The Francis report was a “missed opportunity” to address nurse staffing levels, the head of the Royal College of Nursing has told congress.
In his annual address to conference, chief executive and general secretary Peter Carter said the need for mandatory staffing levels had “never been greater”.
He told delegates Robert Francis QC’s recommendations on staffing levels were good - and would lead to an important improvement if implemented – but did not go far enough.
In his Report of the Mid Staffordshire Foundation Trust Public Inquiry, Mr Francis recommended the National Institute for Health and Care Excellence should develop safe staffing levels for a variety of settings. These should be monitored by the Care Quality Commission and commissioners, however he stopped short of recommending they be compulsory.
Mr Carter said: “I respect Robert Francis and his report, but it’s a missed opportunity.
He said the RCN also felt “let down” by the government’s continued failure to acknowledge the importance of staffing levels.
“Until they realise the need for enforceable safe staffing, accounts of poor care are going to continue,” he said.
Mr Carter also hit back at criticism of the RCN’s own role in the scandal at Mid Staffordshire Foundation Trust.
The organisation was criticised for failing to support Helene Donnelly, a nurse who blew the whistle on poor care in accident and emergency. She turned to the RCN for support but later discovered they had also been representing the two sisters she had complained about.
Earlier today a spokeswoman for the Department of Health said the RCN needed to set out how it was going to respond to this criticism before they could have credibility in the debate on staffing levels.
Mr Carter accepted things could have been done differently “on the ground” but said nursing had come in for “too much criticism” for its role.
Mr Carter rubbished the government’s plans for all nurses to have to spend a year as a healthcare assistant before embarking on training, describing it as a policy with “more holes than Swiss cheese”.
He questioned who would pay the 210,000 individuals who apply to nursing courses every year to work as HCAs and whether health secretary Jeremy Hunt realised nurses already spend half of their training on clinical placements.
Mr Carter said: “What’s more, let’s not forget [Mr Francis] actually said unregistered staff shouldn’t be delivering hands on care in the first place, so how does it stack up that the government want tens of thousands of HCAs to be parachuted in to care for patients?”
Addressing the changes to the Agenda for Change pay framework agreed by the RCN and other health unions earlier this year, Mr Carter said rejecting the changes could have led to the end of a national framework.
“It would have sent message that AfC was inflexible and that the days of a national framework might be over.”