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Chronic staff shortages will compromise the NHS long term plan

The Royal College of Nursing has warned that chronic staffing shortages could undermine the goals set out in the NHS Long Term plan. 

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Chronic staffing shortages could undermine the goals set out in the NHS Long Term plan.

The Royal College of Nursing has welcomed publication of the long term plan for the NHS in England but has warned that, if left unchecked, the 40,000 nurse vacancies in England could compromise the implementation of the plan.

The plan provides a blueprint for the NHS over the next 10 years and sets out how any additional funding will be spent – focusing on prevention and early detection with primary and community care services getting the biggest funding increases.

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However, the college has warned its plans for securing the staff required to deliver such services are vague, with pledges of a further workforce implementation plan promised for later in 2019.

Though it recognises the incredible strain nurses are under as a result of the “unsustainable number” of shortages within the profession, it suggests some concerning solutions for increasing the number of nursing graduates. These include the creation of online degree courses linked to placements, which the Government hopes will help reduce the nursing vacancy rate to 5% by 2028.

‘The NHS’s biggest asset is its staff’.

Dame Donna Kinnair, Acting RCN Chief Executive, said: “We welcome the ambitions outlined in the plan, and it deserves to succeed. But translating good intentions into better treatment and care for patients relies on having the right number of nurses with the right skills across our NHS. Three priorities of the plan are cancer treatment, mental health and caring for patients at home. 

“This is undoubtedly the right direction, yet with 40,000 nurse vacancies in England, cancer centres are struggling to recruit specialist cancer nurses, we have lost 5,000 mental health nurses since 2010, and district nurse numbers fell almost 50% in the same period.  

“As the Prime Minister said in her speech today, the NHS’s biggest asset is its staff. It is strange then that this plan offers no money for nurses to develop the specialist skills patients need. And it is equally concerning that online courses are presented as a magic bullet to solve the workforce crisis. 

“Nursing degrees demand both academic and practical skills which student nurses learn from contact with professionals and peers, a model not easily replicated online, even with clinical placements. Nursing is career like no other, and it takes the right values and ambition to succeed. Entry standards are rigorous because they have to be – it is what safe patient care demands.”

Health Politics

Bill calling for safer staffing legislation put before Parliament

There are now 43,671 vacant nursing posts throughout the NHS in England alone.

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Maria Caulfield

The Bill will seek to “establish legally enforceable nursing staffing levels in the NHS in England.”

Maria Caulfield, Conservative MP for Lewes, nurse and member of the Royal College of Nursing (RCN), today brought a Bill designed “to establish legally enforceable nursing staffing levels in the NHS in England.”

The Bill comes as nursing vacancy rates hit a record high with 43,671 empty nursing posts in the NHS in England alone – leaving 12% of full-time nursing posts unfilled.

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In a report released today titled ‘Standing up for patient and public safety’, the RCN highlights the impact the nursing staffing crisis is having on patient safety.

Scotland recently secured new legislation on safe staffing and a nurse staffing law was introduced in Wales in 2016.

‘No one is responsible and no one is accountable’.

Ms Cauldfield said; “There is increasing evidence that the right number of qualified nurses can improve patient outcomes in terms of mortality, morbidity and quality of care and that conversely, an insufficient number of nurses can have a potentially life-threatening effect for patients.”

Presenting the primary aim of the Bill as; “to make the Government accountable for nursing levels in England, as currently no one is accountable for nursing levels in England and that is why we have such a high nursing vacancy rate.”

Before adding that the other aims of the Bill were ensuring the NHS has “a fully costed workforce strategy and nursing numbers” alongside ensuring training and development for nurses throughout their career.

Cauldfield controversially voted against scrapping the pay cap for NHS workers in 2017.

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Health Politics

Labour promises free home-care for the over 65s

People living with dementia currently face the highest costs for care.

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The over-65s will not have to pay for help with dressing, washing and meals.

The Labour Party is promising free personal care in England for those over-65s who are most in need of it, so they will not have to pay for help with dressing, washing and meals.

Currently, only people with low levels of savings receive publicly-funded personal care and there is state help with home costs and residential assistance for those with assets below £23,250. However, people living with dementia face the highest costs for care.

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They promise to introduce free personal care for all older people, providing help with daily tasks in their own homes and residential care; Free personal care will ensure people with dementia receive the same care as those with other conditions.

Labour claims the move will reduce the burden on unpaid carers and benefit the NHS by reducing delayed transfers of care from hospital and admissions to care homes and hospitals.

A million people are not getting the care they need.

At the Labour conference, shadow chancellor John McDonnell said the move would be funded out of general taxation. Also, that cuts to care funding since 2010 had left a million people not getting the care they need and “87 people dying a day waiting for care”.

Subsidising the cost of basic tasks such as getting in and out of bed and going to the toilet will enable more people to continue to live independently in their homes, he said. ” I believe the right to dignity in retirement is a part of that right to health at any stage of life.”

Free personal care is something campaigners have long been calling for in England as Scotland has already introduced it and Wales and Northern Ireland each provide some level of universal entitlement.

In Wales the cost of home care is capped, while in Northern Ireland the over-75s get it for free; Based on Scottish figures, Labour said the move could save those currently self-funding their care almost £10,000 a year while 70,000 fewer families would be liable for “catastrophic” lifetime care costs in excess of £100,000.

Mr McDonnell also pledged to close the gap in social care funding and give local authorities extra support to provide care so services are not outsourced to private firms; The King’s Fund think tank has estimated that free personal care could cost £6bn a year in 2020-21, rising to £8bn by 2030.

The organisation said Labour’s announcement was a welcome step but “it is not the same thing as free social care, and some people would still be left facing catastrophic costs.”

Care services have been pushed to the brink.

Further support to the care workforce has been pledged to ensure that older people receive support from trained staff who have the time and skills needed to provide care; As part of the National Care Service, Labour has pledged to raise standards of care by ending the use of zero-hour contracts and ensuring that carers are paid a real living wage, including for travel time. Also, to end 15-minute care visits and improve access to training and development for care staff.

Barbara Keeley MP, Labour’s Shadow Social Care and Mental Health Minister, said: “Nine years of cuts to local council budgets have pushed care services to the brink. For years, the Tories have failed to bring in much-needed reform, leaving too many people and their families struggling to afford the care they need.

“Tackling the crisis in social care is a priority for Labour. Our plans for social care will address the immediate crisis in care, double the number of people receiving publicly-funded care, and stop people with dementia being treated unfairly by the care system.

“It is vital that social care is a universally-available public service which provides dignity, security and compassionate care. Our National Care Service will have these principles at its core.”

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