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Unsustainable healthcare pressures putting patients at risk, warns RCN



Patients are being put at risk because of the ‘unsustainable’ pressures facing the English health and social care system, the RCN has warned.

A report published by the nursing body yesterday found a mixture of factors including nursing vacancies, high absences rates and a building backlog has created a ‘perfect storm’.

It highlighted data published last month by NHS Digital showing the NHS in England recorded over 88,417 more sick days among nurses and health visitors in June 2021 compared to June 2019. Mental health reasons, and not Covid-19, was the most common reason for sickness.

Likewise, the average number of sickness days taken every year among registered nurses working in the social care almost doubled – increasing from an estimated average of around four days per year in 2019/20 to 7.7 in 2020/21, according to Skills for Care data.

The report warned high sickness rates have a ‘direct impact on sustainability of services’ and could suggest high levels of burnout among the workforce. This puts ‘even more pressure on services’ as ‘remaining staff are even more stretched as they try to cover for those off sick,’ it added.

Meanwhile, chronic nursing shortages are compromising ‘the safety and quality of care that patients receive’, it noted. It pointed to the latest NHS Digital statistics from June 2021 showing there are 38,952 full-time-equivalent registered nurse vacancies in England.

There have been consistent decreases in the number of NHS district nurses (-44%), school nurses (-30.6%), learning disability nurses (-44%), mental health nurses (-6.1%), and health visitors (-22.4%) between September 2009 (when workforce reporting began) and July 2021, it added.

The number of registered nurses working in social care has also declined. Just in the past year (between 2019/2020 and 2020/2021), there was a decrease of 1,800 jobs – a 5% reduction.

These form part of the 10 ‘key indicators’ identified by the RCN which it says reveals the ‘enormous’ and ‘unsustainable’ pressures on the healthcare system in England. They also include:

  • High Covid-19 rates, with the UK experiencing the highest total number of cases of Covid-19 in Europe (9,448,402 as of 11 November 2021);
  • Record emergency waiting times, including ‘corridor care’ where patients spend time on trolleys in hospital corridors before being admitted to a bed;
  • A high NHS bed occupancy rate, climbing above the safe limit of 85% in two in five trusts between April and June 2021;
  • The care backlog, meaning the number of people waiting to start elective treatment rose to 5.8 million people in September.

Patricia Marquis, RCN director for England, said: ‘Speak to any nurse and they will tell you just how concerned they are for their patients as well as their colleagues.

‘They have known for a long time just how the pressures have been growing and they can see the risk to patient care every single day in every part of health and care. This was coming long before the pandemic and is a direct consequence of a long-term failure to invest in the nursing workforce.’