Unsafe staffing levels unacceptable in Wales NHS
Published: 22 April 2013
Immediate action needed to combat unsafe staffing levels across the health service
The number of staff on hospital wards and in the community is falling to unsafe levels regularly, in some cases on a daily basis, according to new evidence from the Royal College of Nursing (RCN).
A survey of 2086 nurses in charge of hospital wards and team leaders working in the community across the UK found that almost three quarters (71 per cent) were not confident that staffing levels were always safe and of these three out of four (74 per cent) said staffing levels dropped to unsafe levels at least once a month. More than a third (36 per cent) reported staffing levels were unsafe on a weekly basis, while almost one in ten (9.5 per cent) said staff numbers fell to an unsafe level on every single shift.
More than two-thirds (69 per cent) of ward sisters surveyed by the RCN reported a difference between the numbers of nursing staff deemed necessary to staff wards and community nursing teams safely and the actual numbers of nurses in place. 27 per cent reporting that posts were being permanently cut.
In Wales, 69% all nurses across sectors in Wales said problems of poor care could happen where they work and the majority of nurses in Wales (99 per cent) said they wanted to see a change in culture where patients are put first, ahead of finance or targets.
Peter Meredith-Smith, Associate Director (Employment Relations) Royal College of Nursing in Wales, said: “Nurses across Wales rank staffing pressures as their biggest problem. Research shows it is a problem for patients too. Insufficient nurse staffing is linked with poorer patient outcomes. This includes lengthened hospital stays and in extreme cases increased chance of patient death. Poor nursing staffing levels also contribute to poor staff morale and causes increased work-related stress, more sickness and absences, job dissatisfaction, burn out and staff turnover.
Nurses have a duty to their patients, the National Health Service and themselves to heighten concerns the about the compromises that are being made in relation to staffing levels in our services from day to day. It is clear from our members that nurses are working longer shifts to care for larger numbers of sicker patients, with decreased support staff to assist them. This situation is not acceptable and is unsustainable. The Government must listen to the concerns of nurses, who are calling for mandatory staffing levels. Nurses strongly support the Francis recommendations. It is now for the Government to take action”.
Despite their concerns over unsafe staffing levels, many ward sisters are unable to secure extra staff when their clinical judgment says it is needed. Nearly half (46 per cent) said they were unable to authorise additional staffing when necessary and of those who were able to initially authorise extra staff, many reported that even then, their requests were ultimately turned down.
Peter Meredith-Smith added: “Sir Robert Francis highlighted in his report that ward sisters will be crucial in driving improvements in care, and this means the Government must listen to their concerns. Nurses are central to the patient’s experience and the Ward Sister or Charge Nurse is responsible for managing a great deal of that experience.
“In Wales, Free to Lead Free to Care was launched several years ago to empower ward sisters to take responsibility for everything on their ward from cleanliness and hygiene, nutrition and hydration to protecting patients’ mealtimes, raising the standard of care and maintaining dignity and respect of patients.”
A key area identified by Robert Francis was the urgent need for a change in culture where patients are put first, ahead of targets. Almost all (98 per cent) nurses support this recommendation; however there are worrying signs that such a culture change is still a long way off, with only a third (34 per cent) of respondents saying their place of work had a good culture. Three quarters (75 per cent) believed that financial issues are put ahead of patient care in their workplace.
Peter Meredith Smith said: “The Royal College of Nursing values the vital role of support workers as members of the nursing team and recognises the important role that HCSW’s play in delivering health care across all sectors and in many specialties. We want to see mandatory regulation of health care support workers. 88% of the nursing workforce supports this.”
Ends
Notes for Editors
1. For further information, please contact RCN in Wales Communications Office on 02920680732 or 07773367707.
2. The Royal College of Nursing (RCN) is the voice of nursing across the UK and is the largest professional union of nursing staff in the world. The RCN promotes the interest of nursing staff and patients on a wide range of issues and helps shape healthcare policy by working closely with the UK Government and other national and international institutions, trade unions, professional bodies and voluntary organisations.