We have a severe shortage of nursing staff in Northern Ireland, as the latest (31 December 2019) figures from the Department of Health illustrate, with 2,659 nursing vacancies in the HSC and a similar vacancy rate estimated in the independent sector.
We have a significant over-reliance on the supply of nurses on an ad hoc basis through the nurse bank and nursing agencies. There are alarmingly high sickness absence rates amongst nursing staff that are largely attributable to stress and mental ill health.
Nurses in Northern Ireland are more likely than nurses in England, Scotland or Wales to cite increases in workload, unfilled vacancies and recruitment freezes in their workplace. We need to invest in safe staffing across all areas of nursing practice. Mortality rates increase by up to 46% in hospitals with a 1:8 nurse-patient ratio compared with a 1:4 nurse-patient ratio. Every patient added to a nurse’s workload is associated with a 7% increase in deaths after general surgery. Higher patient satisfaction is recorded in hospitals with fewer patient per nurse workload and good nursing work environments.
We need proper workforce planning that is based on health needs and strategic priorities, not financial considerations. Three-quarters of all nurses in Northern Ireland currently work beyond their contracted hours each month because they are concerned about patient care. More than 50% of those that do so work unpaid for these extra hours. Nurses in Northern Ireland (84%) are more likely to work unsocial hours than nurses in Wales (79%), England (78%) or Scotland (77%). Nurses in Northern Ireland (68%) are less likely to be paid enhanced rates for working unsocial hours than those in Scotland (66%) and England (53%). Nurses in Northern Ireland are more likely to work additional hours than nurses in England, Scotland or Wales and are less likely than nurses in any country except Wales to be paid for these additional hours.
We need to make sure that health and social care transformation is delivered and this requires investment in community nurses such as district nurses, school nurses, and health visitors. However, we learned recently of significant cuts in the Northern Ireland training budget for these areas of practice.
The RCN is committed to securing safe nurse staffing in Northern Ireland and our priority now is to hold the Department of Health and the Northern Ireland Executive to account for the delivery of the Health Minister's safe staffing framework, particularly in respect of the need for safe staffing legislation. We will continue to keep you informed of how the campaign is progressing.