Nursing chief: ‘Nurse shortages are life-threatening’
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Version 0 of 1. Nurses are increasingly turning to food banks and payday lenders to make ends meet as a result of years of public sector pay restraint, according to Janet Davies, new general secretary and chief executive of the Royal College of Nursing (RCN). She warns that absence of “light at the end of the tunnel” on pay is leaving nurses feeling undervalued and could push some to walk away from the profession altogether. “We can’t afford for any to leave,” she says. The nursing union says its members are accessing food banks or becoming victims of payday loans to cope Pay and workforce numbers are two key pressures that Davies, who began her tenure last month after being appointed to succeed Peter Carter, wants addressed for her members. The nursing union’s welfare service is receiving a growing number of calls from its members who are experiencing financial hardship. They report accessing food banks or becoming “victims of payday loans” to cope. In addition, nurses stressed out by workloads are turning to the union’s counselling service in increasing numbers. Directors of nursing, meanwhile, report difficulties filling staff vacancies, leading to more use of costly agency nursing, and an even greater reliance on overseas recruits. “These huge agency bills, nurses going to food banks – this is not a great place to be,” says Davies, who is Bolton-born and was educated at a direct grant school. She boasts a long career in the NHS, which began when she trained as a general nurse in 1975 and later qualified as a mental health nurse. She wants nurses to feel valued as professionals, in terms of both pay and being properly resourced to deliver safe and compassionate care to patients. A staff nurse is already 20% worse off in real terms than in 2010, after a two-year pay freeze under the coalition government followed by a 1% cap on pay rises, says Davies. So her heart sank when the chancellor, George Osborne, used his first Conservative budget in June to announce that public sector pay rises will be capped at 1% a year for the next four years. Being on a salary of around £156,000 doesn’t mean she’s forgotten what it is like being a staff nurse with friends who chose other career paths and could afford holidays she couldn’t. “I know what it’s like when your friends’ jobs are valued more than you feel yours is.” Related: Public service staff face four more years of pay pain Davies says already more nurses are opting for agency or bank nursing because they can earn more. Another pressure on pay is the increasing prevalence of “downbanding” – essentially where a senior nursing post is re-evaluated and downgraded. “Because of this pay issue, because of this downbanding going on, they [nurses] just feel they are not valued as professionals and my worry is that this will push some to leave.” She wants more of her members to speak up about how valuable they are, and for others to listen. Could Davies be the first RCN chief to lead the membership – numbering 420,000 – on strike? She’s not convinced that it would get nurses anywhere, she replies, but adds that she would if the mood was there. “It would have to be something that came from the membership. We will always ask them, but at the moment we are not feeling that.” It’s not just pay that needs to improve to make nurses feel valued, but addressing workloads, says Davies as she highlights the demoralisation an overstretched nurse feels when she doesn’t have the time or resources to do what she knows needs to be done to deliver good patient care. It’s not good for the patient experience or for clinical outcomes. The true picture for vacancy rates is hard to come by, but Davies says the reality of empty posts is being felt on the ground: directors of nursing lament the lack of recruits to fill vacant posts. “They’re saying, we want to employ people, we can’t employ people, there aren’t people there, which is why they are recruiting overseas.” She also draws on evidence of shortages from Freedom of Information requests made by the union to NHS trusts. Could patient lives be at risk as a result of workforce pressures identified by the RCN? International research shows “absolute evidence”, says Davies, that in acute wards the number of registered nurses per patient “does mean the difference in whether you survive or not”. More evidence is needed for other areas of healthcare, “but we do know, obviously, that if people are not getting enough to eat or drink or washed as often because [staff] have not got the time, we know that those are causation factors that might lead to them not surviving. So I think it does affect patients’ lives.” Davies says job cuts were introduced in the first two years of the coalition government, accompanied by cuts in student nursing places. Both trends were reversed following the Francis inquiry into failings at Mid Staffordshire NHS foundation trust, which put the spotlight on the link between poor patient care and unsafe staffing levels. Since than there has been a concerted push to reverse nursing post cuts, and adult nursing training places have increased by 13.6% in the past two years . The Department of Health claims there are 8,100 extra full-time equivalent posts on NHS wards in England since 2010. Figures published by the RCN earlier this year put the figure at just 1,470. The union insists an additional 20,000 nursing posts – minimum – are needed when increases in demand and seven-day working are taken into account. The RCN leader concedes there has recently been too much overseas recruitment to plug the staffing gap, but stresses that it is a “safe solution” given the level of skills and experience international nurses bring. However, many of them may soon be leaving as a result of the Home Office decision to raise the minimum salary thresholds for skilled migrant workers from outside the European Economic Area. For nurses, it means that those who earn an annual salary of less than £35,000 will have to leave after six years. The RCN says the impact will start being felt in 2017, with 3,365 NHS nurses potentially affected. The RCN is campaigning to have the nursing profession placed on the list of recognised occupations suffering from a skills shortage, and therefore exempt it from the income threshold. “We go out there and recruit them; we are desperate for nurses, we bring them in and then to say, ‘actually, we don’t want you anymore,’ I think is a real moral dilemma. They’ve given so much,” says Davies. “These are valuable people and if we lose them, we will be in an even bigger mess than we are in at the moment.” Curriculum vitae Age 56. Lives London. Family in a relationship. Education Bolton school, Bolton; South Manchester School of Nursing, state registered nurse training; Lancaster School of Nursing, registered mental health nurse training; Manchester Polytechnic, BSc (Hons) nursing studies; Manchester Metropolitan University, MBA. Career July 2015-present: general secretary and chief executive, RCN; 2005-15: executive director of nursing and service delivery, RCN; 2002‑05: chief executive, Mersey regional ambulance trust; 1997-2002: director of nursing, Royal Liverpool and Broadgreen University Hospitals; 1993-97: director of nursing, West Lancashire health services trust; 1990-93:director of nursing, Central Manchester (Manchester Royal Infirmary and Barnes Hospital); 1988-90: clinical nurse manager, Trafford health authority; 1985-88: nursing officer, Stockport health authority; 1982-85: ward sister roles in the north-west; 1978-80: ward sister, then staff nurse, Withington Hospital, Manchester. Public life member, executive committee, European Federation of Public Service Unions. Interests Cycling, walking, theatre and socialising with friends. |