Legal limbo is leaving patient care at risk, says RCN

By agency reporter
October 11, 2019

The Royal College of Nursing (RCN) is warning that the lack of watertight legal responsibilities for the supply and planning of the health and care workforce is fuelling the staffing crisis. 

The College makes the claim as NHS figures show that there are now a record 43,617 empty nursing posts in the NHS in England alone, a figure compounded by a global shortage of nurses and the removal of the nursing bursary. In the NHS in England, 12 per cent of posts are now without a full time Registered Nurse.

To address the record number of vacancies, and the gap between the numbers of health and care staff needed to deliver patient care and how many are actually in the system, the College says there must be clarity on the roles, responsibilities, as well as accountabilities, for workforce planning and supply, and that these must be set out clearly in law.

Recent polling for the RCN pointed out that 80 per cent of the public agrees that the Government should have a legal responsibility for ensuring there are enough nursing staff.

In a new report Standing up for patient and public safety, the Royal College of Nursing outlines the evidence of the need for a new law that allocates specific legal responsibilities for workforce planning and supply. The RCN says it is no longer the time to be discussing whether legislation is needed, but to discuss how essential changes in legislation are secured.

The Health and Social Care Act (2012) devolved many of the roles and responsibilities for workforce planning and supply, but the RCN report shows that the resulting lack of clarity in relation to those responsibilities across all parts of the health system has left parts of it in ‘limbo’ and held back attempts to address the crisis.

In September, after pressure from RCN members, NHS England and NHS Improvement stated that the issue of accountability for workforce planning and supply remains an area that needs be resolved.

The RCN says lack of nursing staff in particular is already compromising patient care. The report presents new analysis by the RCN that shows when there were less than 50 per cent of the registered nurses than planned, staff were twice as likely to report that care had been compromised than if they were working on a fully staffed ward.

The RCN says the new report demonstrates clearly why action is needed to tackle the current workforce crisis, but also to ensure there is a sustained investment in the future workforce, of at least £1 billion per year.

Dame Donna Kinnair, Chief Executive and General Secretary of the Royal College of Nursing said: “Nurses are working harder than ever to deliver safe patient care but are being held back by a system that is legally lacking teeth. Despite the public, patients and nurses all agreeing that clarity is needed on responsibilities for delivering enough nurses, we have yet to see any government pledge anything of the like, and as a result are staring down the barrel at a record 43,000 empty nursing posts.

“We know how dangerous it can be when there aren’t enough nurses to provide care, but at present, almost all accountability rests with the frontline nurse working on the understaffed ward, rather than those responsible for the system they work in.  We believe the time has come for change and that patient care was future-proofed by law, and that from the government down, decision makers are held to account.

“But whilst legislation is fundamental to protecting patient care, it is not the only piece of the puzzle. The nursing profession needs serious investment, particularly in education and training. So alongside vital legislative changes to lock in accountability throughout the health and care system, there must also be at least £1 billion a year put into nursing higher education.

“Without these bold changes, the public and staff within health and care services cannot be confident that safe and effective care can be delivered, risking the health of patients now and in the future.”

* Standing up for patient and public safety is available to download here

* The Royal College of Nursing


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