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'It is nurses who will have to manage the fallout of poor planning'

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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.


  • Comments (2)

Readers' comments (2)

  • Anonymous

    Agree my hospital is struggling with discharges. Not sure what it will be like this winter. But we must not blame older people.

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  • Anonymous

    The blame lies squarely with this slash and burn government we have now, and the total lack of funding to the health service under the guise of the "deficit."
    Political posturing by both major parties is causing the problem, the Labour Party inherited a huge deficit in 1997, and the Tories inherited the same deficit in 2010. They may have kept their pals in clover with tax cuts for the rich etc, but the deficit is still there because they have starved the NHS and other vital social services such as housing, education. We have a Health Secretary who does not believe in the NHS and has written books on the subject. He doesn't believe in "socialised" medicine - yet he neglects to add that we all pay for it through our tax and NI system.

    It is convenient to blame uncaring nurses and hide behind inquiries and reports, and allow odious rags like the Mail/Express/Sun to conveniently scapegoat us.

    It is lack of planning and funding for an ever increasing and ageing population.

    We may stand wringing our hands looking at our "failures" but the buck stops with this swingeing "nasty" Government.

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