Nurses for Reform Blog

Interesting to note that the very excellent Professor Anne Marie Rafferty et al., Professor of Nursing at Kings College London has just published research which proves that wards with a lower nurse-to-patient ratio had a 26 per cent higher patient mortality rate. Following her survey of nearly 4,000 nurses in 30 hospital Trusts in England she concludes that had there been more nurses on the wards then 246 more lives could have been saved. This research has just been launched by the Royal College of Nursing. Results:

‘Patients and nurses in the quartile of hospitals with the most favourable staffing levels (the lowest patient to nurse ratios) had consistently better outcomes than those in hospitals with less favourable staffing. Patients in hospitals with the highest patient to nurse ratios had 26% higher mortality.’

When I trained at South Lothian College of Nursing & Midwifery from 1982-1986, long before the dreaded Project 2000, this knowledge that it was intensity of bedside care that determined the quality and safety of healthcare on any given ward be it acute, psychiatric or, as we had in those days, a ward for the learning disabled, was self-evident and was just one of the reasons why student nurses spent much of their training learning on wards at the bedside with trained nursing staff. Now we need highly trained and gifted academic nurses like Anne Marie to research and prove the case. Doubly so when we have a Government encouraging Trusts to ‘shed staff’ at the moment in the interests of balancing the books of an under pressure NHS their policies have overheated with too many productivity targets.

Those of us who have spent long careers in health and UK public healthcare understand that it really is time for politicians to ‘butt out’ of healthcare as our American cousins would say. Politicians cannot and should not be allowed to manage health services and health service delivery. This important matter should be left to the professional community of health service managers, doctors, nurses, therapists and paramedics. Self-governing Foundation Trusts are a good thing, a self-managing independent NHS, responsive to the consumer-patient, would be even better. Let’s get there as quickly as we can.

Ask a patient going into hospital for a hip operation what they expect of their care and they will probably come up with the following list:

• A bright clean surgical ward with some privacy – a single room or at least a four bedded bay would be a great bonus
• A well staffed ward with friendly competent nurses in clean uniforms and perhaps a lead nurse in the team responsible for their personal care plan, who discusses it with them
• Decent food and some choice of menu
• Polite, attentive and caring medical staff and a consultant that comes to see them on his ward rounds to explain and discuss the treatment options, their operation and the recovery timeline
• Opportunity to discuss their operation
• Opportunites to for structured convalescence before discharge
• The right to see their nearest and dearest when they want to see them

The problem we still have in the UK is that although we have come a very long way from the great variability of NHS care of the 1980’s, this list is still not a guarantee in every NHS hospital in the UK, but it is in the independent sector. Now why is that?

I am delighted to introduce you to Robert McIndoe who is joining NFR today as a regular weekly blogger.

A registered nurse and former NHS national general management trainee, he has spent more than twenty years working in the NHS going through the ranks – from Staff Nurse to Senior Manager. He has also worked in the independent sector.

Take my advice, never trust a politician. When a politician tells you they are going to look after your child’s education, its perhaps time to go private – or even to home educate. When a politician tells you they are going to ban guns – expect vast increases in gun crime. When a politician tells you they are going to ban dangerous drugs – watch out for your community being awash with these substances.My heart sinks when politicians get involved in anything. Invariably, they promise the earth, coercively tax you out of your hard earned money, and then they deliver bugger all when you really need the service.

In today’s Europe people pay their taxes but increasingly find they have to go private to get what they want.

It is perhaps in this context that the political body that attempts to centrally plan what NHS patients can and cannot receive in terms of medication and treatment, the National Institute for Health and Clinical Excellence  (popularly knows as NICE), is increasingly known as NASTY – “Not Available So Treat Yourself”.

It was with all of this in mind that I relished this recent article in the Guardian

The really good news is that while NASTY states it is “responsible for providing national guidance on promoting good health and preventing and treating ill health” you know it is again time to get out and go private!

Whatever the case nurses must never get into bed with government and so deny their patients the best available medications and treatments.

In this murderous game of political power, it is time for nurses to stand up for the weak and ill – and to attack NICE.

Just as Richard Thomas, the government’s information commissioner, is warning that Britain is sleep walking into a surveillance state I note this article on electronic patient records in the Guardian  It states:

“Millions of personal medical records are to be uploaded regardless of  patients’ wishes to a central national  database from where information can be made available to police and security services, the Guardian has learned.”

This is no surprise. Having previously written this  back in 2001, I have long feared what the Guardian is now alluding to.

Mark my words, electronic patients records in the hands of “joined up government” really will turn out to be a nightmare.

I am delighted to be launching the Nurses for Reform blog today. The purpose of NFR is to campaign for more consumer-oriented and sustainable healthcare systems in Britain and Europe.

NFR believes it is no longer acceptable for nurses to sign up to careers in public sector healthcare only to find they are unable to access the resources and autonomy they need to do their work. NFR rejects bland egalitarianism in favour of contestability. Above all else we believe that greater partnership with the private sector is to be actively welcomed and that this sector’s contributions are good news for patients and healthcare professionals alike.

Today, too many nursing trade unions and representative bodies fail nurses because they invariably stick to old and out dated agendas. Instead of championing substantive reform – and in doing so, championing the rights of consumers – they default to short term platitudes such as demanding more tax payers’ money or new forms of legislative favour. Such an approach is not only disasterous for nurses but it is catastrophic for patients.

NFR believes in fundamental change. It believes that only by putting patients and consumers interests first will healthcare improve. It is only when healthcare is opened up to real consumers and trusted brands that nurses will find themselves working in a sustainable environment and with the incentives, resources and encouragement to deliver a responsive, popular and truly high quality service.

From now on this blog will be updated regularly by me and by my other NFR blogging colleagues. I hope you enjoy the site as it develops and that you will be inspired to send in your comments.

If you are a qualified nurse and would like to become an NFR supporter please visit us here to sign up.