I was struck last night by a tweet which quoted a CEO of an NHS Trust saying “I’m running the biggest nursing home in Europe. We haven’t done any elective work in years”.
If this is true across the country, it raises some challenges for nurses working on acute wards.
The first is the perception of older people who cannot be discharged from hospital as a burden on services.
The Francis report raised an interesting question about the rights of older people to access services: “Although older people hold the same right of access to NHS services as any younger adults, why are older people accused of ‘blocking’ the beds?”
In my view a patient should never be considered a burden. If they cannot be discharged because they need nursing or social care then they have a right to that care.
“In my view a patient should never be considered a burden”
The next challenge is whether the acute services have sufficient appropriate skilled nurses to care for very dependent older people. This issue was raised by Mr Francis who asked, “When admitted to a general adult ward, where older adults now outnumber younger adults, why is specialist gerontological nursing not widely available to prevent readmission?”
However the suggestion by Mr Francis to develop a specialist role for older peoples’ nurses who could “change the care of older people and create a different value system” was rejected.
While initiatives such as the Health Education England one-year, part-time fellowship for older peoples nursing is developing leaders in the field, there are initially only two cohorts of 12 nurses which is unlikely to meet the growing demand for expertise in the acute sector this winter.
Which leads to the problem of staffing numbers.
“Failings in workforce planning are yet again challenging the standards of care nurses will deliver this winter”
Sadly, Nursing Times has reported this week that the Francis effect seems to have stalled with nursing numbers falling. Yet our ageing frail population who occupy large numbers of our acute beds need experienced motivated nurses to care for them but also pairs of hands so care can be delivered in a dignified and timely manner.
Failings in workforce planning are yet again challenging the standards of care nurses will deliver this winter.
It is nearly two years since the publication of the Francis report which laid down the challenges of providing care to older people in acute hospitals.
While we can discuss and attribute blame about failure to act on these challenges, it is nurses who will have to manage the fallout of poor planning. Poor morale, poor recruitment and retention of staff is the net result.