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Royal College of Nursing

RCN report reveals the sad state of the NHS as staff leave work “sobbing” and patients die alone

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by Ian Snug.
RCN report reveals the sad state of the NHS as staff leave work “sobbing” and patients die alone

The Royal College of Nursing has called for an urgent patient safety review after nurses ‘blow the whistle’ on staffing shortages.

The healthcare union is urging care providers to review if they have enough staff to provide safe and effective care this winter as it reveals the concerns of 30,000 front-line staff.

Research completed by the union showed that over half of shifts did not have the level of nurses planned and the shortage is compromising the care given to patients.

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The survey of nursing staff in all four UK countries asked about staffing levels on their most recent shift and the quality of care provided. More than a third reported having to leave elements of patient care undone due to a lack of time, while two-thirds work an unpaid extra hour on average.

Seven in 10 nurses in England said their last daytime shift exceeded NICE guidelines, which state that more than eight patients to one nurse should act as a ‘red flag’. A quarter reported shifts with 14 or more patients per nurse.

Accident and emergency departments had the lowest quality ratings of all hospital services, with one in seven A&E nurses rating care as poor or very poor.

Almost half of all respondents said no action was taken when they raised concerns about staffing levels.

The respondents also reported that:

  • patients are no longer afforded enough dignity, even dying alone.
  • colleagues have burned out and have become sick themselves, unable to come to work.
  • staff leave work “sobbing” at the impact of shortages on patient care.
  • many question their future in nursing and contemplate leaving the profession.
  • they struggle to give their children and families enough support after shifts that can exceed 12 hours.

The findings come after the Nursing and Midwifery Council warned the nursing profession was shrinking as more people are leaving than joining the register.

Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said:

“When this many professionals blow the whistle, they cannot be overlooked. The nursing shortage is biting hard and needs the attention of Ministers - this warning comes from the very people they cannot afford to lose.

“The findings in this report are a direct result of years of poor planning and cost-cutting - it was entirely predictable.

“Nursing staff are revealing desperately sad experiences and their honesty must drive forward the policy debate. We urgently need assurances from every health and care provider that services are safe for patients, and new laws on staffing should follow swiftly.”

The RCN has repeated its call for increased funding for health and care services to meet the patient demand.

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Unions call for pay deal to be extended to the private sector

Thousands of NHS workers, many of whom are the lowest paid, have been excluded from the deal because they are indirectly employed by the NHS.

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by Ian Snug.
Unions call for pay deal to be extended to the private sector

Healthcare unions have warned that a “dangerous imbalance” between sectors could cause harm to patients.

The Royal College of Nursing and Unite have called on the government to ensure the NHS pay deal is extended to those providing NHS services in social care, the private sector and primary care.

The NHS pay deal, formally accepted by healthcare unions earlier this month, will mean at least a 6.5% increase for the majority of NHS staff in England. Pay negotiations in Scotland, Wales and Northern Ireland are ongoing.

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However, thousands of NHS workers employed by social enterprises, general practice, social care, arms-length bodies, independent and charitable providers, have been excluded from the deal because they are indirectly employed by the NHS but still have a direct impact on patient care.

Made to feel like the poor relations.

Colenzo Jarrett-Thorpe, Unite National Officer, said: “Excluding indirectly employed NHS workers from the new pay deal is unjust. It will be a disaster for morale with thousands of low paid NHS workers being made to feel like the poor relations of NHS employees. 

"Regardless of whether an NHS worker is employed by a private company or the NHS, they are still health workers and their contribution to patient’s health must be recognised.”

In a letter to Jeremy Hunt, Janet Davies, Chief Executive and General Secretary of the Royal College of Nursing, said: "“I urge you to consider how to address the pay of all nurses and health care assistants providing NHS services, whoever their employer, so that a gap in pay does not result in workers being drawn away from primary, community and social care services.

”This would include those employed by social enterprises, general practice, social care, arms-length bodies, independent and charitable providers.

"I do believe that without this additional funding, we will see a dangerous imbalance of the workforce, which will significantly harm patients of non-NHS services.

"Many of our members delivering NHS services but not employed by NHS organisations complain that they endure poorer working conditions, loss of career and education opportunities,"

"We recommend the establishment of a new and separate national staff council, negotiating for all nurses and care assistants in health and social care who are not directly employed by an NHS organisation."

 

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Healthcare must be redefined as a safety critical industry, says RCN

Healthcare should be reframed as a safety critical industry in order to avoid errors and improve patient outcomes.

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by Clare Bodell.
Healthcare must be redefined as a safety critical industry, says RCN

The Royal College of Nursing has called for the healthcare sector to be refined as a safety critical industry.

Healthcare should be reframed as a safety critical industry in order to avoid errors and improve patient outcomes, according to written and oral evidence submitted to the Draft Health Services Safety Investigation Bill Committee by the Royal College of Nursing.

Speaking at the Committee hearing earlier today, Dame Professor Donna Kinnair, Director of Nursing, Policy and Practice at the RCN, told MPs and Peers that while the College supports the creation of an independent body to investigate serious patient safety incidents in England, this could only work effectively if healthcare is redefined as a safety critical industry.

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Donna said the Bill in its current form places disproportionate emphasis on blaming individuals, and ignores examining the wider context in which mistakes can happen. As well as blaming frontline professionals for system issues beyond their control, this risks investigations failing to root out the true cause of errors, further compromising patient safety.

In light of the 40,000 nurse vacancies in England alone, the RCN has called for nurse staffing levels at the time of an incident to be reported by the HSSIB for every investigation.

In addition the College has called for concerns raised about staff shortages on shift before the incident to be noted by the investigation.

Safe staffing levels should be enshrined in law.

In England, 71 per cent of NHS day shifts in adult acute wards fell outside the recommended nurse to patient ratio (1:8) standard set out in the NICE guidelines. Of those, 26 per cent shifts had more than 14 patients to one nurse. The RCN has previously called for safe staffing levels to be enshrined in law.

The College also raised concerns that healthcare staff who speak out in HSSIB investigations must be guaranteed a genuine safe space in which to discuss errors. It further recommended that findings of investigations be shared with health and care providers both within the NHS and independent sector, in an anonymised and appropriate way.

Speaking at the hearing, Donna Kinnair, Director of Nursing, Policy and Practice at the RCN, said: “The HSSIB will have to tackle those thorny cultural issues such as lack of staff, which people so often say we can do nothing about. It becomes more and more perverse that we tend not to look at the issues that are right in front of us.

“One of the things we are very clear about is we have an understaffed health service. The fewer nurses you have on duty, the worse patient outcomes you have. Nurses deliver 70 per cent of care. We would be working with HSSIB to make sure safe staffing levels are enshrined in law.

“It’s cheaper and easier to deal with the individual, and place the blame on the individual’s head, but this is not the solution. We can make the system safer.”

Nurses are forced to deliver care in unsafe circumstances.

Speaking outside the hearing, Donna said: “To improve patient safety, HSSIB investigations must root out the true cause of errors including systemic failures by Government and agencies. With staffing levels on many shifts below recommended safety guidelines, it is unjust, and potentially misleading to emphasise individual blame when systems and procedures are at fault. 

“Many nurses already struggle in the knowledge they are forced to deliver care in unsafe circumstances, yet their concerns are often ignored. Investigations should note concerns raised prior to incidents, and must take into account inadequate staffing levels.

“Staff should not be held to account for all care that is delivered, irrespective of resources and funding. Appropriate levels of accountability have to exist at all levels, including Government.”

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Unbelievably poor turnout on vote over NHS Pay

Many healthcare professionals are unaware of the need to vote on the proposed changes or confused over the complexities of the deal.

Published on

by Ian Snug.
RCN starts balloting members over proposed pay deal

Only 10% of Royal College of Nursing members have voted on the proposed NHS Pay Deal.

Graeme Stokes, Chair of the Royal College of Nursing in Brighton and Hove, revealed on social media that only around 10% of RCN members have exercised their right to vote over the proposed NHS pay deal that was announced in March.

The proposals include significant changes to the agenda for change pay structure which will affect the majority of healthcare workers.

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In April, a leaked motion calling for RCN branches to reject the deal revealed several key concerns over the proposed pay deal.

NursingNotes revealed research last week which indicated that many healthcare professionals were unaware of the need to vote on the proposed changes or are confused over the complexities of the deal.

You still have time to vote.

When we contacted the Royal College of Nursing to comment on the rumoured poor turnout a spokesperson said; “Voting is still ongoing and we will announce the result when the poll closes in June.”

RCN members only have until the 5th of June 2018 to vote when the results of the consultation will be passed to the RCN Trade Union Committee who will make the final decision over the deal. RCN Member working for the NHS in England? You can vote here.

It is expected that the results of the consultation will be announced alongside other healthcare unions on the 8th of June 2018.

It is not known how these figures compare with other healthcare unions.

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