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OPINION

Peter Carter: 'We can look ahead to 2014 with a great deal of optimism'

Trusts are starting to realise that staffing levels are clearly linked to patient safety and quality of care, says Peter Carter

No one will deny that 2013 was a tumultuous year of reviews and soul-searching for the NHS, and nurses can justly feel that they have been on the receiving end of more than their fair share of the criticism, which has been levelled at the health service.

The Francis report, Professor Don Berwick’s review into patient safety and Sir Bruce Keogh’s blueprint for an overhaul of accident and emergency have all shown that the health system needs to adapt quickly to new methods of guidance, and a growing and more diverse population.

However, despite what has been an unprecedented year, I believe we can look ahead to 2014 with a great deal of optimism, and look at the last 12 months as an opportunity to learn from mistakes and always strive to improve patient care.

‘The things we have been debating over the last 12 months - such as staffing levels, skill mix, and training for healthcare support workers - are things that will all make a real difference to patients’

The reason I remain optimistic about 2014 is that at the end of last year we did finally begin to see some positive signs that NHS trusts are starting to realise that staffing levels are clearly linked to patient safety and quality of care.

The things we have been debating over the last 12 months - such as staffing levels, skill mix, and training for healthcare support workers - are things that will all make a real difference to patients.

There was also reason to be optimistic when the government announced plans to introduce mandatory reporting of staffing levels on hospital wards from April this year, in its response to the Francis report. Then at the end of the year Health Education England increased nursing commissioning places by 9%. All of this means we can be hopeful that we are reaching a consensus on the importance of staffing levels. However, we also know that the solution is not a simple one. Now we know what the problems are we must take effective, long-term action to solve them.

Our latest Frontline First report in November last year revealed that there are at least 20,000 nursing staff vacancies in England alone. This will not come as a surprise to many frontline nurses who simply do not have the time to deliver the high level of care to every patient that they would like to.

We also know that in the wake of reports by Robert Francis, Professor Berwick and Sir Bruce, many trusts saw the importance of getting nursing staffing levels right. However, many have been forced to recruit from overseas to fill the gaps in their workforce, as reported in Nursing Times.

This demonstrates that simply acknowledging the importance of safe staffing levels is not enough. Work commissioned by the government suggests there could be a shortage of 50,000 registered nurses by 2016 and relying on the workforce from overseas is not a sustainable long-term option. We must see long-term workforce planning now to ensure we can still deliver care in
the future.

I think it is important to mention that throughout what was a difficult year for everyone in the NHS, nursing staff continued to do what they do best - deliver the best care possible for patients. I believe that this central pillar of the nursing profession will never change, and that should be our biggest reason for optimism in 2014. This year the Royal College of Nursing will continue to raise awareness and lobby government to ensure the important issues raised last year do not get forgotten, and I know that nurses will continue striving to deliver excellent patient care.

The last year of reviews has certainly laid the foundations of reform - let’s hope 2014 sees everyone involved in the NHS act on all of this evidence and ensure robust action plans are put in place.

Peter Carter is chief executive and general secretary at the Royal College of Nursing

Readers' comments (14)

  • I'm sure Carter is optimistic, everyday is a boon for the man who said this of his visit to Mid-Staff's:

    "I found the hospital to be well managed, it was clearly a very clean and efficient hospital, and the quality of nursing and other health-related care was of an exceptionally high standard.

    I had the opportunity to talk in private with patients and their relatives, all of whom expressed a high degree of satisfaction with the standard of care."

    Some of us will never forget how you failed those patients and staff!

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  • Having listened to Dr. Jacky Davis from NHS-SOS on LBC this evening, there seems to be very little in the future of the NHS to be optimistic about.

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  • Not a single word about how you intend to support your nurse members who raise concerns about patient safety. You made lots of promises Mr Carter at Congress about learning from the RCN's failures highlighted in the Francis report into Mid Staffordshire ... We have not seen anything yet on how RCN will provide robust support to nurses who blow the whistle. Time and time again we hear of how so many nurses have been let down.

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  • michael stone

    'Trusts are starting to realise that staffing levels are clearly linked to patient safety and quality of care, says Peter Carter'

    Is that really true ?

    Or is it simply that recently under-staffed hospitals are beginning to get rather more of a boot-up-the-backside from organisations such as the CQC ?

    The link between inadequate staffing and bad patient care, is a no-brainer (the actual levels needed is a different issue - but the damage of falling below the required {if undetermined} staffing level, is ruddy obvious): so Trusts must have been really dim, not to know that !!!

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  • carol seed | 16-Jan-2014 0:13 am

    Absolutely Carol, Carter and his little gang aren't interested in you, me or anyone else for that matter - only furthering themselves. I don't know why Carter is hanging on at the RCN as I think he's blown his chances of a getting a knighthood, unless they give him Castledine's of course.

    The RCN will never be taken seriously by the government or the public until it expunges Carter from its midsts.

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  • "The reason I remain optimistic about 2014 is that at the end of last year we did finally begin to see some positive signs that NHS trusts are starting to realise that staffing levels are clearly linked to patient safety and quality of care".
    I hope that The Chief Nurse for England, Jane Cummings takes not. Up to now she has steadfastly refused to acknowledge that staffing levels are linked to patient safety and quality of care. Instead all she offered us was her nonsense "6 Cs", as though this was going to make any difference. Not fit for purpose.

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  • Why is anyone still an RCN member?

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  • Anonymous | 16-Jan-2014 3:35 pm

    I've no idea either they're really poor as a union. Peter Carter is a complete joke tho.

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  • They are completely hopeless selling their staff who raise concerns down the river
    You would not see the BMA act like the rcn
    They have no idea how to support staff at grass roots level

    They are spineless and there only attribute is patting each other on the back

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  • tinkerbell

    Yes there has been a lot of positive talk about what could be done, what should be done, what would be done, without so far anything being done.

    coulda, woulda, shouda ran and hid from did.

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  • michael stone

    coulda, woulda, shouda ran and hid from did.

    Liked that, Tink ! Very nicely put indeed.

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  • tinkerbell

    Had to laugh at a recent headline

    'So you want to get elected? Think like a clown'.

    There's so much good comedy out there to get us through these dark days, that's what keeps me positive that we're not all as daft as they think we are to which they might respond 'no you couldn't possibly be'. The great british sense of humour prevails come what may.

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  • tinkerbell

    michael stone | 17-Jan-2014 11:45 am

    Plenty more where that came from:) A small wall in Greece I noticed as I walked past. Maybe not, can't fit too much more on that small wall unless we rub something out.

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  • I resigned from the RCN. It's beneath my professional dignity to subscribe to some of the nonsense they put out to members.

    Of course, much of the growth in RCN membership is from HCAs, who don't have these professional concerns and may be easier to impress.

    It's all fluff and impression management now. This marks another step in the decline of once proud professional organisation putting its respectable history behind it.

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