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Opinion

Care Homes & Brushing Influenza under the Carpet

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Last October it was reported in the Guardian that the total number of care homes had fallen from 18,068 in September 2010 to 16,614 in July 2016.

Meanwhile, in early 2017 there are reports of care homes closing around the country, two from East Yorkshire facing closure[1], as well as Devon[2] and Wales.[3] The former Lib Dem Care Minister Norman Lamb has launched a cross-party campaign to solve the crisis in health and social care [4], and in addition an urgent letter was sent to the government from Independent Age, including signatories from the Royal College of Nursing and Royal College of GPs, both expressing similar sentiments.

In and of itself this is concerning enough. Care homes closing will no doubt create a further burden on healthcare services. But not discussed are the number of care home influenza cases. Every week Public Health England produce a report of the cases of influenza for the previous week. Last week (up to January 19th) it can be seen that of 122 new acute respiratory outbreaks in the community (essentially flu), 94 were from care homes.[5] Whilst this figure can enlighten us very little as to why influenza loves a care home, it can be suggested that the collapse of so many of these institutions will do the infamous, and sometimes deadly illness, some favours. Firstly, infected but asymptomatic residents rushed to another care home, or back to family or concerned parties, will possibly infect other people. Secondly, there is a likelihood of these people entering the healthcare service and infecting others. Thirdly, the whole process of closing a care home will no doubt unsettle the virus, and due to its survival of 24 hours outside of the host, it will be able to transfer much more in its immediate environment.[6]

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To turn to those unfortunate enough to go through the upheaval of having a care home close – the combination of respiratory illness alongside the stress of the unfamiliar may be too much for them. Influenza may end up isolating or separating them from those who are close. Thus a spate of care home closures doesn’t only present a challenge for the healthcare and social care systems, but combined with a true epidemic or pandemic, could add to the devastation wrought. Jeremy Hunt congratulated the high uptake of flu vaccinations this year on Twitter.[7] But as any nurse, or other healthcare professional will tell you, stopping something from happening in the first place is better than hoping that pharmaceuticals and a robust immune system will fight it off. If anything the Health Secretary’s heartfelt messages and “thank yous” during his tenure attempt to mask his administration’s poor regard for long term health and social care planning. Influenza is an old and familiar opponent, and hard to stop. But by letting services waste away, the government endangers the health of nurses and other healthcare professionals.

[1]
[2]
[3]    http://www.dailypost.co.uk/news/north-wales-news/colwyn-bay-care-home-shut-12017529
[4]    http://www.normanlamb.org.uk/norman_lamb_launches_cross_party_nhs_and_care_campaign
[5]    https://www.gov.uk/government/statistics/weekly-national-flu-reports
[6]    http://www.nhs.uk/chq/pages/how-long-do-bacteria-and-viruses-live-outside-the-body.aspx
[7]    https://twitter.com/Jeremy_Hunt/status/823934903591063552

Opinion

‘Student nurses graduate with £54k of debt, shouldn’t we pay them a wage instead?’

The Government claims students are “supernumerary” and “not contracted to provide nursing care”.

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student nurses walking

Student nurses are the unseen workforce and vital to patient care.

While I am pleased for the thousands of students who will soon be starting their journey to become a registered nurse, it comes with a stark reminder.

In November 2015, ministers announced the NHS Student Bursary and tuition fee payment would be cut in a plan to increase the number of available student places.

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Suffice to say, this hasn’t worked.

Instead, we have seen a consistent decline in the number of student nurses qualifying. Official figures from the Universities and Colleges Admissions Service (UCAS) show an overall decline in applications of 8% since 2015.

There is no debate that nurses need to be degree-level educated – but are student loans the best way to fill an ever-widing gap in our workforce?

The unseen workforce.

Student nurses are the unseen workforce and are sometimes vital to the delivery of safe, compassionate, person-centered care.

Completing over two-thousand hours of hand-on, direct clinical practice over three years – is it fair to ask them to accumulate up to £54,582 (plus 6.3% annual interest) of debt?

With a starting salary of £24,214, this is a debt the majority of nurses will never pay off.

The Government claims that because student nurses are “supernumerary” and “not contracted to provide nursing care” they need to be treated like all other higher education students.

While is it true that the Nursing and Midwifery Council (NMC) mandates that student nurses are considered ‘supernumerary’ – how realistic is this expectation? We hear stories of student nurses, trainee nursing associates and healthcare support workers being used to fill nurse staffing gaps on an almost daily basis.

A self-perpetuating cycle.

With an estimated 40,000 unfilled nursing vacancies in the NHS alone, health and social care services in England are stuck in a self-perpetuating cycle.

Chronic under-investment in services has led to an increased demand on staff and subsequently affected recruitment and retention rates. Universities then fail to recruit enough nurses to meet the current demand and so the cycle continues.

The Royal College of Nursing has called on the Government to invest at least £1b per year into nursing education and come up with a long-term plan after its plan to increase numbers has failed to work.

Matching the proposed apprentice wage while student nurses are on placement would go some way towards alleviating the financial burden the government has placed on student nurses.

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Opinion

A fresh start?

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RCN Congress

I’m excited and I’m nervous. I qualified as a nurse just 15 months ago. I left a career in IT of “quite a few years” – I decided I needed a fresh start.

Now I’m sat on a train heading to my first ever RCN Congress. I’m a voting delegate and will be honoured to carry that responsibility for my branch.

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I’m also excited to finally be meeting people that I’ve solely (or mostly) only ever connected with online.

Finally, I’m looking forward to the various debates and resolutions. Listening to the speakers will further inform my views and I might even share a thought or two myself – fortunately speaking in public does not generally worry me (I’ll be the one with the ukulele).

A brief glance back to this time last year when certain “irregularities” were noticed by some members around the pay deal and communications regarding it.

The train of events that followed uncovered a number of poor practices regarding transparency and accountability and our current council were elected to address these.

I also mentioned I am nervous.

Recently, it has become clear that further “irregularities” have occurred – and questions will be asked.

Tomorrow morning is the Royal College of Nursing’s Annual General Meeting – an opportunity for members to ask questions. An opportunity for the council to demonstrate its commitment to openness, transparency, and accountability. An opportunity for a fresh start.

I genuinely hope the answers to the questions I raise are clear and dispel the concerns many of us have.

And if they don’t? Well, that’s why I’m nervous.

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