Opinion

'No nurse wants to see elderly patients left on trolleys in corridors'

Janet Davies urges the UK government to invest in staff to ensure a healthy future for the NHS

RCN chief executive Janet Davies with Big Issue vendors and John Bird

This winter has been tough. With the worst flu outbreak in years and hospitals bursting at the seams, I’ve heard innumerable stories of staff doing their best for patients under the hardest circumstances in a generation.

If you, or a loved one, has experienced this first-hand, you will know something of the strain our health and social care services are under. The NHS is a grand edifice sure enough, but successive governments have been chipping away at it for decades. In too many areas of health and social care we’re relying on goodwill, dedication and unpaid overtime – far from solid foundations.

A cold winter is all it takes to bring parts of this edifice to the brink of collapse.

Speak to almost any health professional, and they’ll describe the vicious cycle created by years of underfunding, cuts to services and lack of workforce planning. With insufficient access to community services, people get sicker until they are admitted to hospital. Accident and Emergency departments bear the brunt of this influx, especially as the weather gets colder, and struggle to find hospital beds as ambulances queue outside and patients lie on corridors.

But when patients are discharged, sometimes before they are ready, overstretched community services cannot provide the care plans and support they need. So, inevitably, they end up back at A&E.

How do we break this cycle? More money would certainly help, but it’s not enough on its own.

The NHS is 70 years old this year. Old it may be, but it must learn new tricks if it is to survive in a recognisable form. We are getting older and living longer, and patients come to hospital with increasingly complex needs. The NHS must be prepared to meet this challenge.

As patients’ needs become more complicated, treating them does too. It should come as no surprise that study after study finds that the more degree-educated nurses there are in a clinical setting, the better patients’ chances of survival.

Between May 2010 and July 2017 the number of district nurses has fallen by 46 per cent

Closer coordination between health and social care is vital to cope with the UK’s ageing population. We need to develop, and fund, world-class community services that help people stay healthier in their own homes, instead of being inappropriately admitted to hospital when there are better ways to provide care and support.

A strong and resilient nursing workforce is key to achieving this, yet the profession is facing a recruitment and retention crisis that shows no sign of abating.

For example, between May 2010 and July 2017 the number of district nurses has fallen by 46 per cent.

But it’s not just district nurses. This time last year, 96 per cent of hospitals reported nurse shortages. A year on, and the situation has only got worse. Few jobs offer the same life-affirming combination of variety and responsibility, yet there are over 40,000 nurse vacancies in England alone, and more nurses are leaving the profession than are joining.

Why? Time and again, our members tell us they are leaving because they can no longer offer patients the care they were trained to deliver. No nurse wants to see elderly patients left on trolleys in corridors. No nurse wants to choose between treating the next person and leaving a patient to die alone. Is it any wonder many are reduced to tears? There is only so much of this anyone can take.

We need a national conversation about how we fund health and social care. We need to ask ourselves what sort of services 21st century Britain wants to offer its citizens.

But we also need a government that invests money and effort in our health and social care services’ most valuable asset – staff.

Our challenge to ministers is this: recruit, train and retain a health and care workforce that can serve its patients for the next 70 years.

Janet Davies  is chief executive of the Royal College of Nursing. Follow her on Twitter.

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