of time, depending on the environment that we are talking about. That is why it cannot be prescribed nationally. It has to be delivered locally, but we need the transparency that the legislation provides around how those decisions are taken, and when there has been challenge in the previous year, to arrive at a safe staffing level. The reports will come through in April to determine that, and the ministers will need to respond to those in the Parliament in due course.

They should be, yes, but to supplement that, I reiterate what Emma Harper has just put on the table and my response to Sandesh Gulhane—I cannot prejudge what will be in the reports. I will see the boards’ decisions and the risk assessments and other factors that they have used to determine what the staffing establishment should look like. When there have been issues, that needs to be clearly communicated in the reports that come through to ministers.

To add to Mr Whittle’s point, he will be aware that HIS now routinely inspects maternity and neonatal services. The first inspection is under way and we expect the reports on that in May.

In the light of what we are picking up through the boards’ reviews and other areas of learning, we will interact with boards that have a responsibility to make sure that they are honouring what they should be and providing safe staffing.

I will need to defer to Christopher on that.