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Whistleblower's former trust has too few nurses to 'meet patient needs'

A Care Quality Commission inspection has found “not enough staff to meet patients’ needs” at United Lincolnshire Hospitals Trust.

The regulator said there were 189 vacancies across the trust’s hospital sites, which include Pilgrim Hospital, Lincoln County Hospital and Grantham Hospital.

The report emerged as the trust faces an investigation over its high mortality rates by NHS medical director Sir Bruce Keogh and also found itself at the centre of media attention last week when its former chief executive Gary Walker broke a “gagging order”.

CQC inspectors visited 10 wards at the Lincoln County Hospital on 31 October and 1 November. While the CQC found the hospital was compliant with most standards and gave the trust an overall positive report, it raised specific concerns on staffing.

The report said: “There were times when there were not enough qualified, skilled and experienced staff to meet patients’ needs.”

One patient told inspectors some people had waited half an hour for a call bell to be answered, while a doctor told the CQC there were times when “the nurses struggle”.

Nurses also expressed staffing problems themselves and said there had been occasions when admissions had been postponed due to a lack of beds or specialist nurses. One worker said morale was low, adding: “Everyone is tired because they are trying to do their best.”

The trust had apparently already identified a workforce problem. The CQC report notes the launch of a staffing-level review across in-patient wards by the trust’s director of nursing Eiri Jones. A directive has also been issued by senior managers regarding minimum acceptable staffing levels in advance of the findings of the review.

However, the CQC report marks a significant improvement for the trust, which had three highly critical visits by inspectors in 2012.

Ms Jones said: “This reflects the hard work of all our staff on every ward and department across the trust on a daily basis. We do recognise there is still more to be done in some areas and work is on-going to address issues where they are raised.”

Readers' comments (17)

  • Why did the CQC have to draw attention to a lack of nurses ?

    Was Ms Jones shredding and binning the incident forms?

    Perhaps Ms Jones never steps out of her office and was therefore "shocked" to discover there were no nurses !

    It is time that "managers" like Ms Jones were automatically bought to the attention of the NMC, suspended and subject to a fitness to practice investigation.

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  • LOL---- Dont know what went wrong but that strange word should read "suspended"

    Apologies

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  • well, credit has to be given to the CQC for their astute skills of observation, for which no doubt they are handsomely paid!

    Would it not be possible to eliminate some of this time consuming and costly report writing and use these precious resources to get more people onto the front line instead? It seems everybody is now well aware of all the facts which seem to be reported over and over again.

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  • what a surprise, not enough nurses to do their jobs properly, the CQC need to understand this is happening all over the country. Nurses have been saying for years there are not enough staff with the right skills but no-one was interested in listening to our concerns before the Francis Report.

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  • michael stone

    'The report said: “There were times when there were not enough qualified, skilled and experienced staff to meet patients’ needs.”

    One patient told inspectors some people had waited half an hour for a call bell to be answered, while a doctor told the CQC there were times when “the nurses struggle”.'

    This recognition of inadequate staffing numbers, it appears (?), does not stem from some sort of 'assessment tool', but from simple relevant feedback from patients (nobody comes when I use my call bell) and doctors (the nurses are struggling at times).

    It is called VALUING REAL-TIME FEEDBACK - but the NHS seems to do everything possible, to DEVALUE actual real-time, on-the-ground observational feedback !

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  • Susan Markham

    Mike Stone

    Yeas you are an Aspie - but as long as you are comfortable with that definition - we have no problems....

    Actually I like Aspies... RainMan.... 445 matches on the floor....

    Doctor: Ray, can we try something?

    Raymond: Yeah.

    Doctor: Do you know how much 312 x 123 is?

    Raymond: [saying digit after digit] 3-8-3-7-6.

    Doctor: [amazed] He's right.

    Charlie: What?

    Doctor: He's right!

    Charlie: He's right?

    Doctor: Yeah.
    [the calculator shows 38376]

    Doctor: Ray... How much is 4343 x 1234?

    Raymond: [saying digit after digit] 5-3-5-9-2-6-2

    Charlie: He's a genius...

    Doctor: Right.

    Charlie: He's a genius!

    Doctor: Ray! Do you know how much a square root of 2130 is?

    Raymond: 4-6 point 1-5-1-9-2-3-0-4.
    [the calculator shows 46.15192304]

    Raymond: 2-3-0-4.

    Charlie: That's amazing! He is amazing! He should work for NASA or something like that.

    Doctor: [walking to Raymond] If you had a dollar... and you spent 50 cents, how much money would you have left?

    Raymond: About 70...

    Doctor: 70 cents?

    Raymond: 70 cents.



    Mike - That's why I love you - you have your figures right but you are never on the money!

    Yup - you will probably have to get someone to explain that joke to you... Just like the South Park - Kanye West - Fish-sticks one....


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  • Susan Markham

    Doohhhh....

    Okay I've got to do this for Mike Hokayyy...

    Sue : Mike, do you Fish-sticks?
    Mike: Yeah...
    Sue : Do you like Fish-sticks in your mouth?
    Mike: Yeah....
    Sue : Then you must be a gay fish!!!!


    Mike - can you tell me what that joke was about?

    I thought not.

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  • Susan Markham

    Anonymous | 19-Feb-2013 11:17 am

    "well, credit has to be given to the CQC for their astute skills of observation, for which no doubt they are handsomely paid!

    Would it not be possible to eliminate some of this time consuming and costly report writing and use these precious resources to get more people onto the front line instead? It seems everybody is now well aware of all the facts which seem to be reported over and over again. "


    Exactly... why are they not listening to US in the first fugging place?

    We have been telling these little nobodies this for frikking decades.... Why does nobody take Nurses seriously?

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  • I hope this helps Gary Walker, the former CEO who left under a gagging order but has now post Francis, challenged it. It's starting a wave of them, senior people forced to resign coming back to put pressure on the DH. Ruth Carnall's written to all the CEOs in London re PID. The wagons are circling.

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  • When nobody listens, no wonder why people give up complaining. Do you think anyone is going to complain when jobs are at risk?
    Nothing gets done until patients, relatives or doctors complain. If it threatens the senior hierarchy, the crap just rolls downwards and stating negligent care by junior doctors and nurses, how could they leave the bell ringing for ages.
    We're told to prioritise our work, as if we didn't already, but we're left with a mountain of "must do's" and the "would be nice to do" pile grows, its no wonder why patients don't feel cared for and that nobody has time to listen.
    Then if the documentations for care planning, implementation and evaluations aren't completed, then care is not complete. Getting documentations written up contemporaneously is important as we can deliver proactive patient care and speed up their rehabilitation and reduces litigation. Otherwise we're just firefighting, waiting for doctors' assessments and unnecessarily prolonging patients' stay.
    When there's not enough nurses left... see
    http://www.youtube.com/watch?v=XsjNXWIW28w
    or http://www.youtube.com/watch?v=hLRDpQ3x7KQ

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  • Staffing issues are EVERYWHERE in the NHS, not just nursing, domestic staff are struggling, porters are struggling, junior medical staff are struggling even many consultants are 'struggling'. Staff cost money & they are the biggest burden to the NHS in the eyes of the bean counters, so cut them, share them out. One domestic per 28 bed ward, one porter per shift per block, what happens, patient needs MRI delay for porter, delay for patient care, delay in discharge = internal wait = ear bashing for the ward sister in not freeing up beds in time, . Those upstairs seriously have not got it that it is just not about nurses it is about the whole team that makes the wards tick, Crap money for porters, domestics, estates men who are skilled what do they expect do just what you have to do, fiddle the environmental audits to make it look good, bobs your uncle, fannys your aunt , all is well on shop floor.
    Government needs to sit up & smell coffee & invest. It's not all about nurses.........we are a large part but without the rest we are shot.....

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  • Anonymous | 20-Feb-2013 5:18 am

    Yep, everyone is important, agree with everything above + pay peanuts, get more peanuts ;)
    Cleaning, filing, portering, burning + serving food I can do. But not as good as the properly trained staff, and it will take me away from making sure my patients don't die. I can help patients have quicker recovery, but do need help from others that some people think aren't useful or important enough.

    Next time we see a sparkly ward when politicians visit with their TV media entourage, think how many people it took to clean + tidy everything, including the patients + staff (not a drop of sweat in sight)

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  • Susan Markham

    Pirates of Penzance

    Police: "We go, we go, we go..."

    MG : But dammit you don't "go"


    Gilbert predicted this 100 years ago eh?

    Everybody is teetering on the edge - but no one is brave enough to take the first step!

    It's sad that the Nursing Times doesn't show some testicular fortitude and take that particular leap of faith by starting a relevant "campaign" - unlike those former "wanky" ones.

    How about it NT... Care to fight for Nurses rights?

    Yeah... I thought not.

    The Tory right-wing might cut off your funding....

    Ah well... as long as we are clear about who actually runs this website!


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  • 'There is no point starting your course with a negative attitude'
    recent NT Headline...

    Why, indeed, start off your training with a 'quality' which will be, insiduously, absorbed into your unconscious mind throughout your nursing career, from a 'top down' led philosophy, created from the Ministry of Health itself, comprising of a basic failing in every aspect of the nursing culture over the past 40 years?

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  • michael stone

    Susan Markham | 19-Feb-2013 6:42 pm

    Sadly, we only have fish fingers where I come from !

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  • michael stone

    Susan Markham | 19-Feb-2013 6:42 pm

    I personally find your feeble attempt at a joke based on zoophilia to be in bad taste, but my RSPCA contact considers it totally unacceptable.

    You are now on the RSPCA Watch List, as a potential 'dolphin botherer'.

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  • michael stone

    Susan Markham | 19-Feb-2013 5:17 pm

    Actually, I think I'm 'Aspie-ish' - I think I got the male gene line, that avoided too much 'empathy' because that isn't great for the males who are bashing the other tribe's skulls in with clubs. And although I once commented to a MH nurse (who happened to be managing the local MIND shop) that Aspergers, when defined, looked to me a bit like 'being male and clever', he commented that Asperger had described it as 'extreme maleness'.

    I have no idea, whether the difference between me and a typical male in terms of 'empathy' is greater or smaller, than the difference in 'empathy' between an average man and an average woman (but I suspect, I'm less different from a typical man, than a typical man is from a typical woman).

    Obviously we differ on:

    Mike - That's why I love you - you have your figures right but you are never on the money!

    But I'm still wondering why I resist the idea that end-of-life should be reduced to 'objective things', because I see the experience of the dying person as paramount, while you (more empathic than I) seem to wish to reduce dying to 'objective' factors ? That seems to be backwards - but there are very few 'objective' things about 'death/dying' except for the law, and most clinicians consistently get their interpretation of the law around 'death' wrong !

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