RCN Wales’ wish list for new First Minister
LAST month Vaughan Gething MS was announced as Wales’ new First Minister.
Vaughan is no stranger to the Royal College of Nursing (RCN) as a former health minister for Wales, and so is aware of the huge list of challenges facing him.
The Royal College of Nursing has some good advice for him on how his government can improve health services.
A top priority for the Welsh Government is to alleviate the huge pressure on care services which I know from the stories I hear is affecting every part of the NHS across Wales.
Patients waiting for too long for care right across the system, including primary, scheduled and emergency care.
What we are seeing in hospitals, caused by unsustainable patient demand and insufficient staff, is deeply concerning: patients being looked after in chairs, on trolleys lined up in corridors, in ward areas that don’t properly support patient care. An experience that falls below the level of quality they could reasonably expect.
The health care staff who are providing care in these areas experience a great deal of moral distress, knowing that they can’t deliver the level highest level of care to their patients and families. The wellbeing of staff is impacted, leading to burnout, increased prolonged sickness and a feeling that there is no choice but to leave the profession. Providing care in inappropriate places is a risk to patient safety and lives.
This unacceptable situation is the result of many factors. They include increased demand for emergency care services; workforce challenges compounded by too many vacancies and high levels of sickness absence; delays in discharging medically fit patients from hospital with knock-on effects on the flow of emergency patients from A&E to a ward; and patients not always accessing the most appropriate care for their needs.
The Welsh Government’s six goals for urgent and emergency care try to take a whole-system approach to support people who need urgent or emergency care to access the right care, in the right place, first time. But more is needed if this is to be successful.
For nursing, this means a demonstration of the value of nursing across the NHS and independent sector that makes tangible difference to working lives. This starts at the very beginning with investment in education and support for nursing students including a permanent NHS bursary for tuition fees and living costs, to attract and nurture the future nurses in Wales.
A strengthened policy implementation on safe staffing levels is essential.
Accountability must lie with Welsh Government and health boards to ensure the correct number of nurses are employed, with the right skillset, in the right environment to deliver patient care. Research has shown that low nurse staffing levels can increase patient mortality.
Next comes improvements to pay and conditions.
This government needs to make good on its promises made in last year’s NHS pay award: to deliver full implementation of existing conditions like paying nurses when they can’t take breaks or leave on time: flexible working options, which is a reality for everyone: funded continuing professional and career development: care in inappropriate areas as an exception. And it needs to come good on its commitment to pay restoration with actions.
For nurses outside the NHS the government needs to ensure their pay and conditions at least mirror their NHS colleagues.
Eight years ago, the then labour government introduced the first legislation in Europe that set out safe nurse staffing levels. This government needs to build on their seminal legislation, extending its duties to more health care areas like mental health and community setting, and strengthening the consequences of non-compliance.
Doing this will show the public and the nursing profession that they are serious about patient safety. Doing this will keep nurses practising in Wales and make nursing a career of choice. Doing this will improve everyone’s experience of care.
Finally, the Minister for Health and Social Services has made the momentous decision to introduce a new nursing role in Wales: the registered nursing associate.
A nursing associate acts as a supportive role between health care support workers and registered nurses and could be a positive addition to the workforce if introduced responsibly.
This government must take that responsibility seriously by ensuring there is new money to fund the initiative even in a financial crisis, and mandating employers that the substitution of registered nurses will not be tolerated.
The government must satisfy itself that the role is being used as a genuine addition to a health care workforce.
I look forward to working with the new First Minister and his government as RCN Wales continues to influence with and for our members.