Great Britain

Safer standards for nursing care unveiled as public fear effect of shortages

New standards for the safe working of nurses across hospital wards, care homes and in the community have been set out by the Royal College of Nursing, for the first time in its 100 year history.

In a bid to underline the safety-critical nature of expert nurses in healthcare, the RCN hopes the minimum standards will be used to force improvements in safe staffing levels and the treatment of nurses across the country by NHS trusts and other employers.

It comes as a new poll finds a majority of adults believe there are not enough nurses to provide safe care. There are 50,000 nursing vacancies across the NHS and research has repeatedly shown having degree-educated nurses leads to better patient safety.

A major study across 500 hospitals in 12 European countries found for every extra patient a nurse was expected to look after, the chances of the patient dying increased 7 per cent. Other studies have shown replacing degree-educated nurses with less educated staff led to an increase in mortality of 21 per cent.

Despite the research, the UK government and NHS England has consistently opposed tougher ratios of nurses to patients and has invested in new non-degree roles to fill gaps in staffing.

In an interview with The Independent, the RCN president, Dame Anne Marie Rafferty, a professor of nursing policy and advocate for safe staffing said she hoped the standards would empower nurses to push for improvements in their working conditions.

She said nurses were “safety critical” and the best “insurance policy” to have on busy hospital wards.

“These standards are designed to empower nurses with expectations about what employers should provide in the workplace. They’re covering a whole range of elements that haven’t previously been included in any guidance.

“They’re partly aspirational, inevitably, but they’re sending a very clear signal and I think it gives nurses a really good set of checks, to come to a clear judgement that they can then articulate to management.”

She warned the standards were needed because of the threat to nursing post-pandemic – with high levels of anxiety, post traumatic stress and some surveys showing up to a third of nurses considering leaving their profession.

The new standards set out expectations that hospitals and other employers should meet when planning their staffing levels. This includes detailed demands about the way rotas are designed, who should be included and the involvement of senior registered nurses. They also set out demands on nurses health and wellbeing and their wider treatment.

The RCN, which is both a professional body and a trade union, said it would back any member who challenged their trust or employer if the standards were not being met.

The standards could also be used in other settings such as employment tribunals as well as investigations by the Nursing and Midwifery Council or other regulators.

Wendy Preston, head of nursing practice at the RCN told The Independent: “We looked to see what professional guidance there is around the nursing workforce, and there’s a real scarcity of evidence.

“As the professional body for nursing and the largest trade union, we felt we were best placed to develop the standards. These are UK wide and they cover all settings.

“Every nurse will be able to see where there’s something in the standards that could be a change lever with their own employer.”

A new poll by the RCN found one on four adults were worried they or their families would not get the care they needed because of a lack of staff with 7 out of 10 saying there were not enough nurses to deliver safe care.

RCN acting general secretary Pat Cullen, said: “The survey shows that patients experience nursing staff being rushed off their feet and want to know what is being done about it. At no time has this been more evident than during the pandemic.

“The shortage of nursing staff across all specialisms in the profession, in the NHS and independent sector, compromises patient safety. These standards must be consistently applied across the UK.

“Nursing is the largest safety critical profession in healthcare and it's vital that we have the right staff, with the right skills, in the right place, at the right time.”

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