Your browser is no longer supported

For the best possible experience using our website we recommend you upgrade to a newer version or another browser.

Your browser appears to have cookies disabled. For the best experience of this website, please enable cookies in your browser

We'll assume we have your consent to use cookies, for example so you won't need to log in each time you visit our site.
Learn more

No opt-out: nurses told of 'moral duty' to save money


Nurses have been told how to fulfil their “professional and moral responsibility” to help the NHS cut waste and save money, in comprehensive guidance shared exclusively with Nursing Times.

The 260-page document has been published to show nurses how they can implement and measure the eight “high impact actions” aimed at saving more than £9bn.

Produced by the NHS Institute for Innovation and Improvement, High Impact Action for Nursing and Midwifery – The Essential Collection draws on lessons learnt from trial sites.

It states: “A few nurses and midwives may still think that money is someone else’s business, but those that think this are, quite frankly, out of touch with reality - opting out isn’t an option.

“Addressing financial inefficiencies is a key personal, professional and moral responsibility.”

The “high impact actions” were announced last November and include areas such as improving patient nutrition, reducing pressure sores and falls and cutting staff absence.

A major theme in the document is the importance of good communication methods. At one trust, infection control teams carried out trolley dashes through the wards, handing out themed “goodies” to get people talking about catheter care.

Another trust designed a giant floor game to disseminate important information.

The guide also sets out how cost benefits can be calculated. For example, by using the Department of Health’s estimate that the daily cost of care for a patient awaiting hospital discharge is £100, nurses can identify savings from reducing delays.

Chief nursing officer Dame Christine Beasley urged nurses to read the document, saying  senior nurses such as matrons and ward sisters would be “absolutely pivotal” in achieving the drive.

She said: “We have seen that’s the case from productive ward work, where ward sisters and ward leaders at that level have really taken it on and made it their own.”

She told Nursing Times that successful pilots had often addressed two or three areas together such as pressure ulcers, falls and nutrition.

But work to date had also shown that nursing leaders also needed the backing from their organisations to ensure change actually happened, she stressed.

NHS South Central chief nurse and director of clinical standards and workforce Katherine Fenton said it was vital nurses took action now to avoid “slash and burn policies.”

She said: “Nurses have got to get involved otherwise we will suffer.” Unless senior nurses were engaged, “others haven’t got a chance.”

Some might be worried about schemes appearing to pit ward against ward, but Ms Fenton said the work had shown nurses could be “energised” by an element of competition.

However some improvements, such as nurse led discharge and nutrition, had proved particularly tough to crack, she said.

NHS County Durham and Darlington took action on nutrition, involving enforcing protected meal times, gathering patient feedback on menus and ensuring hot, fresh meals were available 24 hours a day.

Modern matron Karen Dyson said patients were happier and catering costs had fallen.

Another case study in the guide is East Kent Hospitals University NHS Foundation Trust, which used routine falls risk assessments, sensor alarms and falls “champions”. One ward reduced its falls rate by 85 per cent in a year.


Related files

Readers' comments (72)

  • Couldn't agree more with all the above. How about we all learn self catheterisation so that prior to duty we can insert and go, avoiding the need to take time to sit, therefore saving untold millions in wasted pee time? Along with the missed breaks, unpaid overtime, and always going that extra mile, we should be able to save a fair wack. Here our pay has been frozen along with increments resulting in the longterm effect of a ward sister eventually working on a top band 5 salary. Unsocial pay on a Saturday is being removed along with all bank staff. We are working 60+hrs a week. All funding for toys for use in play therapy has been stopped and the nurses are buying toys out of their own pay. However, let us not forget that 'we are all in this together' - thus spake the multi-millionaires. Anyone for major walkout?

    Unsuitable or offensive? Report this comment

  • Mike,
    Those who use the service should also be prepared to do something about the NHS spending more on bureaucrats, administration, IT and contracted out workers than it does on those who provide patient and family care.

    Let the public take a hand in deciding who is worth more to the Health Service. It does after all belong to the Nation not the shadowy overpaid accountants who try to run it on the basis of a profit making enterprise. These people probably use private health care anyway seeing the same NHS trained consultants and Nursing staff in their private clinics.

    Unsuitable or offensive? Report this comment

  • Roger, too true mate. What you are saying, that basically it is up to the public as a whole who they want in the NHS, is the exact reason why I think a strike would be so effective. The public on the whole would back us, we are after all fighting for their services here against those beauracrats and managers, alongside better pay/status and working conditions for ourselves. The two go hand in hand in my opinion.

    And Peter, I haven't read quite such an eloquent post in a long while, but I hope to hell that tipping point is soon.

    Unsuitable or offensive? Report this comment

  • And I hope someone sends all these comments to that turncoat Beasley.

    Unsuitable or offensive? Report this comment

  • Hi again..Can I offer some more advice seeing as you have the "Pittance Union" to do ZILCH for you in your fight, and who really should be the backbone in this.
    ( I am still amazed that nurses have not banded together to make their union work for them! Stop paying the fees! ) Anyway with them classed as not available and nurses over there on their own, my first thought would be a major rally in a major city. Getting multiple speakers that would let the public and MEDIA know exactly what is going on and what you demand now as a still caring PROFESSION of Health Care . I feel this would start the ball rolling for you. How difficult would it be without the union who should be the main orginisers and more so supporters of your cause ..its a disgrace. However with the amazing WWW now....communication can roll to every hospital and nurse! Major planning and time, but I believe would be very effective for you. No one wants to strike....absoluatly. Thats always been a thing nurses have been known for.not doing in UK...and thats where the government will always have you unless you make a stand not only for your rights as nurses, but for those you are caring for. They have rights too, and they are suffering too.
    However nurses Work to Rule can cripple a Health Service very quickly without patient compromise...and be very costly in the process.
    Canada did a strike I believe, but I havent looked much into it, however I think it was super fast effective. Here in Melbourne we did strike in 1984 with the results we needed. We have also had a few rallies since ( organised and atteneded for the nurses by our union!! )The ANF ( Australian Federation of Nurses ) Victoria Branch do not like such militant action, but there again they protect their nurses...Fees I am happy to pay in to at a cost of approx $370 a year tax deductable.
    You can either continue with the tears.....or rally round all the great nurses who deserve better
    Get Googling for some feedback on Canada and Melbourne ....:)

    Unsuitable or offensive? Report this comment

  • I agree with the above comments, we all have to do something and stick together or stop moaning about it and accept it! I to am fed up with never getting off on time, skipping meal breaks and working dreadful shift patterns with little time off between 12 hour shifts. I too love caring for the patients but fel everydy I am letting them down due to limited resorces and too much time spent on repetative paperwork that was really designed to make auditing easier. Not patient care. I prefer to spend more time with my patients who I feel are getting neglected. It all about meeting targets nowadays, get them in and shunt them out regardless off wheather they are actually fit for discharge! then low and behold the same patient is back again within days sometimes. What I have noticed more and more is that corners are being cut with paperwork as we simply do not have the time to do the amount that we are now pressurised in to doing by our auditing line managers.

    Unsuitable or offensive? Report this comment

  • They can stick their moral duty paradox where the sun doesn't shine.

    Chris Beaseley has a moral duty to fight for nurses across the country yet she is just another 'jam making traditionalist' who having made it financially herself sees nothing wrong with the rest of us starving.

    She and the others of oour unions should have legal action brought against them for continually ignoring the central issues of nursing; for making no headway in fair and realistic pay (which should be £25-28000 on graduation)

    Never mind that we are paid the worst for doing the most work and having the least recognition for it.

    my job involves doing work that many other people ought to be doing ;

    physios:- who often pick and choose who they will se and go at a snails pae around the ward.

    dieticians:- who don't order meals, check patients nutritional status or even offer advice. ours just prescribes TPN

    pharmacists and their techs:- who do office hours and don't empty my CD cupboard of dead patients CD's/

    doctors:- who seem less and less willling to cannulate, properly assess (how any times have you seen them coach patients through the MMSE?!) prescribe adequate IV fluids or ignore me drawing attention to declining patients - especialy the post-op ones
    (if you're not worried, why do you keep coming back?)

    She is not up to the taskand should be let go without a pension for utterly failing to meet objectives beneficial to the profession

    Unsuitable or offensive? Report this comment

  • Hear hear Jjez! Does anyone have any idea where or how to send all of these comments to Beasley and the ridiculous NHS institute? I can't seem to find a contact email, but I'd love to hear their self serving responses!

    Unsuitable or offensive? Report this comment


    Christ, A&E nurses look happier and healthier than those working in acute medicine, why do it?

    Unsuitable or offensive? Report this comment

  • I am going to contact my union and ask why they haven't bothered to contact members since the government announced a 2 year pay freeze. With this, and talk of a demolition job on the pension Christine Beasley has just about finished me off!

    Unsuitable or offensive? Report this comment

Show 102050results per page

Have your say

You must sign in to make a comment

Please remember that the submission of any material is governed by our Terms and Conditions and by submitting material you confirm your agreement to these Terms and Conditions. Links may be included in your comments but HTML is not permitted.