Responding to NHS pressure and the Prime Minister's speech, RCN General Secretary and Chief Executive Pat Cullen, said in a letter to health secretary Steve Barclay:
Dear Secretary of State,
In the first week of January, many have come to expect performance challenges in the NHS. However, I am compelled to put on record that what is unfolding in England’s health service this week is far from ordinary ‘winter pressures’. Nor can COVID and flu be blamed for the current performance of the NHS.
In his speech this afternoon, the Prime Minister’s language appeared detached from the reality of what is happening and why. As far as the current NHS situation, it focused on false promise and hollow boasts when practical and urgent measures are required on the part of government.
I fear that, when so many nursing professionals are considering their future in this profession and record numbers have already left, this situation will push even more out of the NHS.
Nursing staff are being forced to care for patients in corridors and other inappropriate locations against their own clinical judgement. This practice is grossly unsafe for the patient and the registered professional alike and the risk to life is severe. Furthermore, nursing these patients, many of whom are elderly and vulnerable, in such conditions is undignified and demeaning and should not be tolerated.
Nursing leaders tell me of deep distress experienced when their teams are not able to give high-quality patient care in their areas of practice. They can see the systemic failures, due to years of underinvestment in capacity across all care settings, culminating in increased urgent and emergency presentation.
This pressure is not constrained to Emergency Departments either. I hear that every square inch of hospital space is being used to add more patients, in escalation beds, including by closing existing services. Systemic failures include the clear and significant lack of capacity and workforce in social care, including nursing homes, in primary care and in acute inpatient care.
In most acute hospitals there are at least 200 patients that could be cared for in a non-acute setting. Many nursing home and social care providers struggle to recruit the registered and non-registered nurses with the skills they require. This has a massive impact on patient flow both into and out of the hospital. The vacancies in GP practices and lack of primary care provision puts even more pressure on acute services. The lack of primary care infrastructure means that 111 primary recommendations at times are to divert patients to hospitals.
The RCN, supported by NHS and social care leaders, professional bodies, think tanks and Parliamentary committees, has resoundingly concluded that a lack of workforce is one of the root causes of today’s situation. The responsibility for equipping publicly funded NHS and social care services so that they can meet the needs of the population lies squarely with the UK Government. It is disingenuous to insist that these services are adequately resourced, when the evidence clearly demonstrates that they are at the point of collapse.
You are already aware that in two weeks there will be two successive days of industrial action by members of the Royal College of Nursing in more locations across England than in December. My members are saying ‘enough is enough’ for their patients as well as themselves. I urge you to show a renewed sense of urgency in opening negotiations on the current NHS pay award so that this situation can be avoided later in the month.
Yours sincerely,
Pat Cullen
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