Letters
We welcome all readers’ letters, but reserve the right to edit them or withhold names and addresses. Please email: [email protected]
Please keep letters to a maximum of 150 words, and include your full name, address and a daytime telephone number
Using the carrot and stick approach to improve care is not the solution There seems to be a carrot and stick approach after the scandal of poor care at Mid Staffordshire NHS Foundation Trust. The Nursing and Midwifery Council is providing the carrot and the government the stick. The carrot is that the new code of conduct for nurses spells out the core duties of care and we will be able to pat ourselves on the back when we tick all the boxes (Features June 11). Meanwhile, the government is sending out the message that poor care will not be tolerated – or else. It is introducing new laws that will make ill-treatment or wilful neglect of patients a criminal offence, with punishments of up to five years in prison and a £5,000 fine. So, where does the blame lie when nurses are put in impossible situations? Will we see patients or their relatives calling the police when they fail to get their medication on time or no one has time to assist patients at mealtimes or with toileting? Unless our numbers are boosted to such an extent that we can all do our jobs properly, we are going to see a good few nurses in the dock. Helena Soni, by email
DECISION TO SPELL OUT BASIC CARE DUTIES IN NEW CODE IS PATRONISING Katerina Kolyva, director of continued practice at the Nursing and Midwifery Council (NMC), says new clauses have been added to the forthcoming code of conduct to ‘remind nurses what nursing is all about’ (Features June 11). I find this patronising. Is it really necessary for the code to spell out in great detail the basics of patient hydration, nutrition and cleanliness? I agree with RCN head of policy Howard Catton that the existing code ‘covers the areas it needs to, 34 june 18 :: vol 28 no 42 :: 2014
the language is clear and it is about the right length’. If it’s not broke, don’t fix it. Naomi Lyth, by email
CARE ASSISTANT REGULATION WOULD HELP IMPROVE CARE HOME QUALITY I agree with Marie Rowe that recruiting the right people is key to stopping the scandals of poor care and abuse in care homes (Letters June 4). I disagree with her when she says that the qualities of compassion, empathy, respect and integrity cannot be taught in the classroom, but can shine through in interviews. She also says interviewees ‘should always be encouraged to talk about themselves, their life experiences and what has contributed to making them the person they are now’. It is not as simple as this. In interviews, we do not really get to find out what people are like in the workplace or what they are capable
of doing. They may seem a perfect fit for the job in the interview, but the reality is often different. The key to tackling cruelty in care homes is improving every aspect of the home and the care of patients. Staff morale, dignity, encouraging teamwork and good relations between managers and front line staff are fundamental. There also needs to be more stringent inspections by the care regulators, with clear policies and guidelines in place. Care assistants need to be regulated, with more formal education and training to help support them in their role. Support staff need to be given the opportunity to develop professionally, in the same way we do as nurses. Marc Evans, by email
PERSONAL HEALTHCARE BUDGETS FAIL TO MEET ‘THE GENERAL GOOD’ Here in the United States, there is a growing movement to put people in
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
charge of some of their own funds for health, with personal health budgets. This is in response to single-purpose agencies and funding available only for specific provision, such as medical care and services, prescription drugs, imaging and lab testing. Many of these services are not particularly helpful for patients. They may be perceived as coercive and impersonal, with no rhyme or reason for multiple referrals and with little accountability. This is unfortunately too often the reality of medical care in the US, especially in terms of public services. We face very high costs, with poor health outcomes. Patients often want to use these personal funds for yoga, nutrition or movement classes, gym membership and alternative and complementary therapies such as acupuncture. There is a reaction against the idea that professionals should be in charge of all decisions, that they always know best, and that the western biomedical model of care is the only thing important in recovery or improving outcomes. Here in the US, we are already customers or, more usually, consumers – so perhaps we are already past the point of ‘common decency for the general good’ in our health services. Eileen McGinn, by email
GOVERNMENT’S FAILURE TO LEGISLATE PUTS UNSUSTAINABLE ONUS ON NMC Earlier this month the government failed to include the Regulation for Health and Social Care Professionals draft bill in this year’s Queen’s Speech (Editorial and News June 11). This bill would have enabled the Nursing and Midwifery Council (NMC) to commit to further reductions in the time it takes for us to deal with fitness to practise cases brought against nurses and midwives. It would have given us modern case-disposal methods to conclude cases earlier, without having to take them to a full hearing. These two changes alone would have allowed
NURSING STANDARD
the NMC to fulfil its commitment to conclude most fitness to practise cases within 12 months. Sadly, the government’s failure to include the bill in the Queen’s Speech means that as complaints continue to rise, and as we have no alternative disposal methods, we will have to continue to plough most of our funds into fitness to practise. This is simply unsustainable. We are calling for a commitment from all of the political parties that this bill will form part of their first session plans. Until then, we at the NMC will continue to work hard to make all of the efficiencies and changes we can. Jackie Smith, chief executive and registrar, Nursing and Midwifery Council, London
HELP US IN OUR AMBITION TO END FGM IN THE UK WITHIN A GENERATION Thank you for highlighting the abuse that is female genital mutilation (News May 28 and Letters June 4). The Liberal Democrats have begun a campaign to end female genital mutilation (FGM) within a generation (www.libdems.org.uk/endfgm). Please back our campaign. Your support will lead to many more people in the UK becoming aware of this harmful practice. With more than 20,000 girls in the UK believed to be at high risk each year, the Home Office has used a European Commission grant of £250,000 to promote the NSPCC FGM helpline. Anyone who is concerned a child may be at risk of FGM can contact this 24-hour helpline anonymously on 0800 028 3550 or by emailing [email protected] Planned initiatives include placing posters in key cities across England and Wales where a high prevalence of FGM is suspected. We will also reach out to mothers through Facebook and Netmums advertisements, and direct them to the NSPCC site for advice and support. Norman Baker MP and Lynne Featherstone MP, by email
TWEETS OF THE WEEK A named professional responsible for care. Been there done that. *sigh* @JuneinHE
Named doc on site 40/168 hours per wk. Busy most of that time. Not necessarily involved in your care @NHSwhistleblowr
One thing many organisations need is a robust and transparent policy on bullying and harassment @RoslynByfield
Home or inpatient. Is there an ideologically ‘correct’ place where children should die? Surely not @PDarbyshire
How can nursing salaries be performance based? Count how many pts fed, dressings changed, meds administered? #NScomment @hannahmannamoo5
Other ways of dealing with underperformance. Pay isn’t the best way to deal with it @Kelly_M_Owen
‘Poor performance/unable to time manage’ could mean massive workload. Who knows? @alisonleary1
‘It was such a relief to have the privacy for relatives + loved ones to come + say final goodbyes’ @patientopinion
Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm june 18 :: vol 28 no 42 :: 2014 35
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
We welcome all readers’ letters, but reserve the right to edit them or withhold names and addresses. Please email: [email protected]
Please keep letters to a maximum of 150 words, and include your full name, address and a daytime telephone number
Using the carrot and stick approach to improve care is not the solution There seems to be a carrot and stick approach after the scandal of poor care at Mid Staffordshire NHS Foundation Trust. The Nursing and Midwifery Council is providing the carrot and the government the stick. The carrot is that the new code of conduct for nurses spells out the core duties of care and we will be able to pat ourselves on the back when we tick all the boxes (Features June 11). Meanwhile, the government is sending out the message that poor care will not be tolerated – or else. It is introducing new laws that will make ill-treatment or wilful neglect of patients a criminal offence, with punishments of up to five years in prison and a £5,000 fine. So, where does the blame lie when nurses are put in impossible situations? Will we see patients or their relatives calling the police when they fail to get their medication on time or no one has time to assist patients at mealtimes or with toileting? Unless our numbers are boosted to such an extent that we can all do our jobs properly, we are going to see a good few nurses in the dock. Helena Soni, by email
DECISION TO SPELL OUT BASIC CARE DUTIES IN NEW CODE IS PATRONISING Katerina Kolyva, director of continued practice at the Nursing and Midwifery Council (NMC), says new clauses have been added to the forthcoming code of conduct to ‘remind nurses what nursing is all about’ (Features June 11). I find this patronising. Is it really necessary for the code to spell out in great detail the basics of patient hydration, nutrition and cleanliness? I agree with RCN head of policy Howard Catton that the existing code ‘covers the areas it needs to, 34 june 18 :: vol 28 no 42 :: 2014
the language is clear and it is about the right length’. If it’s not broke, don’t fix it. Naomi Lyth, by email
CARE ASSISTANT REGULATION WOULD HELP IMPROVE CARE HOME QUALITY I agree with Marie Rowe that recruiting the right people is key to stopping the scandals of poor care and abuse in care homes (Letters June 4). I disagree with her when she says that the qualities of compassion, empathy, respect and integrity cannot be taught in the classroom, but can shine through in interviews. She also says interviewees ‘should always be encouraged to talk about themselves, their life experiences and what has contributed to making them the person they are now’. It is not as simple as this. In interviews, we do not really get to find out what people are like in the workplace or what they are capable
of doing. They may seem a perfect fit for the job in the interview, but the reality is often different. The key to tackling cruelty in care homes is improving every aspect of the home and the care of patients. Staff morale, dignity, encouraging teamwork and good relations between managers and front line staff are fundamental. There also needs to be more stringent inspections by the care regulators, with clear policies and guidelines in place. Care assistants need to be regulated, with more formal education and training to help support them in their role. Support staff need to be given the opportunity to develop professionally, in the same way we do as nurses. Marc Evans, by email
PERSONAL HEALTHCARE BUDGETS FAIL TO MEET ‘THE GENERAL GOOD’ Here in the United States, there is a growing movement to put people in
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
charge of some of their own funds for health, with personal health budgets. This is in response to single-purpose agencies and funding available only for specific provision, such as medical care and services, prescription drugs, imaging and lab testing. Many of these services are not particularly helpful for patients. They may be perceived as coercive and impersonal, with no rhyme or reason for multiple referrals and with little accountability. This is unfortunately too often the reality of medical care in the US, especially in terms of public services. We face very high costs, with poor health outcomes. Patients often want to use these personal funds for yoga, nutrition or movement classes, gym membership and alternative and complementary therapies such as acupuncture. There is a reaction against the idea that professionals should be in charge of all decisions, that they always know best, and that the western biomedical model of care is the only thing important in recovery or improving outcomes. Here in the US, we are already customers or, more usually, consumers – so perhaps we are already past the point of ‘common decency for the general good’ in our health services. Eileen McGinn, by email
GOVERNMENT’S FAILURE TO LEGISLATE PUTS UNSUSTAINABLE ONUS ON NMC Earlier this month the government failed to include the Regulation for Health and Social Care Professionals draft bill in this year’s Queen’s Speech (Editorial and News June 11). This bill would have enabled the Nursing and Midwifery Council (NMC) to commit to further reductions in the time it takes for us to deal with fitness to practise cases brought against nurses and midwives. It would have given us modern case-disposal methods to conclude cases earlier, without having to take them to a full hearing. These two changes alone would have allowed
NURSING STANDARD
the NMC to fulfil its commitment to conclude most fitness to practise cases within 12 months. Sadly, the government’s failure to include the bill in the Queen’s Speech means that as complaints continue to rise, and as we have no alternative disposal methods, we will have to continue to plough most of our funds into fitness to practise. This is simply unsustainable. We are calling for a commitment from all of the political parties that this bill will form part of their first session plans. Until then, we at the NMC will continue to work hard to make all of the efficiencies and changes we can. Jackie Smith, chief executive and registrar, Nursing and Midwifery Council, London
HELP US IN OUR AMBITION TO END FGM IN THE UK WITHIN A GENERATION Thank you for highlighting the abuse that is female genital mutilation (News May 28 and Letters June 4). The Liberal Democrats have begun a campaign to end female genital mutilation (FGM) within a generation (www.libdems.org.uk/endfgm). Please back our campaign. Your support will lead to many more people in the UK becoming aware of this harmful practice. With more than 20,000 girls in the UK believed to be at high risk each year, the Home Office has used a European Commission grant of £250,000 to promote the NSPCC FGM helpline. Anyone who is concerned a child may be at risk of FGM can contact this 24-hour helpline anonymously on 0800 028 3550 or by emailing [email protected] Planned initiatives include placing posters in key cities across England and Wales where a high prevalence of FGM is suspected. We will also reach out to mothers through Facebook and Netmums advertisements, and direct them to the NSPCC site for advice and support. Norman Baker MP and Lynne Featherstone MP, by email
TWEETS OF THE WEEK A named professional responsible for care. Been there done that. *sigh* @JuneinHE
Named doc on site 40/168 hours per wk. Busy most of that time. Not necessarily involved in your care @NHSwhistleblowr
One thing many organisations need is a robust and transparent policy on bullying and harassment @RoslynByfield
Home or inpatient. Is there an ideologically ‘correct’ place where children should die? Surely not @PDarbyshire
How can nursing salaries be performance based? Count how many pts fed, dressings changed, meds administered? #NScomment @hannahmannamoo5
Other ways of dealing with underperformance. Pay isn’t the best way to deal with it @Kelly_M_Owen
‘Poor performance/unable to time manage’ could mean massive workload. Who knows? @alisonleary1
‘It was such a relief to have the privacy for relatives + loved ones to come + say final goodbyes’ @patientopinion
Follow Nursing Standard @NScomment and join the #NScomment chat on Thursdays at 12.30pm june 18 :: vol 28 no 42 :: 2014 35
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 21, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
