Once again we find ourselves in a situation where patients are being put after the pound notes.
Reporter Shaun Lintern has this week learnt that 92% of trusts are unable to meet their own targets for the number of hours filled by registered nurses at their hospitals during the day. The story, on page 2 of this issue, indicates a deteriorating picture of staffing levels as the NHS approaches winter.
This is a classic case of reaping what you sow. The last government cut nursing posts at the beginning of its term in office. So we failed to train enough nurses and suddenly we have a nursing shortage that is so dire, trusts are scrambling to recruit nurses from overseas to meet their nurse staffing targets.
It is little wonder then that nursing directors were so concerned earlier this year when migration controls were looking likely to prevent overseas recruitment, and agency caps were introduced to reduce the reliance on agency staff.
I sometimes feel that being a director of nursing must feel like a game of musical chairs. Every time a chief nurse thinks they can just about cope, the government seems to take away another chair. Not enough homegrown nurses? Go abroad. Oh wait, you can’t. Get out your chequebook for the agency staff – er, no that’s off limits too.
Thankfully good sense prevailed over the migration controls, mainly due to smart lobbying by the Royal College of Nursing. But the scrutiny over agency usage will leave many trusts making a choice between breaking the “rules” and safely staffing their wards. No director of nursing wants to rely so heavily on agencies, but their options are running out. Strike that, they’ve run out.
In the acute sector, we have all the ingredients for another winter of discontent – hospitals bulging with the weight of admissions, ambulances queuing up outside A&Es and patients lining the corridors while nurses are rushed off their feet trying to care for them. Things aren’t any better in other care settings – no nurses means poorer care everywhere.
We seem to have learnt nothing from Francis’s report into the care failings at Mid Staffordshire Foundation Trust, and once again finance is being put before the safety of patients. And I am left wondering – if Mid Staffs didn’t shake the government into understanding the value of nursing, then what ever will?
Jenni Middleton, editor