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Health service needs serious improvement – RCN Scotland comment

18 Jun 2016

Survey of RCN members in Scotland shows pressures of rising demand and worsening finances are affecting services.

At the start of its annual Congress in Glasgow, the Royal College of Nursing (RCN) is today (Saturday) revealing what Scotland’s nurses think about the current state of the health service and the pressures they are under at work.

The RCN surveyed nurses from across the UK and almost 1,000 nurses from Scotland responded.  Of those, only 12.8% believe that the health service is able to meet demand or exceed expectations, while 3 in 10 (30.2%) say it needs serious improvement.  

The pressures of rising demand and worsening finances are being felt by the majority of Scottish nurses:
  • 9 out of 10 (88.8%) say that their workload has got worse
  • 9 in 10 (88.1%) have felt the impact of a rising number of older people requiring care, with almost three quarters (74.1%) reporting a higher prevalence of age-related conditions and 62.5% saying that there’s a struggle for hospital beds. 
  • Over three quarters (78.6%) of nurses surveyed said that finances have got worse. 

As one nurse said: “I get scared for the future, as we are already overwhelmed and often work long hours without overtime. Missing breaks to meet demand is normal now.”

Another nurse commented: “There are constant staff shortages, but still an expectation to do 100% of the workload, which increases regularly. The stress in our profession is immense.”

As RCN members debate a number of related issues during Congress week, Royal College of Nursing (RCN) Scotland Director Theresa Fyffe commented: “This survey clearly shows how much pressure nursing staff are experiencing on a daily basis because of rising demand, made worse by the financial position of many of our health boards. It’s just not realistic to think that health boards can deliver the same services to more and more people and achieve the ongoing efficiency savings demanded by Government. The RCN is really concerned that, without urgent transformation to how health services are delivered in Scotland, there’s a risk of a return to the bad old days of ‘boom and bust’, with health boards targeting the nursing workforce for cuts simply to balance the books.”

Theresa continues: “The nursing workforce is the single, largest group in the NHS, but health boards must not use the current shortages of nursing staff and having to resort to expensive agency nurses to fill the gaps, as an excuse to downband nursing posts or replace registered nurses with non-registered staff as a way of containing costs. This would be short-sighted and impact patient care.”

In the RCN survey, over 4 in 10 (41.4%) said that if they could ask for one thing for the future of nursing, it would be more time to care.  As one nurse commented: “More staff will give us more time to care for patients and raise standards in the process.”

Theresa concluded: “Our health services are at a crossroads and could go one of two ways – either continuing down the same road of trying to deliver services in the same way to more and more people and piling ever more pressure on nursing and other staff; or taking a different route and urgently transforming how services are delivered and how success is measured.  By investing in nursing staff and putting aside vested professional and political differences, the RCN believes transformational change is possible. It would mean a new approach to measuring success in health, focusing on outcomes for people who need to use services and on sustainable improvement in people’s care. Our recently-published report sets out nine principles which we believe are the basis for these changes which are so urgently needed.”