Creating healthier workplaces

On 10 and 11 October RCN reps came together in Milton Keynes to discuss how they can work with employers to retain and support nursing staff, while continuing to influence and campaign for staffing for safe and effective care.

The theme of the two-day conference was “healthier workplaces” with reps sharing their own experiences of helping to improve conditions for members and exploring the importance of prioritising mental health in workplace settings.

“It all comes back to safe and effective care”

With the Northern Ireland strike ballot opening the previous day, the fight for safe staffing was on everyone’s mind as reps from across the UK took their seats for the RCN’s October UK joint reps conference.

The event kicked off with a minute's applause in support of nursing staff in Northern Ireland, where, for the first time in its 103-year history, the RCN is balloting members on industrial action, up to and including strike action. 

RCN Chief Executive & General Secretary Dame Donna Kinnair then took to the stage to give her keynote speech. Commenting on the nurse staffing and pay crisis in Northern Ireland that has led to the ballot, Donna said: “The people that spend 24/7 with patients are nurses so if we don't value nurses, we're not valuing the outcomes for our patients. We have come to the stage where enough is enough.” 

Donna went on to tell delegates: “Everything we’re doing as an organisation – whether we’re talking about pay or education – it comes back to safe and effective care.

“Right now we're living in a world that feels off kilter. Every day brings something which is 'unprecedented'. What really is unprecedented, is that 54 members of our nursing community are leaving the NMC register every single day.

“The NMC is very clear in saying that many people are leaving because they are dissatisfied with the environment they work in. Right across the UK, successive governments have consistently put finance ahead of staff and patient care, and staff and patient wellbeing.”

You are the backbone of the organisation. Because of you, our voice as the RCN is getting louder

Donna acknowledged the enormous pressures nursing staff in all four countries of the UK are facing due to staff shortages and implored delegates to look after their own mental health and support one another. Donna also thanked reps for the support they offer members and the crucial role they play in campaigning for staffing for safe and effective care across the UK.

“You are the backbone of the organisation,” said Donna. “You walk the floor every single day interacting with members in your place of work. Because of you, our voice as the RCN is getting louder.” 

Speaking about the member-led campaign in England, Donna said: “We are learning from the work done in Wales and Scotland, as they turn legislation into practice, and we are following down the path which they have led on.”

Earlier this year, RCN members in Scotland secured new legislation on staffing for safe and effective care after a similar law was introduced in Wales in 2016. Donna described these events as “watershed moments”.

“These have been achieved by you and our members,” Donna said. “It is you and our members that are champions for safe staffing.”

RCN Chief Executive Dame Donna Kinnair at the UK joint reps conference in Milton Keynes

As Donna brought her speech to a close, she urged reps to continue to lobby politicians in the fight for safe staffing in every health care setting across the UK.

“We can challenge and stand up to any government, to any politician, in any party,” said Donna. “We need accountability, investment in education and investment in the NHS. And we need it now. We will continue to demand this.

“The key to amplifying our voices is you. It’s you that hold politicians to account. You have been foremost in creating change to protect your patients. You are out there enabling us to practice safely and effectively.

“We have never been louder as a trade union. It is our time to create great change. The power to do that is held by you. My plea to you is let's work together to get it done.”

New campaigning resources for reps 

As part of the conference programme, delegates were asked to review two draft resources being developed to support reps in campaigning and to help strengthen their influence within workplaces on staffing for safe and effective care. 

The resources, which have been developed by steering groups made up of members and RCN staff, will now be reviewed and updated in light of feedback from the conference before being made available.

Pictured below: Delegates take a moment to stand in solidarity and strength with members in Northern Ireland

Reps in action

The conference offered an opportunity for delegates to hear from a number of reps on how they’ve worked in partnership with the RCN and their employers to create healthier workplaces for members.

Rest, Rehydrate and Refuel

Our 3Rs initiative – Rest, Rehydrate, Refuel – was launched in March 2018 following concerns raised at RCN Congress that nursing staff were missing breaks because of short staffing, and that some staff were even being denied access to water during shifts.

The initiative, which is part of our Healthy Workplace, Healthy You campaign, offers reps resources and the tools to help them introduce improvements in their workplace and promote the importance of the 3Rs for all health care staff. 

Since introducing the initiative in her workplace in Scotland, RCN steward Hilary Nelson told delegates that she has seen real progress.

Hilary Nelson

“I started off working with my own senior charge nurse to make sure all staff in our department had access to water and were taking regular breaks,” said Hilary. “We introduced a designated place for staff water bottles and we introduced break buddies.

“Working in intensive care, some nursing staff were initially reluctant to take breaks as they didn’t want to leave their patients. The break buddy system means staff are covered and given the peace of mind that their patient will be cared for. 

“The culture has started to change and people know they need to take a break. I thought to myself, if we’re doing it, why isn’t everyone else doing it?”

Hilary told conference delegates that she arranged to attend peer group meetings with band 5 and 6 nursing staff from across her organisation so she could introduce the initiative more widely and share resources like posters and promotional coasters. 

I thought to myself, if we’re doing it, why isn’t everyone else doing it?

Not long after the meetings, a couple of RCN members approached Hilary and asked to show her what they’d done in their department. Hilary was delighted to see they’d introduced a “hydration station”. 

“They told me it’s working really well,” said Hilary. “They have water available for visiting nursing staff and people aren’t going home with sore heads from dehydration. They’re also using ‘wee charts’ on the back of staff toilet doors to remind people to refill their water bottles.

“Some members have told me they’re not allowed water bottles on the ward which isn’t the case so I’m now working with our infection prevention and control team to develop a standard operating procedure. 

“This will help us to spread the message that staff can have their water bottles, and should be encouraged to have them. I want these positive changes to happen across the whole organisation.”


Spread the message far and wide

Hilary’s top tip for reps was to “talk to everyone and keep talking”. “You need to get your managers on board but also speak to members,” she said. “Solutions come from our members. Empower them to say what’s needed and give them the resources they need.”

Hilary added: “It’s important we don’t forget community nurses and take the campaign out to other settings.”

RCN steward Donato Tallo, who works in a large London trust, agreed with Hilary that the most important thing is to spread the message far and wide.

“I’m a practice education facilitator so I meet lots of people from across the organisation,” said Donato. “I try to share resources and ideas with staff, including clinical staff who don’t work in direct patient-facing roles. 

“It’s also really important to ‘myth bust’. People need to know that there is legislation and policies to support this work. We have a huge amount of resources and they can act as a catalyst for conversations about staff wellbeing.”

RCN rep Donato Tallo

Get involved

There are lots of resources available to support the RCN’s 3Rs initiative, including posters and a handbook outlining the legal requirements for employers to provide rest breaks and facilities, as well as the impact that dehydration and fatigue caused by missed breaks can have on patient safety.

Read more about the RCN’s 3Rs campaign and download resources.

Making a healthier workplace 

RCN Reps Valerie, Claire and Penny also shared what they’ve been working on to help protect members’ health and wellbeing at work and to highlight how the three different rep roles can contribute to such work.

Valerie, RCN safety rep

RCN member Valerie

“In our role as safety reps, of course we focus on safety in the workplace but it’s important to think about the health of staff as well, and to be proactive about this.”

Here are some of the ways in which Valerie is helping to make her workplace healthier:

  • attending and feeding into her trust’s staff health and wellbeing committee and staff carers network
  • holding workshops at different sites promoting the RCN’s 3Rs material
  • promoting other health and wellbeing initiatives that nursing staff may not be aware of, such as free eye tests and the trust’s cycle to work scheme
  • using staff feedback to make improvements – staff were reporting a high number of bike thefts so Valerie is working with her employers to make sure there are safe places for staff to store their bikes.

With Valerie’s trust staff survey showing the top two causes for ill-health at work as stress and musculoskeletal problems, Valerie is committed to promoting the trust’s physiotherapy provision for staff accessed through occupational health and the trust’s mental health support services, including CBT therapy.

Claire, RCN steward

Claire Shields 

“Our staff survey had indicated that staff with disabilities and long term illnesses were the most unhappy group at work because there was so little in place to support them. In my role as an RCN steward, I’ve worked with the trust to update our managing attendance policy and introduce better support for nursing staff.”

Improvements to policies and support include:

  • paid disability leave for staff who need to attend appointments or treatment, such as chemotherapy or radiotherapy sessions
  • working with nursing staff to review reasonable adjustments, such as flexible working, to make sure staff with disabilities are better supported at work 
  • better HR support for ill health retirement so staff with long term illnesses have the option to resign rather than be dismissed due to ill health
  • better support to enable staff with a terminal illness to stay in work for longer
  • increasing time periods for redeployment when it’s due to ill health so people can return to work in a staggered and more supported way
  • better access to health checks and support for drug and alcohol problems.

Penny, RCN learning rep

RCN member Penny

“We found there was a lot of embarrassment and ignorance about the menopause in our workplace. Everybody is affected by it, either through experiencing symptoms themselves or by working with someone who is. 

“In my role as a learning rep, and in partnership with a Unison colleague, I’ve worked to change that culture within the organisation and help people engage and talk more openly about the menopause so we can offer better support to staff.”

Penny and her colleague started out by developing a presentation outlining information about the menopause and work, making use of RCN guidance and resources. They then attended senior management meetings and disseminated the information to frontline staff.

The organisation now has an online menopause support group so staff can ask questions, find information and access support and Penny is hoping to develop a policy to further support staff.

Mental health in the workplace

Day two of the conference saw Paul Farmer, Chief Executive of the mental health charity Mind, take to the stage to speak to reps about the importance of prioritising people’s mental health in the workplace.

To reinforce this point, he began by sharing some poignant statistics about mental health:

  • one in four people experience a mental health problem every year
  • one in six workers in the UK are experiencing depression, anxiety or stress
  • 300,000 people leave work every year with a mental health condition
  • poor mental health costs employers between £33 billion and £42 billion a year
  • in the public sector, poor mental health costs employers an average of £1,551 - £1,877 per employee a year.

Paul’s presentation focused on how organisations can embed good practice to look after people’s mental health at work and shared key findings from a report he co-authored called Thriving at Work: The Stevenson Farmer Review of Mental Health and Employers

Paul said: “We can’t really say that mental health isn’t in the spotlight anymore. It is an issue that has slowly but surely risen up the agenda but it’s an important moment for all of us to pay further attention to this really critical issue.

“We think there are clear solutions that organisations can easily follow and they are not always solutions that necessarily mean huge amounts of resource. But what they do require is a sense of priority.”


Paul's report identifies six core standards for organisations to follow:

  1. Produce, implement and communicate a mental health at work plan.
  2. Develop mental health awareness among employees.
  3. Encourage open conversations about mental health and the support available when employees are struggling.  
  4. Provide your employees with good working conditions. 
  5. Promote effective people management. 
  6. Routinely monitor employee mental health and wellbeing.

Standing up for safe staffing

As the programme of lively and productive sessions drew to a close on day two, RCN President Anne Marie Rafferty delivered her closing speech refocusing delegates’ thoughts on the fight for safe staffing across the UK.

RCN President Anne Marie Rafferty at the UK Joint Reps Conference

Anne Marie began by thanking RCN reps for all that they do for members and for nursing as a profession.

“I am really struck by the way in which you're able to support colleagues,” said Anne Marie. “I want to congratulate, commend and thank you so much. You keep members safe and protect workplaces to make them better, and safer places to be.”

You keep members safe and protect workplaces to make them better, and safer places to be

Reflecting on how the campaign for safe staffing across the UK is developing, Anne Marie told reps she believes this is a “totemic moment in the history of the RCN” and that RCN reps and members are “standing up and being counted as activists as never before.”  

Anne Marie said: “Never before have we had Wales, Scotland, England and Northern Ireland all coming together and converging on a path in a very determined way to demonstrate our solidarity and our unity in fighting for staffing for safe and effective care.”

Echoing the sentiments of other speakers and discussions from the conference, Anne Marie said: “When staffing levels are poor and drop below half of what they should be, nurses aren't getting breaks which impacts their physical health – but also increasingly we have to focus on nurses' mental health too.

“What happens to nursing staff over the long haul? When you keep facing the same kinds of challenges day in day out – that’s why we need this policy reset.”

Anne Marie also acknowledged the work reps do to support members’ health and wellbeing, and importantly, to retain staff keeping more people in the profession. 

You are actively and determinedly changing the nature of the policy conversations

“I think that’s an amazing accomplishment,” said Anne Marie. “You’re supporting colleagues and we need to support each other because it’s really tough out there.”

Bringing her speech to a close with a nod to the safe staffing successes in Wales and Scotland, Anne Marie said: “With this build-up of legislative petitioning, lobbying, momentum and learning from each other, we are moving forward and we're doing it in partnership across the devolved countries of the UK.

“I applaud the passion, determination and intelligence you bring to the RCN. You are actively and determinedly changing the nature of the policy conversations. 

“Together we can and together we surely shall.”

What else was discussed?

As well as hearing from fellow reps and the keynote speakers, delegates were able to learn more about different RCN departments and the support available to help them in their roles as reps. 

Sessions included:

  • RCN Employment Relations Department (ERD) update
    Speaking at her first UK Joint Reps Conference, RCN Associate Director Josephine Brady, who has been in post since July, explored the current employment relations landscape and how reps and ERD can work together to improve working conditions for members 
  • Support and supervision standards for RCN reps 
    This session shared the learning from a project which developed support and supervision standards for learning reps and safety reps, and how this learning can benefit the whole rep community. Read more about the new supervision standards
  • Legal update: helping you make a difference in your workplace
    RCN Head of Legal (Employment) Jo Galbraith-Marten shared tips and tools to help reps identify disability discrimination in the workplace and achieve better outcomes for members.

Highlights and recordings from the conference will be available soon on the RCN reps hub.

What did reps think of the event?

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