Editorial EDITOR Nick Lipley Tel: +44 (0)20 8872 3166 Email: [email protected] CONSULTANT EDITOR Debbie Mazhindu Reader in clinical nursing practice and innovation at Buckinghamshire New University and Imperial Healthcare NHS Trust, London EDITORIAL ADVISORY BOARD Jane Brookes Ward manager (paediatric medical), Nottingham Children’s Hospital, Nottingham Geraldine Cunningham Associate director of culture change, Barts Health NHS, London Naomi Elliott Director of international initiatives, school of nursing and midwifery, Trinity College Dublin Gemma Ellis Consultant nurse in adult critical care, Cardiff and Vale University Health Board Anastasia Mallidou Assistant professor, school of nursing, University of Victoria BC, Canada Ada ter Maten Nurse researcher, Rotterdam University of Applied Sciences, Institute of Healthcare, Netherlands Niall McCrae Lecturer at the Florence Nightingale School of Nursing and Midwifery, King’s College London Jane Naish Deputy chief nurse and head of quality, Milton Keynes Hospital NHS Foundation Trust Natasha Phillips Assistant chief nurse, University College London Hospitals NHS Foundation Trust, and visiting research fellow, National Nursing Research Unit, King’s College London Elaine Strachan-Hall Governing body nurse, NHS South Warwickshire Clinical Commissioning Group Donna Swinden Senior therapist, Tees, Esk and Wear Valleys NHS Foundation Trust Ray Walker Director of nursing and secure services, Mersey Care NHS Trust, Liverpool Frances Wong Professor and associate dean, Hong Kong Polytechnic University, Hong Kong, China Haiou Xia Professor at the school of nursing, Fudan University, China
We have been warned What a winter it’s been for emergency care services. As Nursing Management went to press last month, reports from NHS England, for example, showed that fewer than 87% of emergency department (ED) patients were being seen and either discharged or admitted within four hours. The operational standard for most of the UK is 95%; in Scotland, 98%. Media reports of patients, once again, waiting for more than 12 hours to be seen and a string of NHS trusts declaring major incidents prompted the usual rash of reasons at fault: lack of joined-up working between care sectors, difficult access to primary care, ageing population, lack of alternatives, lack of social care.
Acting assistant editor Jennifer Sprinks Tel: +44 (0)20 8872 3186 Email: [email protected] Senior production editor Julie Hickey Tel: +44 (0)20 8872 3148 Email: [email protected] Administration manager Helen Hyland Tel: +44 (0)20 8872 3138 Email: [email protected] Administration assistant Sandra Lynch
But it is not as if this was unforeseen. In October, RCN acute and emergency care adviser JP Nolan warned of a ‘perfect storm of unfavourable conditions’. Even over the summer, the Society of Acute Medicine and the College of Emergency Medicine were warning of how hospital overcrowding and ‘exit block’ were putting lives at risk.
BUSINESS UNIT Display advertisements Tel: +44 (0)20 8872 3123 Classified advertisements Tel: +44 (0)20 8423 1333 NURSING MANAGEMENT RCN Publishing Company The Heights, 59-65 Lowlands Road Harrow-on-the-Hill, Middlesex HA1 3AW Nursing Management is indexed, abstracted and/or published online in the following media: British Nursing Index, Medline and Ovid ABC APPLICATION APPROVED 6,523 (Jan-Dec 2013) SUBSCRIPTION DEPARTMENT Royal College of Nursing Journal subscription department, Copse Walk, Cardiff Gate Business Park, Cardiff CF23 8XG. Tel: +44 (0)345 772 6100 Print edition rates Personal: from £73 a year in the UK and Europe, and from £121 a year in the rest of the world. Institutional: from £446 a year Email: [email protected] ©2015 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers. ISSN 1354-5760 (print). ISSN 2047-8976 (online) Printed by Stephens and George, Merthyr Tydfil, on acid-free paper Acceptance of an advertisement does not constitute a recommendation or an endorsement of a product or service, either by the RCN or RCN Publishing WEBSITE nm.rcnpublishing.com AUTHOR GUIDELINES rcnpublishing.com/r/nm-author-guidelines OPEN ACCESS rcnpublishing.com/page/authors/ open-access-frequently-asked-questions
The ‘whole-system problem’ in A&E is one that many of us can influence, whether as service providers or service users
Nick Lipley Editor
Nor is it as if we are unacquainted with these factors. The question surely is not one of ‘what’ but of ‘how’. We may have had enough of hearing that delay in A&E is a ‘whole-system problem’, but it is a problem that many of us can influence, whether as service providers or service users. And, as reported in this month’s Nursing Management (page 6), the pressure on EDs is having major implications on how hospitals are run. But this spring we have a greater chance than usual to ensure that there is the political will to fix the problems: the general election in May. Understandably, politicians will want us to tell them how services can be improved practically; they want answers so that they can stand in front of the electorate and appear to know what they are talking about. Yes, there have been proposals already on how to spend the extra funding made available for emergency care last year, but let’s keep up the pressure and find ways locally and nationally of lobbying those who represent us in parliament for better patient care.
Our mission Nursing Management inspires and shares professional excellence in nursing leadership and patient care. The journal is editorially independent and opinions expressed in it do not necessarily reflect the policy of the RCN, nor that of any contributor’s employing organisation, unless specifically stated.
Follow us: @NMJournalRCN
Read more at: nursingblog.rcnpublishing.co.uk
Visit us at: Nursing Management
NURSING MANAGEMENT February 2015 | Volume 21 | Number 9 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 05, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
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We have been warned What a winter it’s been for emergency care services. As Nursing Management went to press last month, reports from NHS England, for example, showed that fewer than 87% of emergency department (ED) patients were being seen and either discharged or admitted within four hours. The operational standard for most of the UK is 95%; in Scotland, 98%. Media reports of patients, once again, waiting for more than 12 hours to be seen and a string of NHS trusts declaring major incidents prompted the usual rash of reasons at fault: lack of joined-up working between care sectors, difficult access to primary care, ageing population, lack of alternatives, lack of social care.
Acting assistant editor Jennifer Sprinks Tel: +44 (0)20 8872 3186 Email: [email protected] Senior production editor Julie Hickey Tel: +44 (0)20 8872 3148 Email: [email protected] Administration manager Helen Hyland Tel: +44 (0)20 8872 3138 Email: [email protected] Administration assistant Sandra Lynch
But it is not as if this was unforeseen. In October, RCN acute and emergency care adviser JP Nolan warned of a ‘perfect storm of unfavourable conditions’. Even over the summer, the Society of Acute Medicine and the College of Emergency Medicine were warning of how hospital overcrowding and ‘exit block’ were putting lives at risk.
BUSINESS UNIT Display advertisements Tel: +44 (0)20 8872 3123 Classified advertisements Tel: +44 (0)20 8423 1333 NURSING MANAGEMENT RCN Publishing Company The Heights, 59-65 Lowlands Road Harrow-on-the-Hill, Middlesex HA1 3AW Nursing Management is indexed, abstracted and/or published online in the following media: British Nursing Index, Medline and Ovid ABC APPLICATION APPROVED 6,523 (Jan-Dec 2013) SUBSCRIPTION DEPARTMENT Royal College of Nursing Journal subscription department, Copse Walk, Cardiff Gate Business Park, Cardiff CF23 8XG. Tel: +44 (0)345 772 6100 Print edition rates Personal: from £73 a year in the UK and Europe, and from £121 a year in the rest of the world. Institutional: from £446 a year Email: [email protected] ©2015 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers. ISSN 1354-5760 (print). ISSN 2047-8976 (online) Printed by Stephens and George, Merthyr Tydfil, on acid-free paper Acceptance of an advertisement does not constitute a recommendation or an endorsement of a product or service, either by the RCN or RCN Publishing WEBSITE nm.rcnpublishing.com AUTHOR GUIDELINES rcnpublishing.com/r/nm-author-guidelines OPEN ACCESS rcnpublishing.com/page/authors/ open-access-frequently-asked-questions
The ‘whole-system problem’ in A&E is one that many of us can influence, whether as service providers or service users
Nick Lipley Editor
Nor is it as if we are unacquainted with these factors. The question surely is not one of ‘what’ but of ‘how’. We may have had enough of hearing that delay in A&E is a ‘whole-system problem’, but it is a problem that many of us can influence, whether as service providers or service users. And, as reported in this month’s Nursing Management (page 6), the pressure on EDs is having major implications on how hospitals are run. But this spring we have a greater chance than usual to ensure that there is the political will to fix the problems: the general election in May. Understandably, politicians will want us to tell them how services can be improved practically; they want answers so that they can stand in front of the electorate and appear to know what they are talking about. Yes, there have been proposals already on how to spend the extra funding made available for emergency care last year, but let’s keep up the pressure and find ways locally and nationally of lobbying those who represent us in parliament for better patient care.
Our mission Nursing Management inspires and shares professional excellence in nursing leadership and patient care. The journal is editorially independent and opinions expressed in it do not necessarily reflect the policy of the RCN, nor that of any contributor’s employing organisation, unless specifically stated.
Follow us: @NMJournalRCN
Read more at: nursingblog.rcnpublishing.co.uk
Visit us at: Nursing Management
NURSING MANAGEMENT February 2015 | Volume 21 | Number 9 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 05, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
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