Concerns about ongoing nurse staffing levels at Mid Yorkshire Hospitals NHS Trust and more widely across the country were debated by MPs earlier this week.
Paula Sherriff, Labour MP for Dewsbury, highlighted that regulators had identified serious concerns about staffing levels, especially nurses, at the trust, which was inspected by the Care Quality Commission in July 2014 and June 2015.
“The feeling of being worn down is affecting staff at all levels”
Ms Sheriff noted that the CQC found a “significant shortage of nurses” was affecting care and that her meeting with the trust’s interim chief executive, Stephen Eames, two weeks ago had revealed that nurse recruitment remained an issue.
“He said that the trust had recently put in an additional 120 beds across the trust to cope with increasing demand, but the 100 extra staff who should have accompanied that expansion are nowhere to be seen. The posts simply have not been filled,” she said.
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Ms Sherriff, who called the debate, went on to highlight detailed concerns raised by the CQC’s inspection, including monthly staffing reports being “overly detailed” and procedures for escalating staffing risks not always being followed.
She noted the trust aimed for a ratio of one nurse to every eight patients on adult in-patient wards – as indicated by National Institute for Health and Care Excellence guidance – but it was “very inconsistently met”.
MP warns of nurse shortages at Yorkshire trust
She highlighted that staff on the trust’s spinal injuries unit were constantly reallocated to other wards, which she said was “in essence robbing Peter to Paul”.
“A nurse even told a patient that because they were so short-staffed, if two patients got into respiratory difficulties, which is not uncommon on a spinal injuries ward, the nurses would have to choose which patient they were to save,” said Ms Sherriff.
She added that the problem was “particularly acute” at community in-patient sites – Monument House and Queen Elizabeth House – where between May and June last year 96% of shifts had at least one non-permanent member of staff.
“Indeed, two shifts had only a single registered nurse on duty. The trust as a whole breached the Department [of Health]’s cap on charges for agency staff, on average, 132 times a week during December,” said Ms Sherriff.
She told MPs that the trust had been “making efforts” to address the staffing issue by proactively looking to recruit nurses both locally and from Europe and investing in safety guardians to provide support for patients with mental health issues, freeing nurse time.
In addition, the high number of nursing vacancies was now noted on the trust’s corporate risk register and it was looking at a “range of different structures for nursing teams to get the best out of the available staff”.
But she also highlighted that she had recently received an email from a constituent, whose 84-year-old father had been admitted to Dewsbury hospital with stroke-like symptoms. He was on a trolley for 14 hours and, following admission, his daughter found his bed was covered in food and her father was naked from the waist down.
“When she asked why he had on only a pyjama top and was sitting on an incontinence pad, she was told that it made it easier when he needed to urinate. When she came back later that afternoon, his bedding had still not been changed, which in the end she did herself,” said Ms Sherriff.
“At the moment I receive similar emails more than once a week, which is alarming,” she said.
She warned that working in such circumstances was having an “inevitable knock-on effect on staff motivation”, as demonstrated by poor results in the 2015 NHS staff survey and an increase in disciplinary action being taken against staff has risen in recent months.
“I have spoken to a number of past and present members of staff in the trust, who informed me that they have failed to whistleblow for fear of retribution,” she said. “The feeling of being worn down is affecting staff at all levels.”
She claimed the government “must take the lion’s share of the blame” for staff shortages across the NHS, which she said was caused by “slashing” nursing training places in 2010 and 2012.
“We are in danger of forgetting the lessons learned from the Mid Staffordshire situation about the absolute priority that must be given to safe staffing levels,” she said.
“The service has failed under successive administrations to predict the number of staff that it needs for the future”
Ms Sherriff also paid tribute to “nurses and all the staff” working at the trust, saying she had “nothing but praise for their hard work, dedication and professionalism”.
“I am continually humbled by the quiet and determined way that all the staff at Dewsbury and District hospital, Pontefract hospital and Pinderfields hospital go about providing care and support in the face of what must seem at times like overwhelming odds,” she told MPs.
In response, health minister Ben Gummer said it was “clear that things need to be done in Mid Yorkshire”.
He noted that he had spoken to the trust’s director of nursing and was “assured on some points”, including that it was co-operating with data collection for a new metric that is to become the principal NHS measure of nurse staffing levels from April.
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On the wider issue of nurse shortages, Mr Gummer argued that nursing numbers “could have been addressed only by significant changes in commissioning levels not two, three or four years ago but 10, 15 or 20 years ago”.
“The service has failed under successive administrations to predict the number of staff that it needs for the future,” he noted, adding that this was why the government had chosen to transfer nurse graduates on to a loan system.
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“It will allow us to add 10,000 additional places between now and the end of this parliament,” he said, repeating the claim made in the autumn by the chancellor when announcing the end of bursaries for student nurses.
He added that the creation of the nursing associate role, along with more apprenticeships, would help solve staffing issues in the long term by providing a “ladder of opportunity” into registered nursing.