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RCN chief demands government accountability for safe staffing

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The health secretary must be held accountable for ensuring a safe level of staffing across healthcare services, Dame Donna Kinnair has told MPs.

The new chief executive of the Royal College of Nursing wants the secretary of state for health and social care to be accountable to parliament for making sure there are enough staff, with the right skills, in the right place and at the right time to care for patients, based on population needs.

“The lack of accountability on staffing has put us back years”

Donna Kinnair

The call comes in response to an appeal from NHS England and NHS Improvement for proposals for possible changes to legislation to help with the delivery the NHS Long Term Plan.

Giving evidence to the health and social care select committee on Tuesday, Dame Donna said legislation to address the shortage of nursing staff in England was “vital” to ensure patient safety and to deliver on the promises of the 10-year plan.

“Successive secretaries of state have taken decisions which mean we cannot deliver the long-term plan,” said Dame Donna.

“The lack of accountability on staffing has put us back years, so there needs to be an explicit accountability for the workforce with the secretary of state,” she added.

The RCN has been campaigning for safe staffing legislation since autumn last year.

Dame Donna also warned MPs that the success of the long-term plan was dependent on investment in the workforce.

“We cannot go on thinking we can have the same number of nurses and just move them around and feel we can deliver a safe, quality NHS,” she said. “This is why we need a commitment for accountability.

“We are talking about accountability to parliament for the workforce of our biggest treasure, the NHS,” she added.

The RCN also called for organisations in the health system to be given specific duties and legal powers related to the workforce and for them to be held accountable for the decisions they made around staffing. 

As part of this, the college would like to see NHS England and NHS Improvement, and other national organisations including Health Education England, given powers to develop and grow the workforce, as well as responsibility for workforce planning.

In addition, the RCN’s evidence at parliament stressed the need for more nursing staff in order for the government to be able to implement its drive to move care from acute hospitals into the community. The RCN flagged that the move would be “impossible” without substantially more nursing staff.

“We cannot go on thinking we can have the same number of nurses”

Donna Kinnair 

As part of this, it warned that integrated care providers (ICP) should only be formed if it could be demonstrated that there would not be an adverse effect on the pay, terms and conditions of any staff involved, or on patient care and safety.

The RCN also asked for reassurance that increased deployment of the ICP contract would not lead to a diminishment of the nursing voice within services.

Dame Donna said: “To create an integrated health and care system that operates on evidence rather than political calculation, opportunities for data collection and reporting must be enhanced, and not diminished, through any structural changes to NHS provision.”

As previously reported by Nursing Times, NHS leaders approved a series of initial proposals for legal changes before asking for additional suggestions in February.

As part of this, it was announced that a new “best value test” would be introduced to ensure taxpayers were getting the most for their money from the NHS.

The RCN responded to this by asking for further assurance that the test would not have adverse effects on the workforce by choosing providers based on cost rather than clinical risk management.

The college’s full written response can be found here.

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