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Nurses warn Lansley of pressure in acute sector


Incidents of patients not being treated with dignity or not gaining sufficient nutrition are “unacceptable and must stop”, the health secretary has told nurses.

Andrew Lansley told the Florence Nightingale Foundation conference in London that strong leadership by frontline nurses, in particular ward managers, was the solution to these problems - not an increase in staffing.

However, he was also forced to defend his controversial reforms, with nurses at one trust telling him the changes had contributed to “tremendous pressure” on their hospital services.

The speech on Thursday was the first time this year Mr Lansley had addressed a large nursing audience and follows widespread criticism of the health bill by the profession.

In a wide ranging speech, Mr Lansley told delegates failures to ensure dignity or nutrition – like those identified last year by the Care Quality Commission – were unacceptable.  He said he “never wanted to see reports like those from the CQC again”.

He said bureaucracy and lack of accountability were the “fundamental” causes of such problems, and said the solution was leadership at ward level, with “responsibility taken by nurses on the ground”.

In a view likely to be at odds with the many in the profession, he claimed poor hospital care could not “simply be blamed on a lack of staff”. 

He also repeated the long standing government policy that more services in future would be provided in community settings, rather than hospitals – bringing with an enhanced role for specialist nurses.     

“To be frank, the future of healthcare won’t be dominated by hospitals,” he said. “The future is in giving care closer to home.”

But senior nurses from the Countess of Chester Hospital Foundation Trust in Cheshire told Mr Lansley they had experienced a “crisis” in February worse than the severe weather last year, with accident and emergency activity up by 20% alone.

They warned him that cuts to PCT staff who could help them manage the situation meant that “when we’ve pressed the button there’s nobody there, because they’ve gone”.

Lesley Freeman, deputy director of nursing and quality at the trust, also told him the pace of community service development had been slower than the reduction in acute capacity, even though “we’ve been talking about this since the year 2000 and before”.

She said: “We’ve never really seen the community services stepping up to the mark. Over the last month we’ve been under tremendous pressure.”

The warning comes at the same as Nursing Times has unearthed data showing that bed shortages in London are having a knock on effect on A&E departments.

Mr Lansley admitted the previous development of community services had been “deficient” but said the “consistent story at the moment is telling us that patients are being looked after to a greater extent in the community”.

He said figures for April-December 2011 showed referrals to hospitals and outpatient attendances were both down compared to the previous year. Although A&E attendance was “slightly up”, it was “nothing like” as high as some previous years, he said.  

Mr Lansley also used his speech to announce the creation of a clinical academic careers training pathway strategy, which will allow nurses and midwives to undertake further education in the field of research.

He said the strategy would provide nurses and midwives “opportunities to advance their careers without having to leave clinical practice”.

“This will lead to more consultant roles, meaning they can take not only a clinical and managerial lead in their organisations, but also an education and research lead, advancing practice for everyone and improving patient outcomes,” he told delegates.

It will be funded by the National Institute of Health Research and not from existing nurse education or training budgets.

  • The government announced last week that David Foster, formerly the deputy chief nursing officer for England, had been appointed deputy director of nursing at the Department of Health. It is a new post created under the reforms. His portfolio will include workforce, education and research. He will report to Viv Bennett, who was appointed DH director of nursing with responsibility for public health in January.

Readers' comments (86)

  • All he does is criticise nurses, when it is the government who are insisting on all these cost cutting measures, while still expecting to get the same amount of work done. The man is an idiot!!!

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  • It sounds like Mr. Lansley needs a taste of his own very nasty medicine!

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  • "...strong leadership by frontline nurses, in particular ward managers, was the solution to these problems - not an increase in staffing."

    what does he really know about it?

    "...nurses at one trust telling him the changes had contributed to “tremendous pressure” on their hospital services."

    nurses are only human beings just like everybody else and we all know that human beings can only take a certain amount of pressure before they crack or burst - besides being physical and psychological this also obeys the elementary laws of physics when pressure is applied to any object in the universe.

    Mr Lansley's limits need urgent testing!

    "...he claimed poor hospital care could not “simply be blamed on a lack of staff”."

    too right, it be blamed on vary many other factors such as systems failure, poor management, poor working conditions and benefits such as salaries, pensions, lack of CPD, lack of training and updates for more recent developments, and other incentives which enhance training and motivation, etc. The list may be endless and all of the needs require to be urgently identified and addressed.

    “To be frank, the future of healthcare won’t be dominated by hospitals,” he said. “The future is in giving care closer to home.”

    It looks like hospitals are going to be run down and the care in the community may not be adequate for all so there will be nothing left to offer patients and especially the elderly.

    As far as career pathways and education and training for nurses this has all been said and done before and the system seems to have totally collapsed!

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  • I always treat my patients with respect and dignity and go the extra mile - meaning I go without breaks and leave my shift on average 1 hour late because I cannot fit in everything I have to do. Then I read statements from Mr Lansley who continues to nurse bash. When will nurses be treated with dignity and respect.

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  • Anonymous | 13-Mar-2012 8:47 am

    the question is what can be done to improve the situation?

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  • tinkerbell

    Yeah, yeah Lansley, all the good nurses condemn patient neglect too but unlike you we try us best to ensure best practice with limited staff. Unlike you we actually care. Unlike you we are not in it for any glory.Unlike you we actually work hard for a living. Unlike you we have a moral conscience.

    Keep pushing for your wretched reforms for 'don't care in the community' and pull the rug out from under us all. Keep pushing to have our hospitals filled with private patients whilst us common folk wait at the back door and die waiting.

    You are an absolute disgrace to our society of the first degree.

    You are totally clueless and everyone who needs the NHS because they are not rich hates you. Go and get yourself more body guards and police and take anothe walk around a hospital so that old folk can tell you what for. Sinister, unelected minister.

    I hope you got a right heckling during your speech. Get me some rotton tomatoes. Have it! You will go down in history as a despised, loathsome old tory and that's putting it mildly.

    Why don't you do us all a favour and piss off.

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    The truth about nursing!

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  • Very well said Tinkerbell; you have summed him up beautifully. He is an awful man.

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  • he may not be an awful man but what he is doing may be awful and maybe wrong for the health service in Britain and for the majority of the British public.

    I think when people make personal attacks they should be first be very sure of their facts.

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  • King Vulture

    tinkerbell | 13-Mar-2012 9:16 am

    Anonymous | 13-Mar-2012 10:01 am

    Getting the facts straight before making personal attacks, isn't necessarily accepted behaviour on the NT site or in society at large - but it isn't easy to 'be very sure of the facts'.

    Most people - notably the RCGP, who should know - are not happy about the Bill, think it will have very bad consequences, and suspect that many of the Tories who are supporting it, are supporting it for ideological reasons.

    We cannot be sure about why Lansley says what he says - we would need to be inside his head, to be SURE of that - but it does seem correct, as the Chair of the RCGP said on R4 this morning, that the bits of the Bill which appeal to most people (moving decisions towards GPs & patients) COULD be achieved WITHOUT a new Act of the type sought by this Bill: so, one must wonder why Lansley and Cameron still support it, despite the huge amount of opposition to the Bill ?

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