Almost half of NHS nurses and other healthcare workers say there are not enough staff on their shift to ensure patients are treated safely and with compassion, according to a new survey published by a public sector union.
Unison’s survey examined the attitudes and experiences of nurses and other healthcare professionals across one working day in September 2018, to uncover how staff felt about the pressures they are under.
“This survey shows the extent to which crisis level staffing has become normal across the whole NHS”
According to the union, the study illustrates the effect of chronic understaffing in the health service, with unfilled posts and uncertainty about the future status of many workers having an impact on patients.
As a result of the study’s results, Unison is warning the government that it must pump significant funds into the NHS to fix the problems caused by years of austerity and is calling on ministers to put a greater focus on apprenticeships to encourage people into healthcare professions.
The survey revealed that almost half (45%) of the respondents who were directly involved in patient care (6,778 out of 15,134) said there were not enough staff on their shift to deliver a safe, dignified and compassionate service.
In a report on the survey – titled Just Another Day – an anonymous account from one member of staff highlighted that instead of the four registered nurses required for the shift, they had just two to look after 26 patients.
“There was one person who was dying but we couldn’t get to her quickly enough”
The account read: “There was one person who was dying but we couldn’t get to her quickly enough because the controlled drugs she needed for pain took two nurses to unlock from the cupboard by law and that left the ward without a nurse there. Horrific.”
Unison explained that some departments were more severely affected than others, with staff in working in acute inpatient care hit the hardest. The survey identified almost three in five (1,381 out of 2,345), stating that staffing in this area of care was insufficient.
For those working in mental health, primary care, and community health, Unison said staffing was a “serious issue”.
The survey revealed that for 45% of respondents working in mental health (996 of 2,203) said staffing was insufficient. Meanwhile, primary care saw 41% (777 of 1,893) and community health 36% (642 of 1,794).
The union highlighted how concerns over staff levels had arisen, despite the high number of bank or agency staff being used on the day.
Nearly half of respondents (47%) stated that their service relied on bank staff on the day of the survey, mainly to fill nursing roles. Though it added that healthcare assistant posts, administration and a variety of other positions were also filled with bank replacements.
“It also shows the dedication and compassion these hard-working committed staff continue to show at the most trying times”
In addition to this, Unison’s survey also saw one in seven (14%) healthcare staff rating the quality of care as “compromised” and one in six (15%) stating that patient safety was compromised the day the survey was carried out.
Other findings of the survey saw 47% of nurses and midwives reporting to have worked longer than their original shifts. The report noted that the worst affected workplaces were A&E (45%), community (42%) and acute inpatients (41%).
Nearly one in six (16%) members of staff reported that they were subjected to violence, aggression and/or verbal abuse during their shift and more than a quarter (26%) reported extremely high stress levels.
Following these results, Unison has outlined a number of specific recommendations to the government.
- The NHS must be given a significant increase in funding to tackle the serious cuts to the service brought about by the squeeze on funding. Current resource pledges are not enough to meet patients’ needs
- Legislation must be introduced for mandatory safe-staffing levels in England and Northern Ireland, building on the lead of Wales and Scotland
- A renewed focus is needed on apprenticeship schemes as a way to improve access routes into healthcare professions. Changes to healthcare student finances are also essential to encourage training and recruitment to the service
- The investment in improving pay and rewards must be continued in order to attract and retain health service staff. Stress and violence must be tackled to improve the working environment
Unison reiterated how staffing shortages were illustrated in the most recent figures for the NHS in England, issued in November 2018, which saw nearly 41,000 nurse shortages.
Unison head of health Sara Gorton said: “This survey shows the extent to which crisis level staffing has become normal across the whole NHS.
sara gorton for index
“These are long-term, systemic factors not being properly addressed,” she said. “The government must give the system the funding needed to tackle these issues.
“But hearteningly it also shows the dedication and compassion these hard-working committed staff continue to show at the most trying times,” she added.
In line with her comments, the report also highlighted cases of nurses going the extra mile to help their patients, despite the pressures they are under.
Examples of accounts from respondents include one nurse from Golders Green, North London, explaining how they dyed an elderly lady’s hair after their shift, on top of the hour they stayed late doing extra clinical work.
Another nurse, from Accrington, Lancashire reported: “I gave a crying baby a cuddle for 15 minutes, taken out of my break on a night shift, so a tired first-time mummy could close her eyes for a few minutes.”
The findings are based on responses from more than 18,000 healthcare staff from across the UK including nurses, healthcare assistants and support workers, students, ambulance service staff, cleaners and porters.
The vast majority (90%) worked in the NHS, the remainder from the private and voluntary sector.