RCN: Mid-Staffs driven by finance not patient care

Published: 18 March 2009

The Royal College of Nursing has described the Healthcare Commission's investigation into emergency care at Mid-Staffordshire NHS Foundation Trust as 'shocking' and said that the poor standards of care at the Trust were a result of placing more importance in money saving measures than providing quality patient care.

RCN Chief Executive & General Secretary, Dr Peter Carter, who was interviewed on the issue on Newsnight yesterday evening (17 March 2009), said:

"The RCN has said it time and time again; when trusts cut staff, fail to provide leadership and put money-saving measures in front of quality patient care, this is what happens. Nurses want to give their patients top quality care, but when you have so few staff that you're relying on A&E receptionists to provide clinical care, there are clearly not enough nurses to provide good care".

The comments came as the Healthcare Commission published its investigation into apparently high mortality rates in patients admitted as emergencies to Mid Staffordshire NHS Foundation Trust since April 2005. The report condemned the emergency admissions procedures at the Trust, stating:

"It had become a foundation trust and improved its finances. However, it did not have a grip on operational and organisational issues, with no effective system for the admission and management of patients admitted as emergencies. Nor did it have a system to monitor outcomes for patients, so it failed to identify high mortality rates among patients admitted as emergencies. This was a serious failing".

'Nothing new'

The RCN said this was 'nothing new' and compared the situation at Mid Staffordshire NHS Foundation Trust with the events which took place in Maidstone and Tunbridge Wells. The College reiterated that high quality care requires sufficient nurses to deliver it and highlighted that the Mid Staffordshire Trust were 120 nurses short of the number needed to provide a high standard of care. The RCN says this was because the Trust board were trying to save £10 million. Dr Carter said:

"When you overwork and overburden staff in any profession, the quality of their work suffers. It is no different with nurses.

Poor nursing practice is unacceptable, but just as in Maidstone & Tunbridge Wells, there is almost always a wider reason, whether it's a working culture where patient safety is not the top priority or a finance driven agenda of staff cuts".

The RCN welcomed the resignation of the Chair and Chief Executive of the Trust but said that this alone will not address the problem. Urging the Government to support trusts in putting patient safety and patient care at the top of agendas, the RCN said that enough fully trained nurses are needed to provide that care. Dr Carter said:

"It is becoming more and more obvious as report after report comes out, if you want high quality care; you need enough fully trained nurses to provide that care. There is also something very wrong when trusts are achieving foundation status by putting the health of their budgets over the care of their patients as detailed in the accounts of Trust board meetings".

The RCN has pledged its support to the Trust, acknowledging the significant progress made by the Trust since the Healthcare Commission first investigated. The RCN wants to work closely with the Trust to sustain the improvement and ensure nursing staff at all levels are supported and empowered to deliver the quality of care that patients expect and deserve.

Health Secretary, Alan Johnson has issued an apology to the patients and families of patients who have suffered because of the poor standards of care at Stafford Hospital. He also urged managers and clinicians to ensure the events are never repeated.