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EDITOR’S COMMENT

'It’s time to end the understaffing scandals'

You probably don’t need convincing of the importance of an appropriately staffed ward or unit. There is plenty of evidence confirming that if there are too few nurses, care will suffer.

And yet, even in this post-Francis era, we continue to see organisations that, when forced to make cuts, aim the axe in the direction of their nursing workforce.

It’s interesting to see that most of the 14 Keogh trusts - the ones investigated by Sir Bruce Keogh at the government’s request due to high mortality rates - are increasing their nursing numbers (see page 3).

The trusts, which are in “special measures”, have between them appointed over 650 whole-time equivalent nurses in the past three months. They know that if they are to improve care and outcomes, then nursing will play a vital part in achieving that.

It is heartening to see such an acknowledgement of the important role nurses can play, and an endorsement of the view that nursing numbers affects the quality of nursing care.

Well that’s potentially the happy ending. But at the other end of the spectrum, in Northern Ireland there is a huge problem in A&E (see page 3). Nurses are so worried about the under-resourcing at the Royal Victoria in Belfast, that they are concerned the standard of care they are giving could risk their registration.

Stop thinking that nursing is a make do and mend profession. Imagine what nurses could do if the waters were calm just once in a while

We hear so much about the scandals in care. What about the scandals in understaffing? When trusts, forced by the efficiency agenda, cut into their staffing budgets so much that they leave remaining staff incapable of doing their jobs, stressed, burnt out and in emotional distress?

Nurses choose this career to help people. If you remove their ability to offer high-quality care, it will put them under huge emotional stress. Little wonder that nurses in Belfast are in tears and distraught at the conditions in which they are working.

Such cuts aren’t just putting patients currently in the hospital at risk; they jeopardise patients in the future too. Because making nursing a scapegoat for poor care is deterring candidates from entering the profession. It is putting the future workforce at risk.

It is time to stop thinking that nursing is a make do and mend profession. Yes, nurses’ ability to cope in a crisis is admirable, but imagine what they could do if the waters were calm just once in a while. The profession needs to be given the resources, tools and time to offer the care they so desperately want to.

If nurses are to offer compassion to patients in their care, first they need to receive a little of that compassion themselves.

Jenni Middleton, editor

jenni.middleton@emap.com. Follow me on Twitter @nursingtimesed

Readers' comments (16)

  • Trusts are not 'forced' into cutting their staffing due to the 'efficiency agenda' at all: they are given free-rein to determine where the axe falls. The understaffing scandal is caused by poor management decisions in some Trusts, not by any government diktat.

    It is perfectly possible for a Trust not only to maintain, but improve on its nursing numbers whilst working within the confines of ever tighter budgets; more for less is achievable.

    The NHS is extremely wasteful and £M's could be saved by collaborating with other Trusts in procurement and just by working smarter.

    Yes, understaffing is a scandal, but what is even more scandalous is that articles such as this give credence to some Trusts claims that government 'cuts' are to blame for staffing levels when in reality it is poor management decisions that are ultimately putting patients at risk.

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  • I could not agree more with the above re poor management decisions and would add that not only do some managers make poor decisions they are also wasteful in the extreme, looking back over the last 12 months ours have wasted no end of time on knee jerk initiatives whose pitfalls were all to obvious to front line staff but we were not listened to and the projects failed but not before so much time was wasted on them. 111 is a case in point.

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  • Agree with above. This constant swapping and changing of services all in the name of "fiscal efficiency" is a false economy. It is bad enough that the NHS is being hacked around by private companies all bidding lower that each other for a slice of the pie, but they do so by employing the lowest denominator; ie nurse practitioners instead of doctors, paramedics instead of nurse practitioners, HCA's instead of qualified nurses, telephone operators/clerks etc rather than triage nurses for 111 who are costing the tax payer a fortune by inappropriately calling 999 ambulances.

    Nurses are consequently being pressurised into working to tight consultation times and sanctioned if they try to do their jobs properly. They are being cut at the coal face and the ones that are left often feel they are risking their registrations by the expectations of these private companies.

    And in the meantime, the bean counters and money men are getting their big fat profits.

    Whist these private companies are all earning big returns for the few, the rest of us whether nurses or patients are the ones that suffer.

    Exactly how much profit did Hunt bank recently on his "investments," and exactly which companies were involved??

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  • I work on the Nurse bank at my local hospital. The death of my father (hospital negligence) and other serious family issues over the past 10 months have meant I have not been able to work. I did speak with someone at the nurse bank before Christmas who understood. I contacted them today to arrange shifts only to be told they have cancelled my contract and P45 is on its way. No letter pre advising or nothing I have to reapply but that could take a few months if and when posts are advertised. I am a conscientious nurse and often stayed behind in my own time to complete paperwork etc.

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  • In the trust where I work one of the CCG's gave an extra 800k in the aftermath of the Francis report and the good this money was going to do on the frontline, according to our managers, was immeasurable.
    What happened to the much vaunted improvements we were to expect?
    I bet you've guessed! Yes that's right another layer of management and an orgy of agency staff. So much so that teams were being rung to beg them to use the spare staff that they had.
    They have spent money like it's going out of fashion and now it's all gone we are back to struggling on impossibly low staff levels and many exhortations of how to present the trust in it's best light for the CQC inspections. Makes me want to spit. Shame on them!

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  • Wakey, wakey everybody the NHS is not ring fenced and it has only avoided a serious financial crisis because for the last four years it has been underpaying its staff with zero or 1% pay increases. Hospitals that have gone 'Francis' will in many cases have Monitor or the TDA after them soon.

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  • tinkerbell

    patrick newman | 26-Feb-2014 9:41 am

    Yep! More hospital closures, more redundancies, less staff. More rhetoric. No action.


    With all their posturing and opinions about what shoulda, coulda, woulda been done, from the Clown Party.

    Their opinion are like arseholes, everybody's got one.

    They have left us in a right royal mess. They know the price of eveything and the value of nothing and aren't to be trusted one iota.

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  • Poor Poor Nurse Management.
    I know the goverment has a hand in this, but the majority of the poor decisions has to fall on the shoulders of unsuitable people at the top of the nursing ladder.

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  • tinkerbell

    Anonymous | 26-Feb-2014 10:51 am
    Yes I agree, the puppets, but who's working their strings?

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  • tinkerbell | 26-Feb-2014 3:12 pm

    Anonymous | 26-Feb-2014 10:51 am
    Yes I agree, the puppets, but who's working their strings?

    Punch and Judy ;)
    and someone else has their hands up their...

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  • It seems that managers believe the same management theories apply whether they are running a hospital or a matchbox or canned pea factory. They apply the same processes with little regard for the type goods.

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  • from above

    Google 'scientific management' maybe they believe that would be the most convenient style 'for them' to adopt! Maybe it is the government's aim to return to that era, and they possibly would if they could.

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  • Tinkerbell you say they know the price of everything and the value of nothing. That is very true but it matters not a jot because price is king for the health care companies waiting in the wings to take over the NHS if this government manages to get back in power. If they do it will be a dark day for the NHS and the public at large. As for the manager their mantra is "more for your bucks" get as much work out of your staff for the least outlay. It's the same in industry, retail et al

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  • I hope everybody is fully aware that any NHS services sold off to private companies will be open to tender in the global market. Presumably some of these will be foreign equity firms who may own health care companies but have nothing to do directly with healthcare or any expertise in the field just like those in the rag trade and clothing industry who have nothing to do with fashion. I was naive enough to believe that people who owned all these boutiques and chains were fashion experts but none of it they are investors, speculators and exceedingly rich individuals who try to rule the land - the likes of Phillip Green.

    Not knowing anything about the commercial world, Robert Peston's book opened my eyes
    "Who Runs Britain?: and Who's to Blame for the Economic Mess We're in."

    is this what is happening to our NHS?

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  • Yes lets stop and think, Who really runs Britain?
    Look around the football clubs, the big industries, where are these people from?
    The people of this country care about the NHS, so it is difficult to take over like that.
    The tactic is to break by bits, or chunks if possible.
    Our own nurses at the top is not helping either, they are not fighting for the right amount of staff to do the job, they are being used but they just don't care.
    I am fed up with working so so hard under pressure.

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  • Anonymous | 1-Mar-2014 10:25 pm

    it doesn't seem anyone is helping. neither the nurses at the top, nurses and medical staff in general, other hospital staff, GPs, patients and the public - all could have perhaps done much more to stop the reforms from being passed in parliament in the first place.

    'NHS-SOS' edited by Jacky Davis

    'God Bless the NHS' by Roger Taylor (which I have not yet read but believe it is an equally valid read and look forward to doing so fairly soon).

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