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OPINION

Peter Carter: 'Government’s response to Francis does not go far enough'

  • 14 Comments

The government needs to build on its actions to ensure the system supports nurses to deliver high-quality care, says Peter Carter

At the end of March, health secretary Jeremy Hunt insisted the NHS must not crush “the innate sense of decency and compassion” that drives people to want to work for it.

His comments resonate with the concerns of nursing staff whom I meet every week. Nurses up and down the country are suffering from the demands and often the culture of their organisation, leaving them feeling utterly demoralised and unable to deliver the standard of care they came into the profession to provide.

This is often due to a cocktail of pressures: a lack of staff on wards; bureaucratic burdens on time; a lack of professional support and supervision; and a fear of being open when mistakes have been made. These are the things Robert Francis QC identified in his final report into Mid Staffordshire, and those that the government now has the chance to put right.

Mr Hunt recently announced positive action to tighten regulation and accountability in the NHS, including a new statutory duty of candour covering providers and trust board members, and a new chief inspector of hospitals. Encouragingly, the government has also committed to reducing the paperwork burden by a third.

Despite these positive measures, the government’s initial response to Francis has left a number of unaddressed issues and missed opportunities. It has left the Royal College of Nursing concerned about how nurses are to be supported in other vital areas to deliver patient care.

For many years the RCN has been calling for a system of mandatory training and regulation for healthcare assistants. It is positive that the government will be implementing the recommendation for a code of conduct and national standards of training for HCAs, but a system of mandatory regulation has regrettably been dismissed. This is hugely disappointing. A voluntary system will provide false reassurance; only mandatory regulation will give HCAs and patients the protection they deserve.

Last November, the Willis Commission on Nursing Education, established by the RCN, delivered its independent verdict. It found no evidence that the education system is failing, nor that it is associated with a decline in compassion. Despite this, the government is proposing that students wanting to enter nursing must spend up to a year working as an HCA before starting their degree. We have concerns with this proposal and it raises a number of questions: who will train, employ and monitor tens of thousands of HCAs, and how does the government expect to deliver this radical change to training on a cost-neutral basis?

Mr Hunt recently admitted that more nurses are likely to be needed on the frontline when staffing levels are reviewed by the chief inspector of hospitals. We welcome this commitment to look at staffing levels, but this simply does not go far enough. The RCN has consistently highlighted the real need for safe staffing levels. The reality is that nurses continue to work with up to 11 patients each in older people’s settings, and with even higher numbers in care homes. Simply leaving the setting of staffing levels to local discretion clearly isn’t working; the time has come for mandatory, legally enforceable safe staffing levels.

The Francis report is forcing professionals, organisations and the government to reflect on the changes needed to provide safe and high-quality care. We are facing a watershed moment in the NHS. It is a major opportunity to ensure the system supports, rather than obstructs, the desire of nurses to deliver high-quality care. I urge the government to build on the actions they have set out and work with the RCN to go even further. The time to be bold is now.

Peter Carter is general secretary and chief executive of the Royal College of Nursing

  • 14 Comments

Readers' comments (14)

  • tinkerbell

    Yes' lets boldly go where no man has gone before' RCN. As a union ballot your members NOW. Bet you get a different response this time round.

    It is abundantly clear now that we're all being shafted big time, that the NHS is on the brink of destruction along with safe care to our patients.

    Come on step up to the challenge and do the right thing. No more excuses.

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  • michael stone

    'Despite these positive measures, the government’s initial response to Francis has left a number of unaddressed issues and missed opportunities.'

    Yep - that is why everyone needs to keep the pressure on the Goverment !

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  • 'Government’s response to Francis does not go far enough'...

    ...Neither does the RCN response go far enough! Hang on, have the RCN actually offered a response to the criticisms of the Francis Report? Stop throwing stones and get your own house in order!

    When will RCN Council get out of their plush Cavendish Square ivory tower and start promoting nursing - it is time to split the organisation and bring a sense of pride back into the standards of nursing practice every nurse in the UK is committed to delivering.



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  • michael stone

    tinkerbell | 16-Apr-2013 8:57 am

    Tink, this is off-topic, but I would appreciate your input on something.

    You are well known as a mental nurse, so I think you will be fairly expert in the area I’m struggling with.

    Would you please go to www.dignityincare.org.uk > Discuss and debate > Can some Professionals please explain this one to me It confuses me enormously in legal terms

    and then get back to me with an answer to the question I ask (any other expert answers also appreciated),

    Mike

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  • tinkerbell

    Mike what area are you seeking advice on. I am in greece with unreliable internet connection so can't look up the website.

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  • michael stone

    tinkerbell | 22-Apr-2013 8:55 am

    Thanks Tink - you had mentioned Greece, I'd forgotten that.

    Just save the question, for when you are back to normal online activities.

    It isn't so much that I'm seeking advice - it is more 'I'm prodding people', but it makes sense if you look at the one I posted on the DIC website.

    There isn't any hurry - 'nudging the NHS' is a really slow process !

    PS Did you like my 'well known as a mental nurse' joke ?

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  • tinkerbell | 22-Apr-2013 8:55 am

    'appy 'olidays, Tink!

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  • tinkerbell

    Mike i am a nurse in mentql health and hopefully not a mental nurse.

    Anon: thanks. we're all in a fine mess here in greece.

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  • michael stone

    tinkerbell | 23-Apr-2013 4:48 pm

    Mike i am a nurse in mentql health and hopefully not a mental nurse.


    But Tink - I've read some of your posts on this site ! :) I hope I got that 'smiley' thing right !

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  • DH Agent - as if ! | 24-Apr-2013 10:29 am

    tinkerbell | 23-Apr-2013 4:48 pm

    Mike, we've been trained not to label people and especially not in mental health!

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