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Urgent care staffing concerns boil over into transparency row

NHS commissioners have been criticised for failing to answer questions about patient safety and staffing issues at an urgent care centre in Loughborough.

The Royal College of Nursing submitted a series of questions under the Freedom of Information Act after its members raised concerns about staffing levels at the new facility at Loughborough Hospital.

According to the RCN, the transfer of services from a walk-in centre in the middle of Loughborough to the new facility resulted in the loss of the equivalent of 7.3 full-time nursing posts out of 22 and the resignation of a further three nurses.

“We are concerned that staffing levels at the centre are consequently too low for nurses to be able to deliver a consistently good standard of care to patients and that the service is persistently relying on agency nurses to make up the numbers,” said the union.

The FOI request, which asked for information about agency shifts, waiting times and patient complaints, was initially made to Central Nottinghamshire Clinical Services, which runs the centre.

But it was then passed on to the West Leicestershire Clinical Commissioning Group, which promised to respond but subsequently failed to meet the FOI deadline of replying within 20 working days.

“It is unacceptable that we have not had a definitive reply from a publicly-accountable body to a number of legitimate questions based on genuinely-held concerns,” said Dr Sheila Marriot, director of the RCN in the East Midlands.

Dr Sheila Marriot

Dr Sheila Marriot

In a statement, West Leicestershire CCG managing director Toby Sanders said; “We have a robust system in place to ensure that our FOI responses are complete and sent within the required timeframe.

“However it appears that we have not fulfilled our obligations on this occasion and we apologise for the delay,” he said. “We will rectify this immediately and forward our response at the first opportunity.”

In addition, he said he would like to “offer reassurance” that the CCG was “fully committed” to openness and transparency.

Greater NHS transparency was a centre point of the government’s response to the Francis report last month. Among the measures announced was guidance requiring hospital trusts to publish ward staffing levels each month.

Mr Sanders added: “I can confirm that recruitment for permanent clinical staff at the urgent care centre in Loughborough is now almost complete. We have the right skills mix in place to provide the correct treatment for patients with urgent care needs.”

Nursing Times understands the RCN has now received the information.


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Readers' comments (18)

  • michael stone

    As it happens, a genuine attitude of openness and transparency requires a higher level of responsiveness than simply answering FOIs (some very useful answers, which could help drive service improvement, would only emerge from questions which do not easily qualify as 'FOIs').

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  • This is happening up and down the country, I personally am going through the second huge upheaval in 2 years due to this Governments obsession with privitising the NHS.
    Last year my out of hours employer were forcefully changed to another more incompetent one, who did not honour my hours or place of work, leaving me with only 1 shift a week. This year, just as I landed an enjoyable job in a WIC, it has again been sold off to the cheapest bidder, and not given to a trusted local provider.

    Due to the uncertainty, most staff have left. The new providers don't turn up to meet the staff and answer anxieties when they say they will, we have no idea of what will happen to our jobs and the conditions of employment. We may be forced to work nights. The premises will change, to somewhere with no parking in a small city centre.

    There are now 4 of us left. We struggle to cover shifts and always work light, there is now constantly a 2-3 hour wait, everyone is depressed.

    In the meantime, I am totally lost at what to do. It looks like my NHS pension is lost forever as more and more private companies get in on the act, and the demonising of public service pensions by this measly government. What is the point of paying into private pensions that are not recognised by a new provider a year later?

    Welcome to Conservative Government's new NHS.

    In the meantime,

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  • ......nurses still do nothing.

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  • the private companies taking over NHS services are not bound to any laws on transparency.

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  • michael stone

    Anonymous | 10-Dec-2013 3:01 pm

    I sympathise with you - this is an awful situation to be tangled up in !

    Anonymous | 10-Dec-2013 10:39 pm

    It appears so - but the reason for 'transparency' is at root patient safety: so it is indefensible that privately-provided NHS services, should not be subject to exactly the same transparency 'rules'. That isn't something being 'pushed' strongly enough at present - accepting 'transparency' should be written into [provider] contracts as a conditionality of getting the work.

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  • michael stone what 'should' and what 'is' are not the same thing and global private companies who will be taking over many of the NHS sevices are not bound by the same conditions whether it is right or ethical or safe for patients or not and with such fragmented services provided from companies from all around the world there will be less control on who 'should' be doing what until some government decides to do something about it.

    read 'NHS-SOS' eds. Jacky Davis et al. the whole system and very plausible speculation on its future written by a group of experts in medicine, economics and other is all very clearly (and transparently!) explained there and also why and how the Healthcare and Social Care 2012 and the reforms designed to break up the NHS and turn it from provider of healthcare to commissioner of services from global private companies found its way into law with very little strong opposition from either the British healthcare professionals and the public.

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  • tinkerbell

    A great wrong has been committed against our society by a corrupt few who abused the power invested in them. Corruption has won the day.

    Whatever may have been wrong with the NHS it was still a beacon of light in its founding principle in that it was for the good of all regardless of financial status. No discrimination.

    Now it is being destroyed so that the greedy, rich & powerful can make a profit out of those in need.

    I started out with just a feeling that it was 'wrong' and hoped that I was wrong but it is a horror story unfolding.

    We have all been deceived by misinformation (lies), media blackouts and distraction. I long wondered why so little airtime was given to the NHS, if at all, on Question Time and the BBC in general. Can only guess at that one.

    They have taken something that was good for everyone and made it into a profit making monster that ultimately will be only good for a few.

    I agree with Lord Owen it's all 'very sad'. There's little else to be said now it's a done deal. We need to take action.

    If the current politicians don't like the law they change the law to suit their agenda, total corruption of justice.

    It is not that we will have more choice but that the providers will have more patient choice as to who can make them a profit, meanwhile all our hospitals are being run down so that they can fail and be taken over by private providers. Just like our railways but far more serious consequences on our society.

    It's part of the propaganda machine that we are faced with an nhs that is unsustainable and too expensive. An excuse used so the tories can run it into the ground and hand it over to the private sector.

    We must fight against it otherwise if this unelected government has it's way we are all going to be seriously affected by the monster they have created. If our illness is not profit making we could all be languishing at the end of a very long queue to access what has been stolen from us.

    As for transparency private companies will not have the same accountability nor fall under the FOI Act.

    In 2014 draconian 'gagging laws' are planned to be introduced so that non politicians will not be able to have a say in what politicians decide. Our freedom of speech is to be seriously gagged.

    We will no longer be a democracy where the people have a voice. We are rapidly becoming a dictatorship.

    Politics is too important to be left to corrupt politicians and bankers who appear to have no moral compass to guide them regarding the good of all, their concerns are their own financial investments and getting rich of others need.

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  • Tinkerbell you have lost your marbles. Get a grip- conspiracy theory and dictatorships? Get out of your cupboard and see that there are still many excellent things going on in the NHS that no private company can dampen. The NHS needed updating-not sure this is how I would update it but we have to move with the times-may be that is what you don't like? Are you also going to say we should go back to bedpans and traditional roles too??

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  • Kirsty Armstrong | 12-Dec-2013 4:14 pm

    Thanks for a perfect example of wilful blindness. In or out of a cupbard, there is really no excuse for walking around with your eyes shut. But to remonstrate another for pointing out the startlingly obvious really does take the biscuit.

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  • "Urgent care staffing concerns boil over into transparency row"

    What has 'boiled over'? What row? It's just the RCN doing an ineffectual bit of whimpering and being completely usual. Nothing is happening. No action will be taken. Move along folks, nothing to see here.

    tinkerbell | 12-Dec-2013 7:05 am

    Very well said, as usual, Tink.

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  • Kirsty Armstrong | 12-Dec-2013 4:14 pm

    differing opinion - neither obviously more right or wrong than the other in the view of those who wrote them and their supporters. Is there any need to be offensive if people do not share their opinions? everybody has an equal right to express them on this forum which is not intended as a competition to put one another down but to find answers to the many dilemmas the profession is confronted with in the hopes of finding ways to make improvements for the care of patients and secure a better conditions for the working lives of nurses and others in the hc professions.

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  • michael stone

    'Anonymous | 11-Dec-2013 11:58 am

    michael stone what 'should' and what 'is' are not the same thing'

    Yes, I do know that - hence my use of should.

    And to go over old ground, argument against bad changes DOES need to come from nurses and doctors, because they can see the likely effects of changes, and changes on the ground, BEFORE the general public 'catches on'. Sadly, lots of HCPs who kick up a fuss 'get bullied into silence'.

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  • michael stone
    michael stone | 13-Dec-2013 11:36 am

    it is not the impression you always give and HCPs are well aware of the facts without having to be constantly reminded, thanks.

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  • michael stone

    Anonymous | 13-Dec-2013 1:19 pm

    How come you don't say that people like Tink and Mags are also 'pointing out obvious things' ? I try to be clear about what I write, within the confines (sometimes) of brevity - people misunderstanding your point, is the problem with language (instead of telepathy) as a communication medium.

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  • tinkerbell

    Clause 118 -'The second reading of the Care Bill, to which this clause is attached,
    is on Monday 16th December. Please alert your MP to the existence of
    clause 118 and urge them to vote against it when the opportunity arises in the new year.

    MPs need to understand the importance of this clause for the future of
    NHS services in their local areas : it will effectively remove the
    democratic need to consult with communities, councils or local
    clinicians about what happens to their hospitals. Successful and much
    needed health services could be removed from local people bypassing
    the proper analysis and consultation needed'.

    More information on 38 degrees.

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  • tinkerbell

    'The most effective way to stop people understanding what is going on is to keep it secret' - NHS Doctor.

    Kirsty Armstrong | 12-Dec-2013 4:14 pm rather than wasting your time questioning my marbles, talking about cupboards, bedpans and traditional roles, if you are 'seriously' concerned about the future of OUR NHS and the excellent service that it provides, you'd be better off questioning what has actually happened, what is happening and what will happen.

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  • Anonymous | 13-Dec-2013 10:05 am

    Says who?!!! What a crock!

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  • Anonymous | 10-Dec-2013 10:39 pm, however the commissioning group is subject to FoI requests.
    Concern was raised in the local press a few months back over this issue.

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