Nurses at the end of their tether.

 

 

I’m grateful to Carole for telling me about a Guardian article which refers to this UNISON (Health Workers Union) report. Here’s their press release;

 

14 Apr 2014 10:00

NHS nurses reaching danger point

A new survey of almost 3,000 nurses from across the UK reveals a health service under severe strain, with 65% of staff saying that they did not have enough time with patients and 55% reporting that as a result care was left undone.  This is despite the fact that 50% worked through their breaks or beyond their shift.

The survey - undertaken on Tuesday 4 March - shows a typical ‘day in the life’ of the NHS. The majority (60%) felt that the number of staff working on the day resulted in a lower standard of care and more shocking still were statistics showing that 45% of nurses were caring for 8 or more patients 

Despite the many recent investigations into the NHS, the survey report* – Running on Empty – exposes clear failings to improve staffing levels. The impact on patients was plain to see. A worrying 48% of respondents described their organisation as either being at risk of a similar situation to Mid Staffs, or stated that it was already happening inparts, or across their hospital. 

UNISON’s report highlights research that demonstrates the clear link between appropriate patient staff ratios and patient mortality. Independent evidence shows that nursing cutbacks are directly linked to higher patient death rates in hospitals. In addition, when a nurse or healthcare assistant is responsible for eight or more patients, harm is occurring.

Gail Adams, UNISON Head of Nursing, said:

“One of the most damaging findings of this survey is how little has changed since last year.  Despite all the Government rhetoric, despite the Francis, Keogh and Cavendish reports, the spectre of another Mid Staffs still looms large over the NHS. Progress on safe staffing levels has been glacial and that means poorer care and patients still at risk. 

“It’s clear that despite nurses working through breaks and beyond their hours, they simply do not have enough time to give patients the care and attention they need.  That is distressing for patients and for the staff trying to care for them.  The Coalition Government needs to face up to the damage it is inflicting on patients and staff, by not introducing legally enforceable nurse to patient ratios, and take urgent action.”

The over-use of bank and agency staff is also exposed in the survey with 45% of staff reporting that they worked alongside one or more agency/bank workers. UNISON has always supported their use to cover holidays or unexpected gaps, but the regular use of these staff is not cost effective or in the best interests of patients.

The union points to anecdotal evidence that some hospitals draft in bank or agency staff for the duration when they are expecting a CQC inspection. 

Gail Adams, went on to say:

"Relying on bank or agency nurses because of understaffing is a false economy.  It is frustrating for existing staff because they are often unfamiliar with the ward and it is unfair on patients who experience a lack of continuity of care.  The answer is to ensure that there are sufficient established nursing posts to provide safe dignified and compassionate care."

 Key Findings

·         Three quarters of all midwives and 71% of all nurses (general and mental health) said they did not have adequate time with each patient.

·         59% of all nurses on a night shift said there were elements of care they were unable to give.

·         92% supported minimum staffing levels, with 65% supporting a legally enforceable minimum.

·         45% of staff were looking after 8 or more patients during their shift, this increased to 53% on night duty.

·         Despite National Quality Board guidance, only 24% of workplaces displayed indented number of staff on duty.

·         Just over half (51%) were not confident about raising concerns locally, which, in a post Francis era, is worrying.

Some typical comments taken from the survey findings:

“I have been pressured to take admissions when due to lack of staff it has not been safe to do it.”

“On occasions, staffing levels are bordering on dangerous.  We are in a Mid Staffs situation and I don’t believe we are the only ones.”

“Both my staff and I frequently have to work alone which is very unsafe.”

“I did not feel able to provide the type of care I would have liked to the patients.  It felt more like a conveyor belt.  No compassion, little dignity, I left at the end of my shift feeling distraught and that perhaps I have made a huge mistake training as a registered nurse.”

“My department is running at VERY UNSAFE levels due to inadequate staffing.”

 “I am the only qualified nurse on a 13 hour shift, so I don’t get a break during these shifts.  You get tired. It’s unsafe. 

“Some shifts are now 100% bank staff.”

“We have patients that need to be monitored closely following procedures or during therapy, with many needing to be checked on an hourly basis.  That cannot be done when there is a ratio of one nurse to 11 patients.

“I felt I was being bullied to take extra patients from A&E.”

Staffing levels in the NHS will be debated at the UNISON annual healthcare conference in Brighton between 13-15 April 2014. 

ends 

Notes to Editors

UNISON is sharing details of any hospitals named as having failings on a par with Mid Staffordshire Foundation Trust with the Care Quality Commission prior to publication of the survey. 

The areas of care in which respondents worked on 4 March covered the whole spectrum of healthcare.  This included A&E, paediatrics, elderly care, community mental health, critical care, general practice, learning disabilities, medical, mental health (inpatients as well as secure unit) obstetrics and gynaecology, surgical, rehabilitation and theatre.

The report, "Running on Empty – NHS staff stretched to the limit" is available

Neil Harris

(a don’t stop till you drop production)

Home:  helpmesortoutthenhs.blogspot.com
Contact:  neilwithpromisestokeep@gmail.com

Cutting jobs costs lives.

Thursday, February 27, 2014

 

 

Overworked nurses linked to higher death rates

           

 

Investigations in nine European countries have given statistical backing to claims that patients’ lives may be at risk when nurses are overworked, specialists said on Wednesday.

Published in The Lancet, the study touches on a sensitive topic in countries where health budgets are under strain.
Researchers looked at survival rates after surgery in 300 hospitals, and matched these against the workload and education of their nurses.
They looked at data from the surgeries of more than 420,000 patients aged over 50 who had common operations such as hip or knee replacement, appendix removal or gall bladder surgery.
The number of patients who died in hospital within 30 days of admission was low, on average. It ranged from 1.0 to 1.5 percent depending on the country.
Within a country, though, the death rate varied widely according to the hospital. In some hospitals it could be less than one percent, in others more than seven percent.
Two big factors correlated with higher mortality – a bigger workload for nurses and a lower level of nurses’ education.

Each patient added to a nurse’s workload increased the risk of a patient dying by seven percent. Every 10 percent increase in bachelor’s degree educated nurses was associated with a seven percent fall in this risk.
“Nurse staffing cuts to save money might adversely affect patient outcomes,” said the paper. “An increased emphasis on bachelor’s education for nurses could reduce preventable hospital deaths.”
It offered this statistical scenario: in hospitals where nurses cared for six patients each, and 60 percent of them had bachelor’s degrees, the risk of patient death was nearly a third lower than in places where nurses cared for eight patients and 30 percent had a degree. The investigation was carried out in Belgium, England, Finland, Ireland, the Netherlands, Norway, Spain, Sweden and Switzerland.
The findings in Europe closely mirror a previous probe in the US, said Linda Aiken, a professor at the University of Pennsylvania’s School of Nursing, who led the research.
“Our data suggest that a safe level of hospital nursing staff might help to reduce surgical mortality, and challenge the widely-held view that nurses’ experience is more important than their education,” she said in a press release.

Neil Harris
(a don't stop till you drop production) 

Another Bart's Health NHS Trust scandal.

If you’ve been following this Blog, you will remember that back in May I highlighted my concerns about Bart’s Health NHS Trust. A mega merger trust which uses the historic name of St. Bartholomew’s Hospital, much loved and respected since medieval times but now reduced and diminished and merged into a group of hospitals.

Between them all they are far and away the leading lights in my ‘Bottom 21’ of hospitals with the worst record for ‘never events’; the things that should never happen because simple things like ‘tick lists’ would prevent them; like cutting of the wrong limb, operating on the wrong person or leaving instruments inside people.

Here’s another one hitting the headlines for all the wrong reasons.

By the way, how do you have a course in ‘care and compassion’ – can you teach that? I think if you don’t have it or you lost it, you shouldn’t be looking after people. Sorry.

The London Standard

Sophie Goodchild

06 September 2013

A London hospital was warned today that it must improve care, after maternity staff were reported to have used “disrespectful” language about women they were looking after.

The Royal London in Whitechapel was criticised by NHS watchdog the Care Quality Commission after a visit by its inspectors. They also found that elderly patients did not always receive appropriate care and treatment.

Their report highlights how staff shortages at the hospital — part of Barts Health NHS trust—have left doctors and nurses struggling to maintain basic care standards. This comes weeks after a damning CQC report into care at Whipps Cross University Hospital, which is also part of Barts Health.

The trust is one of half a dozen considered high-risk by Sir Mike Richards, the CQC’s chief inspector of hospitals. It is already being forced to axe services and suspend expansion plans while it tackles a £50 million financial crisis.

Inspectors who visited the Royal London on June 4 and 5 said they overhead maternity staff making comments about patients such as: “I hope bed six isn’t still here,” and: “Bed nine was terrible last night.” There was a lack of experienced staff to meet the needs of mothers and babies, with some women never seeing the same midwife twice.

 

Midwives told inspectors they felt senior managers were not listening to their concerns, especially in relation to staff shortages. One employee told inspectors: “I don’t have confidence in managers to treat staff properly.”

 

Staff on the post-natal ward complained “the management are never present” and do not “treat us well”.

Care plans for patients with pressure sores were not always fit for purpose.

Queues for staff rooms in the ante-natal clinic meant private conversations could be overheard.

 

The CQC found the Royal London was failing five national standards: on care and welfare of people who use services; co-operating with other providers; staffing; supporting workers; and respecting and involving people who use services.

 

Today the CQC warned that some “pretty basic” care requirements were not being fulfilled as they should. Barts — Britain’s biggest health trust — said it was “extremely sorry” for failings identified at the Royal London.

 

The trust said it had put measures in place since the inspection, including a training programme in care and compassion for all 500 staff involved in caring for the elderly. Maternity staff had also been reminded of “the very high standards of care we expect”.

 

Last month, after an inspection in May and June, Whipps Cross in Leytonstone was criticised for its “dirty and unsafe” maternity ward and treating women among “overfilled bins and stained floors”, with women having to wait up to four hours to be seen. Barts Health said it had “taken immediate action to rectify the failures”.

 

Of course the management reaction will be to shut hospitals and sell off the land.

The government reaction will be to privatise it all.

Our reaction?

Rally round the hospitals, save the sites and the departments, fight to break up the trust and win back local control.

 

Neil Harris

(a don’t stop till you drop production)
Home:   helpmesortoutthenhs.blogspot.com

Good planning

I should stop reading the Nursing Times, it depresses me. The following article comes from their site, I’m responsible for the edits.

Question;

What;

1] Fell by 4% last year.

2] Will rise by 2% this year.

3] Will fall by 30,000 between 2014/2016?

 

 

Nursing numbers decline again with more cuts planned

Nursing Times

29 July, 2013 | By Shaun Lintern

Real cuts in the number of NHS nurses – almost 1,000 in a month – have continued to emerge as more than 140 hospital foundation trusts plan to slash their workforce by 30,000 by 2016.

Latest figures, from the Health and Social Care Information Centre, show the number of nursing posts in the health service dropped by 956 between March and April – leaving a total of 307,939 whole time equivalent nursing midwifery and health visiting staff.

This is almost 3,000 fewer than when the coalition government took office in May 2010, while the total headcount has reduced by more than 5,000.

The cuts in nurse numbers have been criticised as “dangerous” by shadow health secretary Andy Burnham. Royal College of Nursing chief executive and general secretary Peter Carter highlighted recent scandals, saying: “Where nurse numbers are slashed, standards of care plummet.”

The figures were published last week, one day after latest three-year plans from 145 foundation trusts exposed plans to brutally cut the NHS workforce by 30,000 whole time equivalent staff in the next two financial years.

The annual review of FT plans by the regulator Monitor revealed there was a 4% fall in the number of nurses at their organisations during the last financial year, 2012-13.

During the current 2013-14 year, FTs plan to increase staff in response to the Francis report on Mid Staffordshire Foundation Trust and this month’s mortality review of trusts with high death rates the report, published by NHS England medical director Sir Bruce Keogh.

The Monitor reports said FTs are planning to recruit staff as a “short-term fix”, with 4,133, or 2%, more nurses along with 5,867 doctors, healthcare assistants and other frontline staff. They will off-set the cost of this year’s £500m recruitment by imposing a 39% cut in the use of bank and agency staff, the plans suggest.

But during the 2014-16, trusts are planning a return to staff reductions and want to cut 30,000 WTE staff, with a majority coming from nursing.

This is despite predictions by the Centre for Workforce Intelligence of a potential nursing shortage. It believes the NHS is likely to have 47,500 fewer nurses than it needs by 2016, as revealed by Nursing Times in June.

RCN policy director Howard Catton described the FT’s plans as a “classic example of boom and bust, yo-yo approach to workforce planning”.

“We have to move away from this, it’s not sustainable for the future,” he warned. The Francis and Keogh reports crossed the Rubicon in terms of making nursing cuts a patient safety issue.”

 

Good planning, good patient care?

Errh no.

Neil Harris

(a don’t stop till you drop production.

Home:     helpmesortoutthenhs.blogspot.com