Letters
Send your views by email to [email protected], the letters editor @NurseStandard, post on the Nursing Standard Facebook page or visit www.nursing-standard.co.uk
Please keep letters to a maximum of 200 words, and include your full name and a daytime telephone number. Letters may be edited
With such an NHS staff shortfall, who will work on the ‘mothballed’ wards? I was interested to read your article about Lord Carter of Coles’ report on saving the NHS £5 billion a year (analysis, February 17). However, the article and Lord Carter’s report fail to mention the £4.5 billion wasted on the NHS internal market, which adds nothing to patient care according to independent and parliamentary reports into the NHS since 2010. Nor does Lord Carter refer to the huge amounts spent on management consultants running, for example, Healthier Together and ‘vanguard’ exercises around the country, whose aim seems to be to close down services and reduce their accessibility – not to mention the inquiry into junior doctors’ morale, following their protests, which is rather like an arsonist asking people who have been run over by a fire engine why they are looking a bit fed up. Lord Carter’s report also referred to slack attitudes in the NHS, where office space has been expanded while wards have been ‘mothballed’. The Office for National Statistics has just published a report. It says the NHS is short of 50,000 staff, begging the question of who will staff these ‘mothballed’ wards. Patients need not only wards, but nurses, doctors, physios, occupational therapists, porters and clerical staff. I am concerned that Lord Carter’s quest for efficiency will mean further staff cuts and a dilution of the skill mix, as care hours include those of a healthcare assistant (HCA). HCAs do valuable work, but studies repeatedly show that qualified nurses give better care – and give patients better outcomes. We should not be thinking of the NHS as a drain on our resources. For every £1 spent on health care, the wider economy benefits by £5. We should be thinking of
it as an investment, and as a mark of a civilised society. Karen Chilver, palliative care clinical nurse specialist, London
NURSE ROLES SHOULD NOT BE AT THE ‘WHIM OF THE POLITICAL CLASS’ If assistant practitioners are doing the work proposed for nursing associates already then fine, but let us formalise who is responsible for what, right here and now. So great is the debate about which healthcare professional does what for patients that I am getting confused. If I am getting confused when I have been a nurse for 40 years, what chance has a patient in all this? To clear all confusion, let us ensure that training, education and importantly regulation are standardised so we know exactly what skills we have. But my question to nursing leadership is this: why has it been left to Shane Byrne (letters, February 17) to highlight the duplication of responsibilities? Surely our leadership should have a strong and forthright
voice in what might be a fundamental professional shift? That said, if Wales can bring in a law that mandates safe nurse staffing levels, then surely that is where we should be starting? Only when we have determined this in workforce planning terms can we possibly look at roles other than nursing. Let’s not get into yet another mess when we could, and should, ensure that whatever comes is done with the full voice and agreement of nursing, and not at the whim of the political class. If we do not engage strongly, it will be undoubtedly thrust on us and it will be too late. Professor Kevin Davies MBE, by email
COULD ITALY’S NEW PRIMARY CARE MODEL BE THE WAY FORWARD? I was interested to hear of Italy’s new model of care in managing chronic conditions. The country has the most rapidly ageing population in the world, and is confronted with an already overstretched healthcare system. Sound familiar?
32 march 2 :: volfrom 30 RCNi.com no 27 :: 2016 STANDARD Downloaded by ${individualUser.displayName} on Sep 04, 2017. For personal use only. No NURSING other uses without permission. Copyright © 2017 RCN Publishing Company Ltd
In our NHS, when services are expected to be holistic and culturally sensitive, perhaps there is a value in sharing expertise in delivering compassionate care in challenging conditions. The Italians have reorganised their primary care to include ‘health care homes’, providing 24-hour care. This is a multidisciplinary team provision, which importantly also shares electronic health records across the different settings. So far, these homes have been shown to reduce emergency department visits and unnecessary hospital admissions. They have also provided better access to care, improved assisted self-management strategies and improved patient experience. Could this also be a way forward for the NHS? Emma Vincent, interstitial lung disease nurse, Glenfield Hospital, Leicester
GUILDFORD SCHOOL OF NURSING TO HOLD REUNION FOR 1976 STUDENTS Guildford School of Nursing’s 1976 set is aiming to hold a reunion in May for members of the group. The event will take place in Guildford itself. Could anyone not part of this set, but who is aware of a colleague who may be, bring this to their attention? If you are interested in coming to the reunion, or finding out more details, please email me at [email protected].
From Facebook ON THE NHS LOSING ITS ROLE MODELS AND MENTORS, WITH CUTS TO SENIOR NURSE POSTS ■■Every senior nurse carrying a registration with absolute no exception, except on medical grounds, should do one shift a month on the ward or in their clinical area. It is no good just passing down all the latest nursing innovations such as the nutrition mission and 6Cs if they are not aware of the obstacles and difficulties in implementing them. Might save a few bob on agency fees too. It would certainly make them think twice about delivering more paperwork, if once a month they had to be at the receiving end of ticking all the boxes.
Cutting senior nursing posts will mean more responsibility for lower bands without the increased pay @nicunurse_rach
Senior nurses leaving with valuable expertise, skills and knowledge – pressure points… little succession planning @louisebrady17
Under this government I doubt many of our best and brightest will hang about to become senior nurses. Warmer shores beckon @GGByrneSTN
■■I weep for nursing, nurses and the NHS.
Axing of senior nursing posts demonstrates the lack of insight our ruling classes have into needs of health care
Paula Gardiner
@edfreshwater
■■I am sad that retired senior nurses, who would make very effective mentors even on a part-time basis, are not given the opportunity.
You can never be too experienced can you? After 36 years, I’m amazed at how much I still don’t know
Zeba Arif
@wendyjpitt61
■■After a year’s preceptorship we are expected to take the Facilitated Learning and Assessment in Practice course and become mentors when only just finding our feet ourselves. It is ridiculous cutting down on staff with years of experience.
Wider context: Does loss of senior nurse roles reflect the general lack of understanding of nurses’ role in health care?
Kirby Walters
Is anything being done to help/encourage experienced RNs go into RN education?
Stephen Taylor
Chris Clunie née Thayre, by email
CORRECTION In the Careers article Life As An Independent Midwife in our February 24 issue, an interviewee suggested that insurance provided via Independent Midwives UK (IMUK) was insufficient to cover home births. IMUK has pointed out that the personal indemnity insurance product held by all IMUK members does cover home births and indeed the full scope of independent midwifery practice. We apologise for the error.
TWEETS OF THE WEEK
■■How frequently do senior nurses work at ward level? Vasanti d’Hooghe
■■I am a senior nurse working at ward level, and I know many others who also do. We are overlooked for promotions, development, etc. The NHS values younger nurses and those who have degrees. I am studying for my MSc, at present self-funded, but I doubt it will make any difference as to whether I get any form of promotion in the NHS. I am planning to go abroad when I finish. G Brooks
@EllzSummary
@DivaCashdoll
Affordability must be seen as a major ideological driver in #policy shift towards #nursingassociates then @KWebbRCN
Follow Nursing Standard @NurseStandard and join the #NScomment chat on Thursdays at 12.30pm
NURSING STANDARD :: voluses 30 no 27 ::permission. 2016 33 Downloaded from RCNi.com by ${individualUser.displayName} on Sep 04, 2017. For personal use march only. No2other without Copyright © 2017 RCN Publishing Company Ltd
Send your views by email to [email protected], the letters editor @NurseStandard, post on the Nursing Standard Facebook page or visit www.nursing-standard.co.uk
Please keep letters to a maximum of 200 words, and include your full name and a daytime telephone number. Letters may be edited
With such an NHS staff shortfall, who will work on the ‘mothballed’ wards? I was interested to read your article about Lord Carter of Coles’ report on saving the NHS £5 billion a year (analysis, February 17). However, the article and Lord Carter’s report fail to mention the £4.5 billion wasted on the NHS internal market, which adds nothing to patient care according to independent and parliamentary reports into the NHS since 2010. Nor does Lord Carter refer to the huge amounts spent on management consultants running, for example, Healthier Together and ‘vanguard’ exercises around the country, whose aim seems to be to close down services and reduce their accessibility – not to mention the inquiry into junior doctors’ morale, following their protests, which is rather like an arsonist asking people who have been run over by a fire engine why they are looking a bit fed up. Lord Carter’s report also referred to slack attitudes in the NHS, where office space has been expanded while wards have been ‘mothballed’. The Office for National Statistics has just published a report. It says the NHS is short of 50,000 staff, begging the question of who will staff these ‘mothballed’ wards. Patients need not only wards, but nurses, doctors, physios, occupational therapists, porters and clerical staff. I am concerned that Lord Carter’s quest for efficiency will mean further staff cuts and a dilution of the skill mix, as care hours include those of a healthcare assistant (HCA). HCAs do valuable work, but studies repeatedly show that qualified nurses give better care – and give patients better outcomes. We should not be thinking of the NHS as a drain on our resources. For every £1 spent on health care, the wider economy benefits by £5. We should be thinking of
it as an investment, and as a mark of a civilised society. Karen Chilver, palliative care clinical nurse specialist, London
NURSE ROLES SHOULD NOT BE AT THE ‘WHIM OF THE POLITICAL CLASS’ If assistant practitioners are doing the work proposed for nursing associates already then fine, but let us formalise who is responsible for what, right here and now. So great is the debate about which healthcare professional does what for patients that I am getting confused. If I am getting confused when I have been a nurse for 40 years, what chance has a patient in all this? To clear all confusion, let us ensure that training, education and importantly regulation are standardised so we know exactly what skills we have. But my question to nursing leadership is this: why has it been left to Shane Byrne (letters, February 17) to highlight the duplication of responsibilities? Surely our leadership should have a strong and forthright
voice in what might be a fundamental professional shift? That said, if Wales can bring in a law that mandates safe nurse staffing levels, then surely that is where we should be starting? Only when we have determined this in workforce planning terms can we possibly look at roles other than nursing. Let’s not get into yet another mess when we could, and should, ensure that whatever comes is done with the full voice and agreement of nursing, and not at the whim of the political class. If we do not engage strongly, it will be undoubtedly thrust on us and it will be too late. Professor Kevin Davies MBE, by email
COULD ITALY’S NEW PRIMARY CARE MODEL BE THE WAY FORWARD? I was interested to hear of Italy’s new model of care in managing chronic conditions. The country has the most rapidly ageing population in the world, and is confronted with an already overstretched healthcare system. Sound familiar?
32 march 2 :: volfrom 30 RCNi.com no 27 :: 2016 STANDARD Downloaded by ${individualUser.displayName} on Sep 04, 2017. For personal use only. No NURSING other uses without permission. Copyright © 2017 RCN Publishing Company Ltd
In our NHS, when services are expected to be holistic and culturally sensitive, perhaps there is a value in sharing expertise in delivering compassionate care in challenging conditions. The Italians have reorganised their primary care to include ‘health care homes’, providing 24-hour care. This is a multidisciplinary team provision, which importantly also shares electronic health records across the different settings. So far, these homes have been shown to reduce emergency department visits and unnecessary hospital admissions. They have also provided better access to care, improved assisted self-management strategies and improved patient experience. Could this also be a way forward for the NHS? Emma Vincent, interstitial lung disease nurse, Glenfield Hospital, Leicester
GUILDFORD SCHOOL OF NURSING TO HOLD REUNION FOR 1976 STUDENTS Guildford School of Nursing’s 1976 set is aiming to hold a reunion in May for members of the group. The event will take place in Guildford itself. Could anyone not part of this set, but who is aware of a colleague who may be, bring this to their attention? If you are interested in coming to the reunion, or finding out more details, please email me at [email protected].
From Facebook ON THE NHS LOSING ITS ROLE MODELS AND MENTORS, WITH CUTS TO SENIOR NURSE POSTS ■■Every senior nurse carrying a registration with absolute no exception, except on medical grounds, should do one shift a month on the ward or in their clinical area. It is no good just passing down all the latest nursing innovations such as the nutrition mission and 6Cs if they are not aware of the obstacles and difficulties in implementing them. Might save a few bob on agency fees too. It would certainly make them think twice about delivering more paperwork, if once a month they had to be at the receiving end of ticking all the boxes.
Cutting senior nursing posts will mean more responsibility for lower bands without the increased pay @nicunurse_rach
Senior nurses leaving with valuable expertise, skills and knowledge – pressure points… little succession planning @louisebrady17
Under this government I doubt many of our best and brightest will hang about to become senior nurses. Warmer shores beckon @GGByrneSTN
■■I weep for nursing, nurses and the NHS.
Axing of senior nursing posts demonstrates the lack of insight our ruling classes have into needs of health care
Paula Gardiner
@edfreshwater
■■I am sad that retired senior nurses, who would make very effective mentors even on a part-time basis, are not given the opportunity.
You can never be too experienced can you? After 36 years, I’m amazed at how much I still don’t know
Zeba Arif
@wendyjpitt61
■■After a year’s preceptorship we are expected to take the Facilitated Learning and Assessment in Practice course and become mentors when only just finding our feet ourselves. It is ridiculous cutting down on staff with years of experience.
Wider context: Does loss of senior nurse roles reflect the general lack of understanding of nurses’ role in health care?
Kirby Walters
Is anything being done to help/encourage experienced RNs go into RN education?
Stephen Taylor
Chris Clunie née Thayre, by email
CORRECTION In the Careers article Life As An Independent Midwife in our February 24 issue, an interviewee suggested that insurance provided via Independent Midwives UK (IMUK) was insufficient to cover home births. IMUK has pointed out that the personal indemnity insurance product held by all IMUK members does cover home births and indeed the full scope of independent midwifery practice. We apologise for the error.
TWEETS OF THE WEEK
■■How frequently do senior nurses work at ward level? Vasanti d’Hooghe
■■I am a senior nurse working at ward level, and I know many others who also do. We are overlooked for promotions, development, etc. The NHS values younger nurses and those who have degrees. I am studying for my MSc, at present self-funded, but I doubt it will make any difference as to whether I get any form of promotion in the NHS. I am planning to go abroad when I finish. G Brooks
@EllzSummary
@DivaCashdoll
Affordability must be seen as a major ideological driver in #policy shift towards #nursingassociates then @KWebbRCN
Follow Nursing Standard @NurseStandard and join the #NScomment chat on Thursdays at 12.30pm
NURSING STANDARD :: voluses 30 no 27 ::permission. 2016 33 Downloaded from RCNi.com by ${individualUser.displayName} on Sep 04, 2017. For personal use march only. No2other without Copyright © 2017 RCN Publishing Company Ltd
