25. Hard Times (emergency resolution)

West Midlands Board

That this meeting of Congress calls on governments and health care organisations across the UK to guarantee that safe staffing levels and nursing expertise will not be sacrificed to make ends meet in tough financial times.

On this page:

• Watch the debate
• Read the progress report
• Read the debate report
• Read the background information

Progress report

Council Committee: MRC/NPPC
Committee decision: Incoporate into existing workstream
Council member/other member/stakeholder involvement:
Staff contact: jane.ball@rcn.org.uk , howard.catton@rcn.org.uk

This item relates directly to two main areas of work which were already underway.

• The Policy Unit’s new guidance on determining safe staffing levels, which had been in progress since the end of 2009. This sets out the context in which staffing level decisions are taken before detailing the impact that nurse staffing has on patient outcomes – the reasons why getting nurse staffing levels right is crucial. It outlines what is known about current staffing levels across the UK in different sectors before presenting an overview of the approaches to workforce planning used at local level, giving examples of different models and systems.
• The Frontline First campaign launched in July 2010, which allows the RCN to monitor the reality of changes being made in the health service, and to detect the impact of financial pressures on staffing levels on the ground.

The staffing levels work was supported by:

• literature search and review and web search
• interviews with RCN members, RCN Council members, RCN staff, health service staff, patient safety advisers and nursing workforce experts
• discussion groups with clinical nurse managers
• establishing links with relevant national initiatives (e.g. Energising for Excellence).

Following sign off by NPPC and at Council, the two papers were published on 8 December 2010:  new guidance and a policy position statement on safe nurse staffing levels and a shorter paper that summarises the RCN policy position in relation to safe staffing levels was also published. The papers were launched at a roundtable event with stakeholders to discuss staffing level issues and gauge reaction to RCN policy and guidance.

The guidance document (with executive summary) covers:

• the context
• evidence as to why nurse staffing is key
• data on current staffing levels
• a summary of approaches to planning nurse staffing (and brief review of a selection of tools)
• conclusion.

The Nursing and Midwifery Council and the Care Quality Commission have produced a joint memorandum of understanding. The NMC now has a role in flagging organisations where the context care is delivered in is of concern.

The RCN responded to the Department of Health England's consultation on the NHS constitution and whistle blowing in January 2011.

Staffing levels will continue to be an issue so work is ongoing to disseminate RCN resources and policy position (e.g. through conferences, an article in Nursing Management and a forthcoming article in HSJ). The RCN is also collaborating with the Royal College Psychiatry (who are undertaking a national audit of dementia care) to look at staffing in relation to dementia care.

The work on this issue culminated in the RCN taking part in the TUC’s March for the Alternative on 26 March, which marked the beginning of a new phase of campaigning against cuts to jobs and services.

Debate report

Echoing concerns about the impact of NHS cost cutting on frontline nursing jobs, the resolution proposed by Tracey Budding, Chair of the RCN West Midlands Board, called for a 'cast iron' commitment by all UK governments and healthcare organisations to protect safe staffing levels and nursing expertise.

Tracey asked whether safe staffing levels will be regarded as a basic essential or an unaffordable luxury item as the predicted public sector spending cuts start to bite.

She cited recent NHS and RCN surveys showing high levels of concern about understaffing and nurses’ capacity to deliver safe, compassionate care, and claimed this was the moment to send out a resounding message that safe staffing levels are non-negotiable.

Geoff Earl, seconding the resolution on behalf of the RCN Scotland Board, questioned whether healthcare organisations would ultimately be able to deliver on politicians’ pledges to protect frontline services. Evidence from the NHS deficits crisis in 2006 suggested specialist nursing posts were among the most vulnerable.

Zeba Arif said budget constraints were not a justifiable reason for understaffing to be tolerated, whilst Susan Tripp called for services and adequate staffing levels to be guaranteed in both the NHS and the independent sector.

Mike Travis warned against the risks to patients of bed and staffing reductions in paediatric services, particularly on medical and surgical wards.

A tearful Billy Drysdale said he had been 'vilified, picked on and bullied' after raising concerns about staffing levels. As a steward, he urged the RCN to equip him with a tool to empower members to insist on safe staffing levels.

Denise Chaffer urged the RCN to utilise the specialist knowledge from within its own forums to shape the development of ‘sound, consistent evidence' and a toolkit to support members.

FOR  404 (99.26%)
AGAINST 3 (0.74%)
ABSTAIN 2