A ‘red flag’ alert should be triggered if nurse-to-patient ratios fall below 1:8 on hospital wards, say the RCN and the Safe Staffing Alliance. They were responding to National Institute of Health and Care Excellence (NICE) draft guidelines on staffing adult acute wards. The NICE document proposes the introduction of ‘red flags’, which would signal an event that needs an urgent response in hospitals. Red flag events would include medication not being given on time, observations not being carried out or basic care not provided. Alliance chair Susan Osborne said: ‘Given that 1:8 marks a ‘high-risk’ ratio, we would like to see greater emphasis put on the fact that this is a level that should not be exceeded.’ RCN director of nursing and service delivery Janet Davies supported the NICE decision to consider red flags. NICE will publish final guidance in July. Nursing Standard hosted a fringe meeting on safe staffing at RCN congress.
NICE TOLD TO BEEF UP ITS GUIDANCE ON SAFE STAFFING
STAFF DEMONSTRATE OUTSIDE CONGRESS TO HIGHLIGHT NHS PAY INEQUALITIES RCN president Andrea Spyropoulos joined nurses angry that since 2012 senior NHS executives have received pay rises worth 6.1 per cent, while they have been given just 1.6 per cent. They demonstrated at RCN congress, outside the Arena and Conference Centre in Liverpool on
the first day of the annual conference. Figures obtained by the RCN show that in the past two years executive directors have also received five-figure bonuses. In March, health secretary Jeremy Hunt announced that in England only nurses at the top of their band would receive a 1 per cent cost-of-living rise.
District nursing could face extinction by 2025
The shortage of district nurses in England is such that the profession is ‘critically endangered’ and faces extinction by 2025, the RCN predicts. The number of district nurses has almost halved in the past decade, to 6,656. But the number of frail older people who require care in their own home has soared. The RCN is calling on the government to fulfil its commitment, made in April, to increase the community workforce, including GPs and nurses, by 10,000 by 2020. The RCN recommends these posts should be district nurses. RCN general secretary Peter Carter said: ‘The district nurse role is the foundation of a system that should be able to manage conditions and keep sick and frail people at home. Remove
the foundations and the whole edifice could come crashing down. ‘It looks as though the NHS is trying to run these services on goodwill alone and staff should not be spending their working lives at breaking point.
‘STAFF SHOULD NOT BE SPENDING THEIR WORKING LIVES AT BREAKING POINT’ Patients simply cannot wait forever for these services to be properly resourced.’ Research carried out by the National Nursing Research Unit (NNRU) at King’s College London, commissioned by the RCN, reveals the current shortage is expected to get worse as more than a third of district nurses are nearing retirement age.
A quarter of the 2,438 nurses surveyed by the NNRU said they had seen more than 12 patients on their last shift, jeopardising the quality of visits. This follows a similar survey by the Queen’s Nursing Institute, which raised concerns about the morale and staffing of district nursing teams. The government has pledged to invest billions of pounds, in the form of the Better Care Fund, which it announced in June last year. It will attempt to integrate health and social care in a bid to reduce hospital admissions and allow more home treatment. But concerns about its viability have been voiced by the Cabinet Office. Dr Carter said that the Department of Health is merely paying lip service to the idea. june 18 :: vol 28 no 42 :: 2014 9
Public trust and confidence in district nurses is essential to the nurse-patient relationship that underpins effective care and treatment. That trust and confidence has even greater focus for district nurses who care for patients in their own homes.
District nurses are a national treasure. They are the key professionals who will enable the agenda of patients being cared for at home to be realised. They are highly trusted and valued by communities who lead and manage teams of nurses and nursing a