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
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