Savage cuts to nursing are stretching resources “to breaking point”, the largest nursing union says today at it’s conference.Government plans to shift care out of hospital and closer to patients’ homes are being used as a cover for the cuts, the Royal College of Nursing warns. It is also leading to patients being discharged too early, the RCN reports.

Over 26,000 nursing posts have been cut in the last two years and a further 61,000 are at risk, according to the RCN.

The college says that, despite government rhetoric claiming more care is being provided outside hospital, there has been less than a 1 per cent increase in the community nursing workforce in the last decade and community nursing is “stretched to breaking point”.

The figures come as Andrew Lansley, the Health Secretary, prepares to address the RCN congress today. In an interview with The Independent ahead of the speech, Mr Lansley denied there were mass reductions in nurse numbers.

He also said staffing numbers were not the only factor in providing good patient care. “In some hospitals the staffing ratios are exactly what we would expect, but some wards are really excellent and some are really bad. This is about leadership,” he said.

Mr Lansley added that a recent staff survey shows that, across the NHS, only 65 per cent of staff would recommend their hospital to friends or family.

A poll conducted for the college on the eve of its annual congress in Harrogate found 90 per cent of respondents agreed patients were being discharged sooner from hospital and with more complex needs than a year ago.

Dr Peter Carter, chief executive of the RCN, said: “Nurses are stretched too thin and many are approaching breaking point. Inevitably patients are going to suffer.” The RCN supported a shift from hospital to community care but nurses reported patients being discharged from hospital before social-care support was in place.

The Health minister Simon Burns said he did not recognise the RCN’s figures: “There are only 450 fewer qualified nursing staff in England than in 2009 and in 2011-12 we expect to train 2,300 community nurses and health visitors.”

From: http://www.independent.co.uk/government-is-cutting-nursing-numbers-by-stealth

One in three NHS staff say they are not enough people in their department to get their work done, according to the annual health service survey.And almost half of NHS staff said they do not have time to complete their tasks, it was warned.

Staff cuts and a lack of cover when people are on leave or sick is to blame, a union said.

The 2011 NHS Staff Survey, of more than 135,000 health service workers in England, found some were struggling with heavy workloads.

The official NHS staff survey comes after the Royal College of Nursing warned that one in three nurses working on older people’s wards are too busy to help patients with eating or going to the lavatory.

However when hospital staff were asked if a friend or relative needed treatment in their organisation, they would be happy with the standards of care, the proportion answering ‘yes’ varied from just one in three at Croydon Health Services NHS Trust to 96 per cent at Clatterbridge Centre for Oncology NHS Foundation Trust.

Health Secretary Andrew Lansley said: “This survey shows that NHS staff remain committed to providing the highest quality of care to their patients.

“The number of staff happy with the standard of care remains stable, with some foundation trusts performing to a very high standard. Too many trusts continue to have less favourable levels of recommendation to family and friends.”

“The NHS should use this as a basis for seeing improvement in the services we deliver for patients in the future.”

Christina McAnea, Unison head of health, said: “The staff survey reflects some of the pressures felt by staff, but our own survey painted a much bleaker picture.

“Unison’s survey showed that 85% experienced an increase in workload and 83% suffered an increase in stress over the past year. The increase in workload is not a coincidence, it is down to cuts in staffing and to a lack of cover for staff on sick or on leave.”

The NHS survey also found that a fifth of staff said they cannot do their job to a standard they are personally pleased with and half would not recommend their trust as a good place to work.

Almost nine out of ten staff who deal with patients said they were satisfied with the quality of care they provided.

From: http://www.telegraph.co.uk/NHS-staff-overworked-survey-finds

The care of the elderly is being compromised in UK hospitals because there are too few nurses, according to the Royal College of Nursing.Research by the union suggested everything from basic communication to care for the dying was suffering.

And it called for minimum staffing levels to ensure standards improved, arguing one nurse for every seven patients was needed.

The intervention by the Royal College of Nursing (RCN) comes after a series of damning reports about the services the elderly are receiving.

The Patients Association and Care Quality Commission have both recently published studies detailing “shocking” levels of care.

Ministers have promised to give more powers to nurses as well as improving monitoring to drive up standards.

But the union said it was now time to insist on strict staffing levels and stop relying on health care assistants to fill the gaps.

It polled nearly 1,700 nurses – 240 of whom were working on wards with older patients.

The survey showed that while older people’s wards only had one nurse for every nine patients on average, general wards, at 6.7 patients per nurse, and children’s wards, at 4.2, were much better staffed.

Respondents said low staffing meant care suffered in a variety of ways.

Eight in 10 said basic support, such as talking and comforting patients, was compromised, while a third said they did not have time to help people properly with eating and drinking.

Nearly one in five also said care for dying patients was neglected.

The research looked at the use of guaranteed staffing rules in places such as Australia and the US and concluded they were needed in the UK.

It recommended there should be one registered nurse for every five to seven patients in the NHS.

Peter Carter, the RCN’s general secretary, said: “Patients on older people’s wards are being let down by systemic failings in our hospitals.

“Despite working tirelessly to provide patients with high quality care, nurses in these settings have repeatedly told us that they are unable to do this because of pressures caused by short staffing.”

Hospital managers are planning to postpone thousands of non emergency operations today, because of the public sector unions striking over pension changes.Patients across the UK have been sent letters warning them of the disruption.

Diagnostic tests and outpatient appointments will also be delayed, but hospitals insist emergency and critical care will not be affected.

Managers say they are preparing as they would for Christmas or bank holidays.

An estimated 400,000 nurses and healthcare assistants, as well as paramedics, physiotherapists, and support staff like cleaners and administrators have said they will join the action on 30 November over changes to public sector pensions.

However, the main medical unions – the Royal College of Nursing, the Royal College of Midwives and the British Medical Association are not taking part.

The Department of Health in England said it was expecting at least 5,500 non-emergency procedures like hip and knee operations to be rearranged.

More than 12,000 patients are likely to have diagnostic tests postponed, and 40,000 outpatient appointments are expected to be rescheduled.

On an average day, 28,000 patients have planned treatments or operations in England and there are 60,000 diagnostic tests.

However, managers say they are putting plans in place to make sure people can still get emergency or urgent care, in the way they do on bank holidays or at Christmas.
999 calls

Patients needing urgent treatment like chemotherapy and kidney dialysis will still be able to get it, and maternity units will remain open.

Calls to 999 will still be answered, but patients are being urged to think hard and only call if it is a genuine emergency.

The Health Secretary, Andrew Lansley, said health service workers should not take action that harms the interests of patients.

“I would ask staff to consider carefully whether going on strike is the right thing to do,” he said.

Three out of four nurses lack the time to talk to patients, a major survey of NHS trusts has revealed.The results of a survey involving almost 3,000 nurses by researchers at King’s College London will prompt further alarm over the standards of care in the NHS.

A quarter admit they are too busy to administer drugs on time and more than 40 per cent said at least one patient under their care had suffered a serious fall in the last month.

The findings were based on unannounced inspections at 100 hospitals to check elderly patients were given enough to eat and drink and were treated with dignity.

In some instances, watchdog’s inspectors saw patients rattling bedrails or banging on water jugs in an effort to attract the attention of nurses.

The report also claimed that some hospitals were “putting paperwork over people” with patients being left for more than ten hours without a drink.

The latest study involving 2,943 nurses looked at 31 NHS trusts across England. Researchers found there was an absence of humanity as without regularly talking to their patients nurses had no way of knowing their needs.

The survey revealed that 76 per cent of nurses did not have enough time to talk to or comfort patients and 40 per cent of staff were too busy to carry out necessary checks such as taking their temperature.

Thirty-nine per cent admitted they did not have enough time to record details about patient care such as whether they had been given anything to eat or drink.

Twenty-six per cent said they were too busy to administer drugs on time and 24 per cent had not been able to check skin for signs of pressure sores.

A further 44 per cent admitted that in the past month at least one patient under their care had suffered a serious fall.

And 26 per cent said that at least one patient in the same period had been given the wrong dose of drugs or developed bed sores.

Professor Peter Griffiths, of the national nursing research unit at King’s College London, told the Daily Mail: “Talking and comforting patients is very important as nurses need to know how they are and how they feel.

“It’s about having humanity, having a relationship with people. It’s important to understand what patients need. Sometimes staff feel that paperwork has to come first.”

The Royal College of Nursing admitted it was “not surprised” that so many nurses lacked the time to talk to patients.

Janet Davies, its executive director of nursing and service delivery, said: “We know many nurses are wilting under the strain of longer working hours, taking on the burden on unfilled vacancies and reduced staffing levels.”

FroM: http://www.telegraph.co.uk/Three-in-four-nurses-dont-have-time-to-talk-to-patients

Nurses and midwives are being urged to get their flu jabs after figures reveal less than a third did last year.All front line healthcare workers are meant to be vaccinated to stop them going off sick with influenza and spreading the virus to patients.

Last year only 30% of hospital nursing staff in England got immunised compared with 43% of GP practice nurses, 38% of GPs and 37% of other doctors.

Nursing and midwifery groups say having the jab is a “professional duty”.

This is the first time the figures have given broken down by occupation.

The number of healthcare workers getting the vaccine had increased from 26.4% in the 2009 winter to 34.7% in 2010.

However, the majority of nurses who work with the most critically ill over the winter months and midwives who work with pregnant women, were left vulnerable to flu, its potentially life-threatening complications and passing it on to patients and family, says the Department of Health which released the figures.

The data also shows that only 25.2% of youngsters aged six months to two years in at-risk groups were vaccinated last winter, compared with 51.7% of those aged 16 to 65.

Those at risk include people with conditions such as asthma, diabetes, heart disease and liver disease, as well as the over-65s and pregnant women.

Last winter people in at-risk groups were 11 times more likely to die from seasonal flu than people with no underlying health problems.

Chief Medical Officer Dame Sally Davies said: “It is never too early to start thinking about flu. So as NHS staff return from their holidays, I urge them to plan ahead and get vaccinated.”

Dr Peter Carter, of the Royal College of Nursing, said while NHS staff should not be forced to get immunised, they had a professional duty to do so: “Patients and healthcare staff suffer when nurses are off sick.

“It is vital that nurses do all they can to take responsibility for their own health and of those around them. The RCN will be working with our members to ensure they have access to all of the relevant information to enable them to make the right decision about the uptake of the vaccine.”

Louise Silverton, of the Royal College of Midwives, said: “Midwives are strongly advised to encourage all pregnant women to be vaccinated against seasonal flu.

“In addition midwives as key health workers should themselves seriously consider being vaccinated to prevent transmission of influenza to the women for whom they care and also to their own families.”

A National NHS Staff Seasonal Flu Vaccination Campaign launches later this month and will use resources like Twitter and Facebook, as well as leaflets, to encourage more healthcare professionals to get vaccinated.

From: http://www.bbc.co.uk/news/health-14792570

NHS managers are trying to restrict access to crucial tests and scans in a move that could mean diseases being diagnosed later. 

An investigation has found that a quarter of Primary Care Trusts are either investigating how many patients individual GP practices send for examinations or looking for ways to reduce the numbers.

In addition, a handful are identifying “excessive” use of the tests or setting upper targets while others have completely stopped letting doctors have direct access to the scans.

Experts said the tactics could lead to patients being diagnosed later with diseases such as cancer, which research shows lowers survival chances.

Dr Clare Gerada, head of the Royal College of GPs, said: “This is about money and finances driving behaviour by the PCT – not about putting patients first.”

Cancer Research UK’s director of policy, Sarah Woolnough, added: “It is very worrying to hear of PCTs setting referral targets and decommissioning direct access to tests that could speed up a cancer diagnosis.”

Meanwhile, official figures show that even patients who are being referred to hospitals for tests are being forced to wait longer than a year ago.

Department of Health statistics show that 10,700 patients were waiting more than six weeks for any one of 15 key diagnostic tests at the end of July, a rise of 7,000 on the figure for the previous year.

The Government has told health service managers to improve direct access to diagnostic scans such as MRI, CT and ultrasound in order to improve early diagnosis of cancer and heart disease.

But an investigation by GP magazine suggests that many trusts want to reduce the number of patients sent directly to tests at specialist centres in order to save money.

Of the 116 Primary Care Trusts contacted, 28 per cent said they had either started looking into how many referrals GPs carried out across their area, or were planning to do so. A quarter are helping practices reduce inappropriate access.

Nine trusts said they had found surgeries that either sent too many or too few patients for tests while two are considering introducing upper and lower targets.

Five PCTs have scrapped direct access altogether to at least one type of test.

Dr Chaand Nagpaul, a leading member of the British Medical Association, said restricting access to scans risks “turning back the clock” on plans to diagnose disease early.

“An intelligent approach would be to have guidelines for appropriate use of diagnostics and incorporate them into the pathway.”

The moves are the latest example of how managers are rationing patient care in an attempt to make unprecedented efficiency savings totalling £20billion across the NHS by 2015.

From: http://www.telegraph.co.uk/NHS-managers-restricting-access-to-crucial-scans-and-tests

Doctors are being warned to take extra care when using social media websites such as Facebook and Twitter.
The British Medical Association guidance highlighted a series of potential pitfalls doctors face.

In particular, it said there was a risk the lines between personal and professional lives could be blurred.

It comes after a series of cases in which NHS staff and other public sector workers have got into trouble through their use of social media.

In 2009, a group of doctors and nurses were suspended for posting pictures of themselves on Facebook lying down in unusual places, including a hospital helipad.

And last year a civil servant found herself in the newspapers after using her Twitter account to make political points and saying she was struggling with a hangover.

Dr Tony Calland, chairman of the BMA’s medical ethics committee, said: “Medical professionals should be wary of who could access their personal material online, how widely it could be shared and how it could be perceived by their patients and colleagues.”

The guidance advises both doctors and medical students to adopt conservative privacy settings where they are available.

It also warns them against making informal or derogatory comments about patients or colleagues as well as not accepting current or past patients as friends on Facebook.

The message was echoed by the Nursing and Midwifery Council (NMC), which has also issued its own guidance this week.

NMC official Andy Jaeger said: “What you regard as just an amusing story could end up causing serious offence more easily than you think.”

From: http://www.searchclinic.org/doctors-warned-over-facebook-risks.htm

Nurses have suggested they should undergo an annual health and well-being “MoT”.
The physical and psychological assessment could take place alongside yearly appraisals, according to nurses at the Royal College of Nursing (RCN) conference in Liverpool.

They believe the plan would help staff set a healthy example to patients and argued that there are more checks on wheelchairs than NHS staff.

Claire Topham-Brown, a critical care nurse from Peterborough, said: “There is no denying that nursing is a physically demanding job. You do need a certain level of physical fitness.”

She told delegates during a discussion on the issue that one activist had “observed that we take better care of wheelchairs than we do of the staff.

“Bizarre but true – we now risk-assess everything, yearly, monthly, weekly and sometimes daily. But when do we ever assess that vital, delicate and most valuable part of the machine – namely me and you?”

She said it was not just about the physical and psychological nature of nursing work but also the culture and environment in which they operated.

“Don’t we deserve an annual MoT?” she said. “It would allow our employers to be more proactive and supportive instead of reactive.”

Ms Topham-Brown was supported by other nurses, including Karen Webb, the RCN’s director of the eastern region of England.

She suggested support was even more important given the expansion in nurses in training in recent years, which could lead to an increase in the numbers not fit for a career in nursing.

She said students had a health check before joining a course but their psychological suitability was not tested.

“It is about making sure people have the right attributes,” she added.

In her local area, screening had been launched to “make sure that the people coming in have the right attitude to what is essentially customer care”.

She said nurses also had a duty to deal with public health issues, such as obesity and well-being.

And those nurses who were overweight themselves could be supported.

“It would be about supporting those people in that position to help them lose the weight.”

The Government’s NHS Health and Wellbeing report, published a year ago, said the NHS needed to do more to improve the health of staff.

NHS staff take an average of 10.7 days off work a year – more than the public sector average and nearly double the 6.4 figure for the private sector. Staff sickness is thought to cost the NHS £1.7 billion a year.

From: http://www.independent.co.uk/call-for-annual-health-check-for-nurses

Looking uncomfortable and sounding contrite, Andrew Lansley came to face his nursing critics yesterday – apologising four times and promising to listen to them in future.
Just hours after members of the Royal College of Nursing had voted overwhelmingly in favour of a “no-confidence” motion in Mr Lansley’s management of NHS reforms, the Health Secretary spent an hour and a half answering questions and listening to their concerns.

During the meeting he hinted that when the Government outlined its concessions to the Health and Social Care Bill in June, nurses would be given a greater role, particularly in deciding where NHS funds are spent. Nurses are likely to be given a statutory role on the new GPs’ commissioning boards, ensuring that at least one nurse is represented. The boards are also likely to be renamed to show that they represent other healthcare workers.

Mr Lansley tried to reassure the 60 RCN representatives who had been chosen to meet him that he did care about the NHS. He ruled out accepting any other job in Government, suggesting he would resign rather than be moved in any cabinet reshuffle.

“I believe in the NHS,” he said. “I am in politics for that. I am not here to do some other job. If there is an ideology behind what I am doing it is a belief in the NHS and a desire to protect it and make it stronger.”

Asked how he felt about being the only health secretary to receive a vote of no-confidence from nurses, he said: “It’s not something I sought out.

“I think it’s a rebuke and from my point of view I take it as a rebuke and I think listening to nurses this afternoon it was very clear some of the reasons why that happened is because they thought I was too focused on general practitioners when I was taking about clinical commissioning, GP commissioning.

“I know that nurses are not only the largest healthcare profession but are responsible for the delivery of most healthcare, and are often in the best place to be able to see the whole of care.

“From that point of view is it a rebuke in the sense that I didn’t get to the right place? Absolutely.”

Many nurses appeared partially mollified by Mr Lansley’s approach. But they all said they would wait to see how his “listening” materialised into concessions.

One of the problems Mr Lansley faces, however, is that it is not just the contents of his contentious Bill that the nurses object to. In the earlier no-confidence debate most were angered at cuts to frontline services as a result of the Government’s plans to try to make £20bn worth of efficiency savings over the next four years.

This is not something Mr Lansley has much control over as an ageing population means that the NHS will have to do “more for less” and savings will have to be found.

Earlier in the day delegates in Liverpool had voted 99 per cent in favour of the no-confidence motion, to 1 per cent against.

The RCN’s leadership had attempted to amend the motion to delay any no-confidence vote until after the conclusion of the Government’s listening exercise. But amid angry and passionate scenes on the conference floor the amendment was dropped when nurse after nurse took to the stage to condemn the Government.

“What this is about is how Andrew Lansley has introduced these reforms,” said Geoff Earl. “They are being driven by ideological dogma, not by what is best for our patients. This [vote] is about our patients, not about us.”

Another nurse went on to the platform and played a tape of David Cameron’s promise in 2010 to “stop the pointless reorganisation of the NHS”. Birmingham nurse Bethann Siviter added: “If these reforms go through, the NHS is dying.”

Andrew Frazer, an emergency care nurse, said: “When Andrew Lansley addressed us last year we listened to him politely and decided to adopt a wait-and-see policy. Well, we’ve waited and we’ve seen, and I for one don’t like what I’ve seen.

“We’ve been trimmed to the bone for years. Trying our damnest to deliver excellent care with limited resources. Here’s a message for Mr Lansley: if you cut frontline services, in the short-term care may be a little cheaper, but in the long-term care will be poorer and people will die.”

From: http://www.independent.co.uk/im-sorry-lansley-tells-nurses-afternoconfidence-vote