Patients at risk from shortage of nursing staff in NHS – poll
MORE than half of NHS nurses say patient safety is being compromised due to severe staff shortages.
A new survey by the Royal College of Nursing (RCN) asked its members in all four UK countries about staffing levels on their most recent shift and the quality of care provided.
Some 55% said shifts did not have the level of nurses planned, with 53% stating the shortage was impacting on the care given to patients.
More than a third (36%) report having to leave elements of patient care undone due to a lack of time, while two-thirds (65%) work an unpaid extra hour on average.
In Wales, the Chief Nursing Officer’s guidance recommends a ratio of one registered nurse to seven patients on both medical and surgical wards. Secondary reference is made to a ratio of 1:11 at night.
But the survey found an average of 9.7 patients to one registered nurse on day shifts in Wales – and an average of 15.7 patients to one registered nurse on night shifts.
Wales introduced the Nurse Staffing Levels (Wales) Act in 2016, and following a period of consultation the implementation guidance is due later this year.
The Welsh Government has committed to extending the legislation to further settings.
Tina Donnelly, director of the Royal College of Nursing in Wales, said: “The results of this report are really devastating for nurses seeking to provide optimum standards of care across the UK.
“Our members have said that as nurses they face staff shortages on a daily basis.
“We know that nurses go home at night exhausted, weary and disillusioned because they fear they haven’t provided appropriate care.
“We don’t have enough of them looking after patients. Our patients deserve better.”
She said the implementation of the Nurse Staffing Levels (Wales) Act cannot come quickly enough.
“Our members lobbied their Assembly Members, set up a petition and got the support of the general public to convince our government that this legislation would improve patient care and save lives.
“We need to see this legislation across all four countries of the UK and a commitment to value nursing by demonstrating they will have the right numbers in the right place of care at the right time our patients need us in all settings.
“Having the right number of appropriate qualified, competent and experienced nurses protects the public and nursing alike, and that is why legislating for nurse staffing levels was so important. We are looking forward to the publication of the statutory guidance on the Nurse Staffing Act and working with the Welsh Government to implement it.”
Speaking at the All Wales Nurse Staffing Conference, Health Secretary Vaughan Gething said nurses were the “lifeblood of the NHS in Wales”.
He said the Welsh Government will be publishing the required Statutory Guidance on the Nurse Staffing Levels (Wales) Act in the next six weeks.
“Wales is the first country in Europe to legislate on nurse staffing levels,” he said.
“We took the lead, empowering nurses and ensuring the resources are in place to care sensitively for patients.
“I’m delighted the guidance, developed with and for the nursing workforce, will be published in the coming weeks.”
Speaking on the 1% pay cap on public-sector workers, the Health Secretary told the conference: “The number of nurses working in NHS Wales continues to increase year on year. There are more nurses working here in our NHS than ever before; something to be celebrated.
“We do, however, recognise there are challenges around the recruitment of nurses in primary and secondary care – that’s why we developed our successful This is Wales: Train Work Live campaign to attract more staff here for the future.
“Pay and the public-sector pay cap is an issue for those already in the profession and those considering a career in nursing. We have called, repeatedly, on the UK Government to end the cap on public-sector pay and give workers across the UK a much-deserved pay rise.
“Any lifting of the cap must be funded by the UK Government, doing so ourselves would mean £50m coming out of the budget for NHS Wales alone.
“This would threaten thousands of public-sector jobs and impact on the services we value and rely on. I know NHS staff do not want a pay rise on the back of redundancies in local government and other public services.
“I have written to the Secretary of State for Health, Jeremy Hunt, on two occasions calling for an end to the cap; he has not given me the courtesy of a response thus far.”
THE nursing profession is going through a turbulent time at present. According to latest figures, there are more than 40,000 unfilled NHS posts in Wales and England combined.
It means many nurses are being forced to work under immense pressure, in understaffed wards with more patients under their care than ever before.
The Chief Nursing Officer for Wales recommends that a single nurse in Wales looks after no more than seven patients at a time and 11 at night.
But a new survey from the Royal College of Nursing (RCN) shows that they are caring, on average, for 10 patients in the day and as many as 15 in the night.
There are understandable fears among the workforce that care could be compromised as a result of this high nurse-to-patient ratio.
Inevitably, staff morale will continue to plummet, nurses will be forced to take extended periods of time off due to stress or will leave the profession entirely.
And, let’s be clear, this problem is not isolated to hospitals.
The RCN has long voiced concerns about the growing caseload of district nurses who travel to people’s homes to provide expert care.
This group of nurses play a major role in empowering people to be cared for in their own homes and in the community.
It has been shown that highquality district nursing reduces the burden on GPs, hospitals and emergency care.
But in certain instances, district nurses have reported seeing their caseload increase from 30 patients to 150. That is unacceptable.
To put it simply, nurses feel undervalued and demoralised in Wales and the rest of the UK, and years of poor pay hasn’t helped.
Nursing staff have suffered a real-terms cut in pay of 14% since 2011 which led to thousands of people descending on Parliament to call on the UK Government to scrap the 1% pay cap.
Intense pressure is being put on Secretary of State for Health Jeremy Hunt to end the cap once and for all for public sector workers.
But axing it at a time of high concern about wage stagnation across the UK could prove controversial and costly.
The Resolution Foundation stated in July that “ending the public sector pay cap in 2018-19 would cost £9.7bn a year by 2021-22”.
The Institute for Fiscal Studies puts the bill slightly lower at £6bn to £7bn.
But while nurses and other health professionals continue to be undervalued, their expertise will be lost from the NHS.
And tens of thousands of students will be deterred from taking up degrees in nursing and instead opt for more financially lucrative careers.
As Health Secretary Vaughan Gething has rightly pointed out, nurses are the lifeblood of the NHS and their contribution needs to be valued more.
Let’s hope that the introduction of the Nurse Staffing Levels (Wales) Act will help to address some of these workforce shortages so patients and nurses don’t suffer. The Western Mail newspaper is published by Media Wales a subsidiary company of Trinity Mirror PLC, which is a member of IPSO, the Independent Press Standards Organisation. The entire contents of The Western Mail are the copyright of Media Wales Ltd. It is an offence to copy any of its contents in any way without the company’s permission. If you require a licence to copy parts of it in any way or form, write to the Head of Finance at Six Park Street. The recycled paper content of UK newspapers in 2016 was 62.8%