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Survey finds NHS staff feel ‘undervalued’ and ‘overwhelmed’


Nurses have spoken out about pressure and stress at work as part of a union report, which suggests around two thirds of NHS workers are seriously considering leaving their jobs.

The Undervalued, Overwhelmed report, which is based on a survey of 10,500 Unison members working in the NHS, found staffing shortages, low pay and changes in the health service were key reasons for wanting to move on.

Overall, the findings paint a rather gloomy picture of the everyday pressures faced by frontline staff.

“The government must recognise the risk to patient care and raise salaries now to stop an NHS staff exodus”

Dave Prentis

For example, nurses claimed they were “at the centre of a perfect storm” with workload, stress and patient numbers all on the rise.

Eighty-two per cent of participants reported their workload had increased, while 79% said the number of patients they were caring for had gone up.

More than a third – 36% – said they felt quality of care had got worse as a result.

When it came to staffing levels, 64% of respondents said there were frequent staffing shortages in the last year. A further 21% said they were sometimes short and another 10% said this happened occasionally. Only 2% said there were never any staffing shortages.

Overall, 67% said they felt there were not enough staff to do the work required.

Worryingly, one in five – 21% – said their employers was not doing anything about staffing, while almost half – 49% – reported relying on agency staff.

As part of the survey, individual nurses shared their thoughts and experiences.

“The workload and pressure are under-estimated,” said one ward sister from the North West. “I don’t think people realise that our wages are going down, while many of us have to work free hours just to keep on top of things.”

The survey found 55% of participants were doing unpaid overtime every week. More than three quarters – 76% – said this was up to five hours a week unpaid, while the remaining quarter – 24% – said they did six hours or more.

“At the age of 40 I am living with my parents because I can’t afford private rent”

Band 6 nurse

Of those who said they were overworked, half said it had affected their own health.

Meanwhile, nearly two thirds said their pay had got worse in relation to the cost of living over the last 12 months, especially when it came to paying for food, fuel and transport.

“At the age of 40 I am living with my parents because I can’t afford private rent,” said one band 6 nurse from Greater London.

Others spoke about a lack of recognition for nurses, the work they do and the amount of training needed to keep up to date.

“The amount of work we do which goes on behind the scenes is huge,” said one band 5 mental health nurse from the South West.

“We go above and beyond for all the patients on the ward. The time and effort we take with care plans, discharge planning, managing risk,” they said. “People think it all happens by magic.”

Thirty-three per cent of survey respondents said they were thinking “very seriously” about leaving their current NHS job, while 32% said they were “seriously” considering leaving.

Of those who gave a reason for wanting to leave, 39% said they had thought about getting a new job completely outside the health service and healthcare.

Unison general secretary Dave Prentis said the survey showed NHS workers were at breaking point with many struggling to make ends meet.


Dave Prentis

“The chronic understaffing and mounting pressures on NHS workers mean many are at the very end of their tethers and feel they have no option but to leave,” he said.

“Health staff work beyond their hours to care for those who need it,” he said. “The government must recognise the risk to patient care and raise salaries now to stop an NHS staff exodus.”

The report forms part of the union’s evidence submission to the NHS Pay Review Body, which is currently considering what to recommend to the government for future health service pay rises.


Readers' comments (13)

  • This government is ideologically blind to the problems faced by nurses. Given all the ongoing problems of staffing and the cost of Agency nurses, they kick off a new 5-year term by announcing that public service staff i.e nurses will get no pay rise over 1% for the next 5 years!!!
    They're clearly setting up the NHS to fail, so they can 'rescue' it through privatisation

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  • Absolutely nothing has changed then in 18 years!! When my Pin lapsed in 1997 I didn't renew it as I felt totally stressed out with staff shortages, masses of unpaid overtime,(time owing was put in a book and never recovered!) I felt totally undervalued.Patients were continually moving wards and shuffled from place to place!
    I decided to return to practie and updated my Pin last year.
    Guess what?
    I'm not going anywhere NEAR the NHS. But I have joined an agency recently and the pay is £20-25 per shift to work on an NHS ward, depending on where you are placed.
    As a Band 5 level nurse what hourly rate would I get NHS?
    Probably wouldn't be £25 an hour.
    Until the low wages are addressed and benefits restored no-one will stay.
    My Mum was a Sister in a long stay NHS hospital for years- we got a house that went with her job and then got the right to buy.
    Those were the days!!!!

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  • STOP PRESS: Pope reaffirms belief in a supreme being, and several learned papers reach conclusions on ursine excretory habits! What the union survey shows is what everyone around us sees - the question is why can't (or more likely why won't) politicians in power? The signs are all around us that the NHS is approaching a major crisis, and the staff are at the sharp end, feeling it while trying to protect patients. However, the fact it is felt not to have the resources to pay its staff as they deserve seems at odds with the way it has treated the outgoing CE of the TDA, paying £415k (or as I think of it nearly 17 mid point band 5 nurses or 25 mid point band 2 HCAs) for someone who chose to step down

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  • So nothing new then! That's the nurses tradition isn't it? It won't change. Do agency if you can but bear in mind the pitfalls eg pensions,sick pay( it's limited) cancelled shifts and no notice if not required. I won't be renewing when fees are due as I've had more than enough but good luck to those who are still hard at it!

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  • 40 yo band 6 living with her parents, as she cannot afford even renting a flat is a walking disaster. Anybody above band 5 in the NHS should have duty to present their credit score, if its less than 'excellent' they should not be managers!!

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  • Anonymous | 29-Sep-2015 8:38 am

    All RCN members should read this blog, you don't often hear another view on the RCN, is this why nothing in nursing ever changes?

    Libcom blogs -

    The Royal College of Nursing (RCN) represents most of the nurses employed within the NHS and has a membership of over 400,000. It started life as a ‘professional’ organisation for nurses, promoting excellence in practice, before registering as a ‘trade union’ in 1976. Scratch the surface of this grubby, conservative, false-flag operation, and you will see it is not a ‘trade union’ by any understanding of the term.

    I have previously written about nurses and industrial action during the pension’s dispute and defeat of 2011. Not a lot has changed in the last three years. Nurses are still being targeted because they are an easy touch and lacking anything resembling meaningful trade union representation.

    The RCN congress is taking place this week, in Liverpool, with ‘pay’ and ‘taking action’ dominating the debate. Against a backdrop of the growing anger of nurses, the RCN General Secretary, Peter Carter, had this to say:


    “The RCN has not called a ballot, and the unique role of nurse’s means that they should think carefully before taking such a decision. Think what going on strike really means. For a strike to work, it has to have a real impact on someone or something. If you work in a car factory, that means stopping the production line. But if you are a nurse, it means abandoning your patients, leaving those babies in the neonatal unit, cancelling that visit to an elderly patient in the community, walking out of the emergency department, or psychiatric ward.”

    He went on to say that it was important to protest by other means, including “writing to your local MP” and asking where they stand on nurses pay. If they agree with the government’s position, then nurses should “unseat the MP by voting for someone else”

    Peter Carters deceitful and cowardly speech was so absurd, that when I first read the transcript I had to double check that I had not accidentally downloaded it from Private Eye, or a spoof website.

    Firstly, Peter Carter says ‘The RCN has not called a ballot’. Of course they haven’t, because the RCN is structured in such a way that any decision to ballot for industrial action can ONLY come from the General Secretary (Peter Carter). I would wager that the vast majority of the nearly half a million nurses in the RCN have no idea that they have zero decision making power in terms of taking industrial action.

    Historically, the RCN had a ‘no strike clause’ up until 1995, when it was dropped. It was only dropped as it was a barrier to recruitment, not because of any ideological changes within the organisation. It is crystal clear that the RCN still operates a ‘no strike policy’, but does this via smoke and mirrors, and deliberately excessive bureaucracy.

    Peter Carters use of a car factory analogy is ridiculous. Why is he suggesting that the only industrial action is that of a full scale strike? There are many ways of taking action short of a strike, which he well knows. Nurses undertake many extra responsibilities that are not part of their job descriptions, work extra unpaid hours to support their colleagues, and undertake many other activities that could be described as ‘goodwill’… Nurses could refuse to engage in those activities, particularly those activities that pertain to the meaningless bureaucracy that swamps the NHS. Furthermore, there are examples throughout the world of nurses taking actual strike action, winning disputes, whilst not impacting on direct patient care.

    Peter Carters deceitful and cynical use of emotive language and examples of who would suffer during a strike is an absolute disgrace. Only a liar would suggest that striking nurses would literally ‘walk off’ a neo-natal unit, leaving babies unattended. His speech was a nefariously planned attempt to deceive nurses, the media, and the general public, into believing a nightmare vision of what ‘nurses on strike’ would look like, and lead to. Furthermore, if you took his examples at face value, you could then argue the point of how valuable the work of nurses is, and why they deserve to be fairly paid.

    Industrial action and patient care is an interesting subject. Patient care is not just instant, here and now, at the bedside. Nurses should be taking action over the wider issues of care provision. What is the RCN doing about thousands of nurses being made redundant, what did the RCN do about the Labour Party saddling NHS with £300,000,000 of PFI debt, what are the RCN doing about mental health beds being stripped away throughout the country, resulting in people being sent hundreds of miles away from their homes, what are they doing about national terms and conditions being attacked, what are they doing about the Conservative Party privatising the NHS? The answer is ‘nothing’, all they do is ‘talk’ and ‘negotiate’. Nurses and their union should be fighting for better patient care, not just accepting what is being handed down to them…. Nurses who want to take industrial action over issues that have a direct impact on patient care, should be applauded and supported, not vilified… How dare you Peter Carter, how dare you……

    Peter Carters solution to the dispute – “Write to your local MP” is so stupendously ridiculous and insulting; I won’t bother dignifying it with a rebuttal.

    Peter Carter and the RCN are obsessed with the public perception of nurses, and how industrial action may impact of that perception. This attitude is steeped in the historical snobbery and classism that runs through the RCN’s upper echelons like a stick of Blackpool rock. The RCN, a so-called trade union would rather have its members viewed as low-paid, over-worked, servile ‘angels’, than fairly paid, nurses, with self-respect and a backbone.

    Every year the RCN has its congress, nurses are said to be angry about pay, pensions, conditions, service provision, and patient care. Yet all Peter Carter and his lackeys can offer their 400,000 members whose work is absolutely key to the NHS, is ‘negotiation’. Anyone with a shred of analysis can see that ‘negotiation’ not underpinned by a meaningful threat of action is little more than a begging exercise, that has NHS bosses and the government laughing into their board meeting buffet.

    The cowardice and inaction of the RCN is not a new phenomenon. Since the day it became a trade union in 1976, it has operated as little more than a ‘corral’ or ‘holding pen’ in order to keep nurses on their knees, away from genuine trade unions. The RCN has proven itself to be perfect bedfellows for successive governments of all stripes.

    The RCN’s primary tool of recruitment is to gather up student members at University when they commence their nurse training. Students are offered a greatly reduced subscription rates, free pens, and diaries, if they sign-up. Once they have completed their training they inevitably maintain their membership for the rest of the career. For many, it is their first and only experience of being a member of a trade union, so expectations of the organisation are low or non-existent. Recruitment of students is not difficult. They either join the RCN or UNISON whilst at University, with many opting for the snobbery and elitism of the RCN, as they wish to distance themselves from ‘Healthcare Assistants’, who generally join UNISON.

    As part of the RCN’s campaign to dampen down any militancy within nursing, they produce the ‘Nursing Standard’, which sells 70,000 copies each week - with a much bigger actual readership. They also produce a series of monthly ‘specialty’ journals, which are aimed at nurses working within a variety of clinical specialities. Via their range of carefully produced publications, the RCN are able to drip their squalid propaganda into the homes and workplaces of hundreds of thousands of nurses each and every month.

    For the size of its membership, the RCN has relatively few stewards. I once worked in an organisation that had 1,000 RCN members, yet had no stewards whatsoever. The RCN are not troubled by this, as those members paid nearly £200,000 a year into the organisations coffers, for zero in return. The RCN are more than happy for the Unison mafia to run the staff side committees, and toady their way through embarrassing partnership arrangements, with their own members as passive passengers.

    Member involvement at branch and regional level is not much different. Some RCN branches are enormous, yet meetings are made up of five reps, who have never consulted their members on any issue. When I challenged an RCN full-timer about lack of internal democracy and general activity, I was told that:


    “The members are to blame if they cannot be arsed to get in touch or turn up to branch meetings”

    That particular individual never made any attempt to advertise branch meetings, encourage people to get involved etc… he, and others like him were more concerned about maintaining their own position of influence within the pecking order, than assisting rank and file members in becoming more involved. They ran the branch as their own personal fiefdom, wielding the influence of such a large branch membership for their own aims. Whilst they wax lyrical about ‘internal democracy’, in reality it is just a meaningless phrase, as the organisation relies on the apathy and historically ingrained passivity of its membership in order to function.

    If there ever was a situation in which the RCN politburo would sanction industrial action, then you have the nursing equivalent to the House of Lords, (NMC) to contend with. The NMC (Nursing & Midwifery Council) is the professional body responsible for the registration of all nurses and midwives in the UK. With its disingenuous strapline ‘Run by nurses for nurses’, the NMC threatened to ‘strike off from the register’ nurses who took part in industrial action (during the pensions dispute of 2011) as they would have been in violation the NMC code of professional conduct…. In response to this outrageous state sponsored threat, Unison made the token threat of legal action, whereas the RCN said and did nothing. A quick look at the crossover of personnel at the top of the RCN and NMC would reveal why.

    The RCN, without a smidgen of sarcasm, calls itself ‘The Voice of Nursing’. It is nothing of the sort. It is the voice of the establishment that thinks slow clapping a health minister at congress is ‘taking action’. The sooner nurses wake up to this state sponsored false-flag, drop the snobbery and elitism, and see the RCN for the scab staff association it is, the better….. Join another union, any union

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  • no s-- Sherlock , the politicans don't give one, they are determined to grind us into dust

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  • rcn is no different than the NMC , the RCN are merely the puppets of the government, if nurses were told to wok 24/7 without pay the rcn would do nothing and the nmc would strike nurses off for not being a slave

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  • Hello Nurses.
    I did warn you about this governments attitude to the NHS some years ago. So, it comes as no surprise to hear of your low morale.
    Cameron isn't interested in you, what you do, or the failing NHS.
    When the tories got back in power, what was the firs thing they wanted to get sanctioned? Yes, that's right... Legalising fox hunting. While that was going, some poxy group of hypocrites were deciding how much more Mp's should get paid, whilst Cameron said nurses would only get 1% or less pay rise, when he and all his like get in the region of £70000-sh a year.
    You should feel demoralised. Your Trade Unions don't help you. Everyone , and his wife wants to complain about the way you look after them, and then we hear you need a proper training. God help the public, that's all I can say.
    But don't feel isolated, Cameron has also demoralised the Police, Teachers, Firemen. But it 's not all bad, he's got loads of spare cash to fork out for more immigrants to come and live here. Seems some of them are queuing up to take over your jobs at less pay too!
    Bloody great to be a Brish subject, is' it?

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  • I certainly felt overwhelmed and under valued when I was told after 40 years of nursing that perhaps I was 'too old' for the job because I queried how I could do 4 two hour assessments, plus the driving, plus putting it all on system one and liaising with GPs and relatives, in a 7.5 hour day.
    Meanwhile the B7 spent most of her day re-typing perfectly good lists of GP surgeries and pharmacies and prettying them up with alternate bands of colour that only served to trigger a migraine trying to read them. The B8a was such a busy bee organising staff photographs (we worked in an office with no outside visitors except for the occasional bigwig to smile benevolently at us) and sticking them on the wall then taking them down and sticking them on another wall. First time I've been pleased to be getting 'too old' for anything - gave me the impetus to say bye-bye to it all.

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