British Nurses Have Fears Over Quality of Patient Care Provided

Fewer than 1 in 10 British nurses (7 percent) feel they have the right number of staff to deliver good quality care to patients, the Royal College of Nursing (RCN) revealed in a new snapshot survey this week.

The online survey of more than 1,900 nurses, asked respondents about staffing levels in their workplace. The results show the mounting pressure on Britain's NHS frontline staff with respondents pointing to unfilled vacancies, recruitment freezes and the feeling that patient safety could be compromised.

With the vast majority (80 percent) of nurses saying they did not have enough staff to deliver good quality care to patients, the RCN said it feared that NHS providers may become unable to provide high quality care for all and that care might be dumbed down as a result of not having the right number and balance of staff.

Todays survey comes on top of recent warnings by the RCN that at least 27,000 jobs have been earmarked to be cut, as NHS Trusts come under pressure to make £20 billion of efficiency savings. Staffing levels need to be given a much higher priority throughout health organisations, given the clear link between failing care and poor staffing levels, the RCN urged.

Nurses felt strongly that inadequate staffing levels where they work could compromise patient safety, with the overwhelming majority (83 per cent) saying that this could be happening on a daily or weekly basis.

One band 5 nurse from Yorkshire told the RCN: "I work on a busy orthopaedic ward and our staffing levels have never been so poor. Our throughput of patients is increasing, and we are expected to give as high quality care as before but with reduced levels of staffing. We regularly work with two qualified staff and one HCA to cover the ward during the day. Night staff levels are often just one qualified member of staff and one HCA. This with patients that are immediately post-op with PCA [infusion] in situ, demanding high levels of care."

Despite this, around half of respondents (46 percent) said that there had been unfilled vacancies in their workplace for more than six months, while 4 in 10 said their place of work was currently subject to a recruitment freeze.

Dr Peter Carter, RCN chief executive and general secretary, says, "The results of our survey act as a reality check for those saying that cuts arent biting in the NHS. It is deeply worrying that some nurses are telling us that they do not have enough staff to deliver quality care and that safety could be compromised. The NHS is about to go through a very shaky transition period as a result of a far-reaching reform programme. Coupled with the drive to make efficiency savings we are concerned at the NHS ability to cope, especially as staff are clearly under so much pressure. What we are hearing is that there are fewer staff doing more work, and nurses themselves are saying it could have a damaging effect on patient care. The health service is facing unprecedented change, uncertainty and economic challenges. Throughout this period it is vital that managers do not lose sight of the basics having the right number and balance of staff to provide safe care."

The RCN urged employers and policy makers to take note of, and act on the findings, to make sure staffing levels are regularly reviewed to ensure patients continue to get quality and safe care. To help providers, commissioners and regulators, the RCN has published a list of indicators that need to be monitored:

- Actual nursing staff in post as a proportion of total establishment

- Proportion of registered nurses as a percentage of total nursing staff

- Nursing staffing relative to patients

- Staff turnover and sickness absence

Carter adds, "It is vital that healthcare organisations prioritise and monitor their staffing levels without this, safe care cannot be guaranteed. Also, what we dont want to see is healthcare organisations dumbing down and only providing a core standard of care. Each organisation must be aiming for the very best for patients. It is imperative that we dont see a growing gap between minimum standards and high quality care."