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NHS must value its nursing staff, warns report


The NHS must do more to look after and listen to nurses, according to the authors of a report that highlights the link between happy staff and patient welfare.

While most NHS trusts claim staff engagement is a key priority, actual engagement levels are relatively low, said the report by the Point of Care Foundation.  This is particularly so for nurses, it warned, with just 27% feeling actively engaged in their organisations.

Pulling together a range of evidence from research, it stresses the importance of “staff engagement” and the need for nurses and others to feel truly valued.

It flagged up links between staff wellbeing and rates for healthcare associated infections and patient mortality. When it comes to death rates there is a strong correlation with staff satisfaction, “with the strongest correlation among nurses”, it said.

In addition, the report highlighted especially high stress levels among nurses, with 55% saying they had felt unwell due to stress over the past year in a recent survey by the Royal College of Nursing.

Jill MabenProfessor Jull Maben

Professor Jill Maben, director of the National Nursing Research Unit at King’s College London and a trustee of the foundation, said staff engagement was all the more important in tough times.

“It is an enormously pressured time and when you’re under pressure there is this temptation to batten down the hatches and not come up for air,” she said.

“But at times like that it’s even more important staff feel valued and listened to, otherwise more people end up burnt out and stressed and then leave, leaving you with unfilled vacancies and making things worse.”

Professor Maben said it was vital nurses had the opportunity to “stop, reflect and feed back on what they are doing”. However, she noted that opportunities had fallen by the wayside in recent years with the advent of 12-hour shifts where nurses rarely left the ward and handovers were brief.

Solutions could include initiatives like Schwarz Rounds, monthly one-hour sessions where groups of nurses and others talk about and reflect upon particular cases, she suggested.

Professor Maben also called for formal supervision currently available to midwives and mental health nurses to be extended to all, and said it was vital managers really listened to staff.

“People often think they are listening but they are not really,” she said. “It’s almost worse to ask people what they think then not do anything, than not asking.”

The report, which features a number of good practice examples, also says frontline staff should be given more responsibility and authority to solve problems affecting patient care.

Its findings were welcomed by the RCN and the NHS Employers organisation.

RCN director of nursing and service delivery Janet Davies said: “Nurses and other frontline health workers understand the issues facing the NHS and can provide the solutions. This is why it is so important that they are listened to and valued.”

Sue Covill, director of employment services at NHS Employers, said the foundation’s report highlighted the “ever-growing importance of the link between staff engagement and patient care”.

She said: “In short, staff who feel valued provide better care and that better care means better patient experience and outcomes.

Sue Covill

Sue Covill

“We are clearly seeing incremental improvements despite reorganisations, incredibly tight resources and reports highlighting the need for new systems, processes and regulations,” she said. “But we know there is no quick fix.

“This is about culture change and to pretend otherwise will lead to unsustainable solutions,” she added.

The Point of Care Foundation is a charity working to improve patient experience and increase support for staff. It grew out of the Point of Care programme, which was run by the King’s Fund from 2007 until last year.


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Readers' comments (14)

  • Nurses doctor
    Doctors prescribe

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  • In times of great activity and masses of negative publicity for nursing staff, it is more important than ever that organisations take time to engage with staff - that simple thank you can do so much.

    This report is very timely and I hope that it will help focus on support systems being considered to assist staff rather than blame them constantly regardless.

    It is clear from evidence that highly stressed staff become quickly demotivated and less able to cope. Therefore support systems are very much needed.

    I am yet to be convinced that 12 hour shifts are the best way to help staff cope with the heavy emotional, physical and mental stresses in todays hi-tech, hi-dependency environment that is the norm in the acute sectors.

    The Schwartz rounds are a good idea and replicate something like the supervision sessions Midwives regularly hold. This time to reflect with colleagues is what has been lost with the reduced handover times and lack of teaching time on the wards which used to be possible.

    I have written previously that staff who feel valued will have a positive impact on patient care delivery. This report clearly supports that view.

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  • I've recently fractured my shoulder (out of work) and have been off sick for nearly 9 weeks, I don't feel valued by my senior staff, I have made all the contact with my ward, the only contact I've had from my manager is a letter for a formal sickness meeting! I understand that there is a sickness policy and that frequent contact may be seen as harassment by some people but after working there for nearly 11 years I expected to be better thought of.

    Under our previous manager I felt much more supported and that the ward as a whole was a supportive environment that helped staff who were stressed and unhappy, now we are told to "get on with it" and "if you don't like it, leave"

    The point I am trying to make is that it is not always the NHS in general that is undervaluing it's staff, individual managers need to take a stand and say "I support my staff 100%" and actually do what they say rather than just saying what they think staff want to hear.

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  • michael stone

    I have noticed that there are LOADS of reports, all suggesting changes and or more emphasis on particular things or areas: it isn't easy to see how this will 'pan out' when the NHS is being forced to try to 'do more with less'.

    Mind you, I'm also 'pushing for change' - so I guess this might be 'pot and kettle' ! Although I'm actually pushing for something that requires less paperwork.

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  • michael stone

    are you now running the NHS?

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  • Just had a meeting with my manager 1 year after returning to work following depression. I have worked hard to get back to full performance levels but home life has taken the brunt. Asked if I could reduce my hours, no problem it will save money and by the way we are cutting staffing in your team by 50%. Reason given twell he wheels didnt fall off when I was off sick so should be able to manage with half the staff

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  • That's pretty crap isn't it? No credit given to you for working hard to get back up to speed. It must have felt like a real hard slap in the face. Put yourself first now, and your family, as your manager obviously doesn't give a s--t

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  • MeThinks

    Anonymous | 21-Jan-2014 3:24 pm

    I very much doubt it - it isn't clear to me, that anybody is 'running the NHS'!

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  • MeThinks


    It seems rather clearer, that certain people are trying to 'run down the NHS', however.

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  • It really boils down to what sort of Manager you have. It's interesting to see some Trusts in England have ditched the 'Ward Manager' and brought back Sister/Charge Nurse.
    Agenda for Change has I feel, let down Nurses very badly. We are just 'a number' these days!!

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