Safe staffing: dream or opportunity?

Like Martin Luther King, I have a dream.

I have a dream that one day we well have enough staff to care properly for our patients.

I have a dream that one day the RCN, RCM, QNI, AHP organisations and medical Royal Colleges will be able to sit down together at the table of brotherhood, and together will transform our care system into an oasis of freedom and justice.

I have a dream that nursing will be united and our voices will roar.

But I want to make my dream a reality.

We have this opportunity now. Safe staffing is the answer. We have a golden opportunity in front of us to shape the future not only of nursing in our country but the entire care system, and for the first time we are in the driving seat.

I was alarmed when it was revealed that NICE was abandoning its programme on safe levels of nursing staff, and I turned to twitter to express my worries and opinion against the decision. But time has passed and I have been able to read and reflect about it, especially as NICE was about to publish its guidance for safe staffing in the community.

How many times have we complained that nursing has never given the opportunity to have a proper say or shape the care that the NHS provides? Plenty of times as nurses we have felt second best. We seen other professions are leading the changes.

For as long as I remember we have been dictated to about how our profession should look and behave. The Francis report, for example, led by Robert Francis, a barrister specialist in medical legal issues; the Keogh review, led by Bruce Keogh, a British surgeon and physician. Shall I continue?

Never before we have we been given this opportunity to showcase to the rest of the health professions, and also the public, what nursing is capable of and that we are ready to lead the change.

I still have some reservations and feel uncomfortable about moving away from minimal staffing numbers as I think we should have a safety net, but I can also see Jane Cummings’ point of view.

The issue was not handled properly after the news was leaked. In an era where news can travel faster than the speed of light, the slow response and her silence didn’t help the situation.

But let’s have a look at the bigger picture. Jane Cummings has shown courage and leadership taking on this important issue. She has not shied away and has embraced the challenge with open arms.

She has also been honest and transparent, and said that her office does not, as yet, have any plans to increase resources to manage this work, and that it is yet to work out the detail of how to implement the plans.

Instead of fighting among us, it is time to join forces and unite our efforts. Nursing needs to change its mentality and be more ‘can do’.

The past decade has seen a 47% reduction in the number of qualified district nursing staff in England, threatening the ability of the whole health and social care system to cope with soaring numbers of frail older people.

But the NHS’s Five Year Forward View clearly emphasises that the healthcare system needs to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care. The future will see far more care delivered locally and in the community increasing pressure on primary care.

According to the RCN, many community staff are being pushed to breaking point, with more than eight out of ten working additional hours on their last shift. Three quarters said they had left necessary activities undone due to a lack of time, and four in ten said that they would leave the job if they could.

We are at a crucial crossroad and it’s paramount that we get the staffing levels in the community right.

Jane Cummings has promised to work on the triple aim of improving outcomes, improving experience and ensuring value for money. Let’s make sure that happens.

The journey has just started and instead of throwing sticks into the wheels, we should rally, join forces and collaborate to make sure we have a future health system fit for purpose.