Nursing has rarely been out of the headlines over the last 12 months. Fran Entwistle reviews the key stories affecting the profession during 2013
With the New Year came another scheme from those in charge in nursing policy. Inspired by the “games makers” from the 2012 London Olympics, NHS England chief nursing officer Jane Cummings and the prime minister introduced us to the term “care maker”. This initiative saw newly-qualified nurses going in to hospitals and care homes to promote core nursing values.
Cameron calls on new nurses to be ‘care makers’
Concerns were raised over the viability of the student mentorship system – with research showing that trust mergers and changes in education contracts have left mentors worried that they are unable to teach effectively.
Mentorship system only just holding together
The Royal College of Nursing hit the headlines with the news that it planned to accept a deal to reduce staff terms and conditions. It followed extensive negotiations over the future of the Agenda for Change contract between unions and the NHS Employers organisation.
RCN accepts Agenda for Change proposals
January saw the “revelation” that giving staff time to reflect reduces stress and burnout. Researchers also revealed to Nursing Times that stress levels among nursing staff are often higher than serving members of the armed forces.
Nurses more stressed than combat troops
A study by the Alzheimer’s Society showed a 3% increase in the number of people diagnosed with dementia. Worryingly, the research also predicted that over 400,000 people are living with dementia without having been formerly diagnosed.
Figures show increase in dementia diagnosis
In February, the nursing world held its collective breath before the long-awaited Francis report into care failings at Mid Staffordshire Foundation Trust was unveiled. Ahead of the seminal report on patient safety, Nursing Times readers warned of widespread staffing shortages.
Wards dangerously understaffed, warn more than half of nurses
Nursing Times reporters were at the Francis report launch conference on 6 February and provided minute-by-minute coverage and analysis throughout the day.
Francis Live: Nursing Times Rolling News
Among the many stories we wrote about the Francis report recommendations on 6 February, one concerning criticisms aimed at the RCN proved one of the most popular. Robert Francis QC recommended the organisation divide its two roles as a union and a royal college in order to improve its effectiveness in both these areas.
Francis report: RCN labelled ‘ineffective’
In the wake of the Francis report, Nursing Times reported exclusively about the findings of a government-commissioned report warning of future shortages of nurses working on the frontline.
NHS facing potential nurse workforce crisis, study warns
Just when we thought Mid-Staffordshire trust was sliding out of the limelight, another story emerged of shocking abuse by a healthcare assistant based at Stafford Hospital.
Stafford HCA struck off after ‘losing it’with older patient
We then revealed how cost-savings are leading some trusts to “bump up” the roles of senior HCAs to take on duties traditionally done by nurses, while nurses are fulfilling the roles of junior doctors. The spotlight on this occasion was on plans set out by Royal Cornwall Hospitals Trust.
Trust plans to count senior HCAs as nurses in cost cutting plans
Nurses in the south west were in the headlines, as March got under way. A consortium – dubbed a cartel by unions – of 19 trusts in the region revealed plans to save “millions of pounds” by threatening to leave the Agenda for Change pay framework unless unions and employers made progress with new negotiations to dilute staff pay and conditions.
‘Cartel’ calls for further cuts to nurses’ pay
Pay continued to be the talk of the month and the announcement of a 1% basic pay rise for health workers – well below inflation, but following a two-year freeze – prompted nursing union heads to point out that the “undervaluing” of nurses and other health workers was quickly leading to low morale.
Unions criticise NHS staff 1% pay rise
The Department of Health was clearly not trying to befriend nurses as March progressed. The government unveiled its initial response to the Francis report and the profession found itself criticised by a heavy focus on changes to nurse education. Topping the list of controversial policies was the idea that potential students should in future be required to complete up to a year as an HCA before starting their course.
Francis response: Hunt announces measures targeting HCAs and students
Unsurprisingly, the influx of negative headlines about the profession had the Labour party pointing out where it thought there were flaws in the way the health service was being run. It claimed that nursing numbers were due to drop drastically over the coming years.
NHS could lose 20,000 nurses by 2015, claims Labour
A top ambulance service boss reported that paramedics were being forced to wait with patients in hospital corridors, due to hospital staff and bed shortages. This sparked discussion among the nursing community, some of whom felt this was an attack on nurses.
Paramedics ‘doing jobs of nurses’ because of staff shortages
As part of the national nursing strategy, Compassion in Practice, chief nursing officer for England Jane Cummings announced plans to review the safety of nurses working 12 hour shifts. The review, which was still yet to begin six months later, follows years of debate over whether nurses should work eight or 12 hour shifts, and if patient safety is a factor.
CNO to review safety of 12 hour shifts
The news that the government’s plan for students to gain experience as HCAs could be piloted as soon as the autumn, sparked 60 reader comments.
Exclusive: HCA pilot for potential nursing students could be set up by autumn
April saw changes made to the UK childhood immunisation schedule. Reducing the number of cases of influenza, shingles and diarrhoea were highlighted as primary aims.
New vaccines to join immunisation schedule
We uncovered widespread use of “HCA apprentices” within the NHS, leading some commentators to dub it cheap labour and a risk to patient safety, rather than the trusts’ view that it was a learning opportunity for those wishing to become HCAs.
Exclusive: fears raised over HCA apprenticeship schemes
Research suggested that a high-potassium diet reduced the risk of stroke by lowering blood pressure.
Potassium rich food ‘a life-saver’
Robert Francis QC was back in the headlines during May. In an exclusive interview with Nursing Times and its sister title Health Service Journal, he voiced his disappointment over nurse leaders’ failure to respond to his report on Mid Staffordshire Foundation Trust and a general lack of action.
Exclusive: Francis criticises nurse leadership over failure to respond to Mid Staffs report
A study found a link between the scourge of many nurses, long-term back pain, and infection by acne bacteria, leading researchers to conclude that antibiotics could help in up to 40% of cases of chronic back pain. This was never going to be a popular finding with those attempting to arrest growing resistance to antibiotics.
Antibiotics ‘can relieve back pain’
A study by the National Nursing Research Unit at King’s College London revealed the perhaps unsurprising, but still important, revelation that investing in staff wellbeing has a directly positive impact on care given to patients.
Invest in nursing staff wellbeing to improve patient outcomes, urge King’s college researchers
NHS Direct found itself uncomfortably in the spotlight this month. It emerged that NHS Direct might not be able to continue to provide the new NHS 111 non-urgent phone service past March 2014. NHS Direct subsequently announced in July that it was seeking to pull out of all 11 of its contracts to provide NHS 111, as they had proved “financially unsustainable”.
Future of NHS Direct becomes more uncertain
Research by the charity Macmillan Cancer Support uncovered the shocking news that an estimated 10,000 cancer patients a year are given the wrong drugs while in hospital.
Estimated 10,000 cancer patients ‘given wrong drugs’
The start of the summer brought with it the Guardian league table of higher education providers. Everyone, including Nursing Times readers it seems, loves a league table. It was largely a tale of two universities in one city. Edinburgh University was ranked as the best place for nursing and paramedic studies while the nearby Edinburgh Napier University was the worst ranked.
Best and worst nursing courses revealed
A pension story hit the headlines this month, with nurses asked what they thought about proposals to make them work until they were 68. This came about as the government agreed with unions to review the impact of The Public Service Pensions Act (2013).
Nurses asked for views on working till 68
The Centre for Workforce Intelligence drew the concerning conclusion that in the next three years, the NHS is likely to have 47,500 fewer nurses than are needed.
NHS to face chronic nurse shortage by 2016
In a bid for more “openness” in the NHS, Jeremy Hunt announced a scheme whereby the name of the responsible nurse is written above each patient’s bed. Giving his argument in favour of the idea, the health secretary said: “The buck always needs to stop with someone and the patient has every right to know who that person is”
Put the names of nurses above every bed, says health secretary
Many of you were outraged over advice to pregnant women to be more aware of the chemical content of household products. With little evidence of the actual harm this causes unborn babies, the advice from the Royal College of Obstetricians and Gynaecologists was branded by many as “alarmist”.
Row over RCOG advice to avoid plastic packaging and cosmetics while pregnant
The Sunday Times journalist Camilla Cavendish revealed the results of her review for the government into healthcare assistant education and training. Her main recommendation was that a mandatory Certificate of Fundamental Care be introduced for all HCAs.
All HCAs should complete care certificate, says Cavendish review
In a bid to help patients identify the roles of different types of staff, East Sussex Healthcare Trust introduced coloured lanyards. The initiative sparked a lively debate on nursingtimes.net.
Trust introduces coloured lanyards for nursing staff
After months of speculation over its potential misuse and appropriateness, a national review of the Liverpool Care Pathway led by Baroness Julia Neuberger showed it could help patients have a dignified death. However, it also found cases where it was linked to poor care and made 44 recommendations on how end of life care should be given. This included phasing out the pathway itself and replacing it with a “personalised end of life care plan, backed up by good practice guidance specific to disease groups”.
Ministers confirm new procedures for end of life care
This one got you talking. Can nurses learn from TV hospital dramas? Study authors noted that the profession’s portrayal in hospital dramas was frequently based on stereotypes. But they argued there was also “value” to be gained from “engaging more closely” with contemporary media portrayals of nursing.
Nurses should watch TV hospital dramas, says academics
After altering discharge times to meet waiting targets, two former A&E sisters at Mid Staffordshire Foundation Trust found themselves struck off the register by a fitness to practise panel.
Mid Staffs A&E sisters struck off by NMC
At the start of the month, changes to the way the NHS Pension scheme is valued were announced, leading to warnings from unions and NHS Employers that these are likely to cost the health service around £2.5bn – resulting in job losses and cuts to NHS services.
Warning Treasury raid on NHS pensions will cost jobs
Parkinson’s UK hit out against the Work Capability Assessment after figures showed many of those with progressive diseases were deemed able to recover enough to look for work.
Fit-to-work assessment ‘farcical’, says charity
Harsh criticism came the way of a London hospital trust, which received three formal warnings from the Care Quality Commission. Barts Health Trust “failed to protect the safety and welfare of patients” at its Whipps Cross University Hospital site.
London hospital branded “unsafe and dirty”
The Berwick report into creating a zero-harm culture within the health service was unveiled in August. The report set out the recommendations of a review by US patient safety expert Professor Don Berwick. Although the report did not recommend a national minimum staffing level, it did put forward the suggestion that healthcare staff should face jail for “neglect or wilful misconduct”.
NHS staff should face prison for patient neglect, says Berwick report
Staff shortages were again in the headlines, this time with the news that the health service in England had lost more than 5,000 nurses in just three years. In May this year there were 348,311 qualified staff working in nursing, midwifery and health visiting, compared to 353,912 in May 2010.
NHS has lost more than 5,000 nurses in three years
We were shocked to hear about the offensive comments a children’s hospice nurse posted on Facebook. Her suspension was a stark reminder of the need to always think about how you use social media as a healthcare professional.
Nurse suspended over Facebook posts
Two Mid Staffordshire Foundation Trust nurses were investigated by the NMC in September, over the death of a patient in their care in April 2007. For failing to ensure a diabetic patient received vital insulin medication, one nurse was struck off while the other received a three year caution order.
Mid Staffs nurse struck off after patient death
Should patient feedback by a part of nurse appraisals? This was one of the big questions being asked by the NMC as part of its proposals for nurse revalidation.
NMC to vote on proposals for nurse revalidation
Staffing, and a lack of it, once again sparked a heated debate on the NT forums. Nurses at United Lincolnshire Hospitals Trust told Care Quality Commission inspectors that they were not able to adequately care for patients because there were not enough of them to do so. The inspection highlighted the problems short-staffing can cause.
‘Emotional’ nurses tell hospital inspectors of low staffing fears
Concerns were raised that early results from the government’s new “Friends and Family Test” were being displayed in a misleading way, which could cause unnecessary worry to patients and damage staff morale. The NHS Choices website found itself strongly criticised by directors of nursing over the issue.
Nurses raise concern friends and family test is alarming patients
It was revealed that “incompetence” could not be given by the NMC as a reason for striking off a nurse, unless they have first been subject to a two-year suspension order. The story related to a High Court ruling made back in February, which did not come to light at the time.
High court ruling prevents NMC from striking off incompetent nurses
A successful initial trial brought an alternative treatment for high cholesterol closer to being a reality.
New cholesterol lowering drug moves a step closer
An investigation by Nursing Times revealed that a third of hospital trusts in England have gone overseas to recruit nurses to make up for local shortages. Our story gained widespread attention in the national media. It formed the first part in a series of exclusives on nursing workforce trends that following over coming weeks.
Exclusive: Nursing shortage drives hospitals overseas
We reported on a new campaign to improve pressure ulcer care – “Stop The Pressure” uses social media to spread awareness of good practice. It builds on a regional campaign developed in NHS Midlands and East. It was the brainchild of student nurse Charlotte Johnson who said it was “overwhelming” to see her idea to increase awareness of pressure ulcer prevention come to fruition.
Call to make pressure ulcer care ‘sexy’
Ministers announced that a new national certificate for care workers will be introduced in an attempt to drive up standards. It followed recommendations made in October by the Cavendish review into healthcare assistant education and training. The main recommendation was that a compulsory training certificate be devised to ensure all HCAs have the same minimum level of training. The government is yet to confirm when the mandatory qualification will be introduced.
Compulsory certificate of care for HCAs
Scientists uncovered signs of the immune system’s “alarm system” response for returning cancer – with the hope of making treatment quicker and ultimately saving lives.
Immune system has ‘early warning alarm’ for returning cancer
A midwife who reportedly left a four day old baby face-down in a stationary cupboard at Queen’s Hospital in Romford, was given a three year caution order by the NMC.
Midwife who put baby in cupboard cautioned by NMC
A private company that had won a three-year contract to deliver community services for the NHS in Suffolk resorted to asking its health service neighbours whether it could borrow nurses on secondment to help fill staffing vacancies.
Serco turns to NHS to help fill vacancies
Another Nursing Times exclusive had many of you talking. We uncovered data showing an increasing number of nurses were allowing their registrations to lapse each year, potentially fuelling a growing national shortage of nurses. Many nurses commented on this story and suggested reasons why this might be happening.
Exclusive: Increase in nurses ‘quitting’ register
Three of the most senior nurses in the NHS warned against introducing minimum staffing levels, in a letter published in The Times ahead of the government’s official response to the Francis report. The letter was penned by Eileen Sills from Guys and St Thomas’ Foundation Trust, Katherine Fenton from University College London Hospitals and Flo Panel Coates from Barking, Havering and Redbridge University Hospitals Trust.
Nurse leaders divided over minimum staffing levels
Figures revealed that patients are significantly more likely to be admitted to hospital in the 10 minutes before a key target could be breached than at any other time – possibly not a huge surprise to many readers. Some 59%of patients are admitted to hospital in the final 10 minutes of a four-hour wait at A&E compared to just 10% of patients who spend 10 minutes in A&E, according to the stats from the Health and Social Care Information Centre.
Hospital admission times ‘linked to A&E target’
The battle against dementia should be refocused away from “dubious” drugs to the benefits of a Mediterranean diet, a group of doctors and health experts said ahead of an international summit on the condition. In a letter to health secretary Jeremy Hunt, they said persuading people to eat fresh fruits and vegetables, nuts, fish and olive oil was “possibly the best strategy currently available”. Dementia experts from G8 countries gathered in London this month for a meeting convened by David Cameron as part of the UK’s presidency of the group of leading economies.
Docs call for more focus on diet to ward off dementia
Nurses who work for private companies that provide care funded by the health service were told they would be granted access to the NHS Pension Scheme under proposals. The proposal applies to staff “wholly or mainly” involved in delivering NHS funded care. However, there was a sting in the tail as the move could provide a boost to independent providers seeking to bid for NHS work as they will no longer have to compete with the taxpayer guaranteed NHS pension.
Private sector staff win access to NHS pension
A High Court judge granted an injunction to stop former Mid Staffordshire Foundation Trust chief nurse Jan Harry from leaving the Nursing and Midwifery Council register and therefore able to avoid further disciplinary action. Ms Harry’s registration was due to lapse this month. She was handed a five year caution order that is being appealed by the Professional Standards Authority, which claimed it was “too lenient”.
Judge intervenes in case of former Mid Staffs nurse chief
Some good news, at last. The first ever national workforce plan for the NHS was approved by Health Education England, promising a 9% increase in the number of training places for nurses. In an attempt to reverse the decline in nurse training and to tackle a growing staff shortage, HEE will commission 13,228 places for trainee nurses from 2014-15, an increase of 1,094 on the 2013-14 level. This could result in 2017 seeing the largest number of qualified nurses ever produced in 2017.
Workforce plan promises 9% rise in nursing course places