service want to know if they’d be recommended to someone else? (Features September 10). Not long ago some mental health patients called themselves survivors – representatives of poor, even barbaric, care. Since then improvements in quality have been on the basis of service-user involvement, openness and investment in the delivery of evidence and community-based practice. The FFT is as useful for people with mental health problems as it is for those with physical conditions. In fact they have been using it for a while already. One in four hospital patients has dementia, one third of people with a long-term condition have a mental disorder and mental health service users are twice as likely to attend A&E compared to non-mental health service users. Like other services, mental health providers will need to work with commissioners, patients and their representatives to understand how to interpret these new metrics. When used with other quality measures, the FFT will provide useful insights in how to improve care. Norman Young, by email

WHO EUROPE MUST START TAKING NURSING PROFESSION SERIOUSLY Having been concerned at the lack of senior professional nursing and midwifery presence at WHO Europe for some years, I read your headline ‘Nursing back on the WHO agenda’ (Careers September 3) with some interest. I thought the article was going to be about advancement of the nursing and midwifery cause and a real step change from the tardy manner in which professional nursing and midwifery has been treated for many years in WHO Europe. Contrast our position with the Asia-Pacific region and the difference is stark and worrying. Europe is far behind. I was disappointed to read that the ‘professional briefing’ was prepared and delivered by the WHO programme

manager for human resources – a doctor by background. My concern was compounded when we are told that she ‘has had a longstanding interest in nursing’. As if that is okay. I have had a longstanding interest in medicine, but I would not have the audacity to think that I could, or even should, represent doctors’ interests at such level. WHO Europe has shown before that it has scant regard for the nursing and midwifery professions, and this is proof. Until we see a return of our right and proper professional place at the table we cannot and will not have the voice required. Being represented in this manner is nothing short of an insult and as a profession we should let WHO know that.

TWEETS OF THE WEEK Have noticed that nurses who are irritable with patients may be depressed. Know the signs of a nurse who’s not coping. @MrsGracePoole

Nurses deal with huge amounts of emotions – their own & others’ – every day. Can be overwhelming without support @annedraya

Sometimes I get so frustrated with Nursing. All these limitations on acquiring knowledge and becoming a better more informed nurse.

Kevin Davies MBE, by email

@CJohnston1903

MIDWIVES SAY ‘ENOUGH IS ENOUGH’: LET’S VOTE FOR INDUSTRIAL ACTION The message is getting through that the public is on the side of midwives in their pay dispute with NHS employers. There is strong public backing for industrial action by midwives and overwhelming support for a 1 per cent pay rise for NHS staff, as shown by the poll reported last week that was undertaken by research consultancy ComRes (News September 10). The Royal College of Midwives is recommending members vote Yes to industrial action. I urge them to cast their Yes vote and return their ballot paper as soon as possible, if they have not done so already. Every Yes vote cast means our voice gets louder. Years of rising bills but stagnant pay are hitting midwives hard. Many have told me that when they sit down to work out their household budget there just isn’t anything non-essential left to cut. Only today I heard of one member who has had to borrow money using her daughter’s student loan. It is time to say loud and clear: enough is enough. The way you do that is to vote Yes to industrial action.

The younger generation of Professional Nurses is using SoMe to communicate – Nurse Educators need to be a part of this – not opposed to it.

Cathy Warwick, chief executive, Royal College of Midwives

@Bartontd

There are attractive places to nurse in Scotland just now – I’d expect that to remain true – and pay is already better. @smrfldstbls

Nhs pensions already devolved and higher in Scotland because we got the full pay rise and it was consolidated @PortyGeoff

The UK may be unable or unwilling to sustain funding the NHS at current levels. Scotland will. People not profit @FalconerBrian

Follow Nursing Standard @NurseStandard and join the #NScomment chat on Thursdays at 12.30pm

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Midwives say 'enough is enough': let's vote for industrial action.

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