The outgoing leader of the Royal College of Nursing has used his keynote speech to highlight the key challenges facing nursing, while also urging nurses to “speak up” on issues that affect them.
Peter Carter was giving his ninth and last speech to RCN Congress before he steps down next month.
The speech, which was warmly received and followed by a standing ovation, noted past and recent achievements made by the RCN under his tenure, which began in 2007.
“Over half of them said they were so demoralised they were thinking of working abroad”
However, the key points of speech covered the broad range of issues facing nursing, including staffing levels, unsocial hours pay and revalidation.
Mr Carter started off by highlighting the controversial takeover of work on national safe staffing guidance by NHS England from the National Institute of Health and Care excellence.
“Already, one of our number one priorities is threatened,” he said. “NICE has been told to stop its work on safe staffing guidelines. Stop delivering one of the key recommendations of the Francis report into Mid Staffs.
“After all the progress we’ve made. All the work we’ve done to highlight the importance of safe levels of staffing,” he told delegates at the conference in Bournemouth.
He said the RCN was calling on the health secretary Jeremy Hunt and NHS England chief executive Simon Stevens to “revisit” the decision.
“NICE is an independent body with the right expertise to judge how many nursing staff we need to ensure safe patient care,” he said. “And I haven’t heard anyone make a good case for stopping its work.”
More generally, Mr Carter warned about the staff shortages facing the NHS and drew attention to the RCN’s warning earlier today that new immigration rules would force many overseas nurses to leave the country.
“Trusts are already finding it difficult to recruit enough staff and the nursing shortage is about to get even worse,” he said.
Peter Carter also highlighted the college’s role in improving education standards for healthcare assistants through the introduction of the Care Certificate, but said it should be mandatory.
“I implore you to put yourselves first more often”
“It has been left to individual employers to decide whether or not to adopt it,” he said. “I put it to you congress that this is not good enough.”
“By not mandating employers to properly train their staff…we are failing to invest in our HCA workforce… Failing to invest properly in patient care,” he said. I challenge politicians to ensure that HCAs have the training that they need.”
In addition, Mr Carter noted that nurses needed to help “shape” the new system of competence checks for re-regulation that is due to replace PREP next year.
He acknowledged that some RCN members were anxious about the forthcoming introduction of revalidation. But he urged nurses to see it as a “positive change, which will give your patients confidence that any nurse treating them is fit for practice”.
“Remember at the moment it is still being piloted and it’s essential that nurses have their say during the consultation to ensure that revalidation is fit for purpose and manageable,” he said.
Returning to the issue of staffing, Mr Carter warned about the job pressures and financial problems facing nurses and in particular students.
“When we spoke to student members…over half of them said they were so demoralised they were thinking of working abroad,” he said.
In a message aimed at the four UK governments, he said: “You need to listen to what the nursing profession is saying to you. Nurses are voting with their feet.”
However, the RCN chief executive called on nurses themselves to “speak up” more about issues such as pay and allowances.
He noted that only 16% of members replied to the college’s consultation last year on the pay dispute.
“Why is it that so few of our members vote when we ballot them,” he asked members. “Use your voice,” he stated.
“I want every single member of the RCN to realise how powerful you can be if you all speak with one voice,” he said. “We need to get more people involved.
“During my time at the college, getting the critical mass of members involved has been a huge challenge,” he added.
Mr Carter said nurses had the “power to change things” for the better in relation to staffing levels, terms and conditions and your pay, “if only” they believed it.
“Far too often nurses and health care assistants put themselves last in the line,” he said. “I implore you to put yourselves first more often.”
Mr Carter used the latter part of his speech to focus on to the government’s plans for a seven-day service in the NHS, saying that nurses supported the idea but not how ministers were going about it.
“Of course we want a service as safe at 9am on a Sunday morning as it is at 9am on a Tuesday morning,” he told delegates.
“But you will not get it by cutting unsocial hours allowances to fund it,” he said. “You will get it by recruiting the right number of staff and paying them properly.”