‘More realistic framework’ needed for delivering person-centred care

Nurses have outlined the need for a ‘more realistic framework’ for delivering person-centred care following concerns around ‘overwhelming’ workloads and unsafe staffing.

At this year’s annual Royal College of Nursing (RCN) Congress in Liverpool, registered nurse Alastair Taylor led a debate focused on concerns around current care structures and the need for ‘professional boundaries and conditions’ to be outlined for nurses, in order deliver safe patient care.

The debate saw nurses vote to lobby the RCN’s governing council to develop a UK-wide framework for realistic person‑centred care, ensuring that nursing practice is ‘safe and ethical’.

‘Current care structures lead to moral distress’

Health and social care services are ‘under pressure’ across the UK and nurses are often ‘left carrying the frustration, the complaints, [and] the blame for system-level failure’, said Mr Taylor.

He stated that current care structures were outdated, leading to ‘inefficiencies and moral distress’.

The Cheshire branch member said: ‘Can we keep promising a model of care that no longer exists in reality? Because when expectations remain high and capacity continues to fall, it is not policymakers and regulators who absorb these consequences.

‘We are being asked to deliver 21st‑century care through structures designed for a very different NHS.

‘The result is inefficiency, moral distress, and care pathways that are increasingly difficult to deliver safely.’

Mr Taylor added: ‘We are not asking the RCN to redefine person‑centred care. We are asking the RCN to strongly define professional boundaries and conditions required to truly deliver it safely.’

‘Nurses’ tanks are empty’

Vicky Keir, a nurse from Dumfries and Galloway who seconded Mr Taylor’s proposal, added that nurses’ ‘tanks are empty’ due to rising demands and pressures.

She said: ‘One thing that patients, services, and families often say is “nurses couldn’t have done more for me”.

‘However, the meaning has changed… now I fear that the same statement means something entirely different – something like nurses, despite their best efforts, have nothing left to give. Our tanks are empty.

‘We are having to settle for less than the gold standard of care our patients deserve.’

Florentina Tutuianu, a registered nurse from Sandwell and West Birmingham Trust, added: ‘Many nurses are tired [of hearing] the words “person‑centred care” while working in the conditions that make that care almost impossible to be delivered.

‘Safe and ethical nursing cannot exist in environments where staff are constantly stretched beyond safe limits.

‘Workloads become overwhelming. Nurses can start to feel they are just like a robot… this creates moral distress because nurses know what good care looks like, but too often we are forced to choose between what is ideal and what is possible.’

‘The system demands speed’

Registered nurse Bibi Croft, from the East Kent RCN branch, said nurses ‘must treat people as individuals and uphold their dignity’ but warned this was difficult as the current framework ‘demands speed’.

She told the congress: ‘Across the UK, nurses walk into their place of work… and they are faced with an impossible feeling.

‘The system demands speed, tick‑boxes and protocols. Yet there is somebody at the end of the bed looking at us, looking for our passion.

‘They want to be heard, they want to be seen – nursing exists to lead the profession, not merely to respond to crisis.’

‘Person-centred care is not a slogan’

Adenike Olakunle, a clinical nurse educator from Northumberland, Tyne and Wear, added: ‘Person‑centred care is not a slogan that we can just print on the wall or on the board. It’s actually seeing patients for who they are.

‘Let us be honest, you can’t deliver that patient‑centred care in five minutes, and every nurse is so stretched that they can’t spend a reasonable amount of time with the person they are caring for.’

The proposal for RCN Council to develop a UK-wide framework for realistic person‑centred care was approved by voting nursing members.