RCN calls for nurse-to-patient ratios as part of NHS review

It comes as the health and social care secretary, Wes Streeting, announced last month that a full and independent investigation into the state of the health service had been commissioned.

“The health system is in a state of crisis, chronically underfunded and lacking the resources it needs to meet population health needs”

Nicola Ranger

Leading surgeon and former Labour health minister, Lord Ara Darzi, has been conducting the NHS Next Stage Review, which is set to uncover the extent of the issues facing England’s health service.

The investigation is scrutinising patient access to care, the quality of care provided and the overall performance of the NHS.

Due to be complete in September, the review’s findings will provide the basis for the government’s 10-year plan to radically reform the NHS.

The RCN announced this week that it had submitted written evidence to the review, focusing on a variety of concerns relating to nursing.

In the submission, the college once again called for the implementation of “professionally and legally enforceable nurse-to-patient ratios” in England, with a safety-critical maximum number of patients per registered nurse in every healthcare setting.

The RCN last year unveiled its campaign for nurse-to-patient ratios to be rolled out across the UK, following concerns of the devastating impact that staff shortages were having on patient care.

Safe staffing legislation is already in place in Scotland and Wales, and is being considered in Northern Ireland.

The Health and Care (Staffing) (Scotland) Act 2019 and the Safer Staffing Levels (Wales) Act 2016 both place a legal duty on NHS health boards to ensure that they have suitably qualified staff working in the right numbers for safe and effective care.

Similarly, the RCN, in its submission, called for legal protection for people raising concerns about unsafe staffing levels.

It also asked for action to eradicate corridor care completely, with mandatory reporting on each instance of corridor care through the NHS Standard Contract.

The RCN set out a series of other demands for Lord Darzi’s NHS review to consider.

These included one for “a long-term aligned approach to both the NHS and adult social care” with a proper focus on the workforce.

In addition, it demanded fully funded, accessible and effective mental health and wellbeing support to be provided by every employer for all nursing staff.

Meanwhile, the college also called on the government to pledge financial support for nursing students, by fully funding tuition and providing living cost grants in line with the increased cost of living for students.

Similarly, it demanded job guarantees for all nursing students upon qualification.

It comes as there have been concerns raised recently that newly qualified nurses are struggling to find jobs, despite the current 40,000 nursing vacancies in the NHS in England.

Nicola Ranger

RCN general secretary and chief executive, Professor Nicola Ranger, has been part of the expert reference group informing the NHS review, and has so far attended one exploratory session.

She is set to join a second meeting on 3 September, where Lord Darzi and his team will share emerging findings.

Professor Ranger said: “The RCN welcomes the independent review of the NHS in England by Lord Darzi and the proposal for a new 10-year plan for health that focuses on addressing the current challenges.

“The health system is in a state of crisis, chronically underfunded and lacking the resources it needs to meet population health needs, with a pattern of short-term emergency funding packages aimed at plugging the gaps.”

Professor Ranger warned that demand for healthcare services was “far outstripping nursing supply” and that the workforce was under “intense pressure”.

“The increasing normalisation of unsafe and ineffective care being delivered in inappropriate settings is a symptom of this state of crisis and a change of course is vital,” she added.