Friday, 19 April 2013


UNISON, the UK’s largest health union, is challenging the Government over its refusal to implement what is potentially the most effective recommendation in the Francis report – the introduction of minimum staff to patient ratios.  This life-saving initiative would dramatically change life on the wards for patients and staff, providing a safer, more caring environment for all.

The call is backed by a new survey* from the union of more than 1500 nurses, midwives and healthcare assistants which showed that 45% of respondents were looking after 8 or more patients on their shift. Research shows that looking after this number increases the risk of patient harm.   The survey, taken on a typical day in the life of the NHS - 5 March, reveals staff under severe strain, reflected in one chilling comment from a nurse: “my ward will end up killing someone. That’s how bad it is and how unsafe”.

In the most damning indictment of the state of the health service under this Coalition Government, almost 20% of respondents described care failings in their organisations as being on a par with the Mid Staffordshire Foundation Trust.

Christina McAnea, UNISON Head of Health, said:

“This survey exposes a health service under severe strain, where nurses are struggling to deliver the high levels of care that they set themselves on a daily basis.  On this typical day many staff worked through their break and stayed after their shift – but this still did not give them enough time to complete all their tasks.

“The hidden voice in the survey must surely be that of the patient who is not getting the level of care they are entitled to expect.

“The Government cannot escape its responsibilities to the NHS by pointing the finger at staff or managers.  Trusts are not being given the finance they need to deliver a growing and complex health service that demands highly expensive equipment, high-tech treatment and costly drugs.

“Government cuts are making matters worse by reducing staff, including nurses, at a time when patient demand is growing.  Introducing minimum nurse to patient ratios would provide a safety net of care, restore public confidence and show nursing staff they are respected and valued.”

The survey revealed a number of key concerns about life on the wards in hospitals across the country on 5 March 2013:

·              Almost two thirds of staff said they did not have enough time with each patient.

I felt patients were neglected and always feel like this lately.”
·              Nearly 60% said they did not have enough time to deliver safe, dignified and compassionate patient care.

“Staff on the ward are stressed and getting emotional over the lack of care we are providing and no support is offered.”
·              Time constraints were blamed for patients not receiving the care that respondents felt should have been delivered, including - reassuring patients’ fears, explaining treatments and diagnosis.  Others cited missing out on taking patients to the toilet, giving food or drink, helping patients move and writing up full and accurate records. Saddest of all was not having enough time to spend with dying patients.

·              Over 85% of respondents support set minimum nurse-to-patient ratios.

“Every shift I think my registration is on the line.”
·              More than half (55.7%) worked overtime and three out of 5 skipped breaks.

“I am fed up working every shift without a break, not even time to go to the toilet.”
·              85.4% said that there should be set national minimum nurse to patient ratios.

“We really did struggle.”  “Staff were stressed out due to both a lack of staff and trying to arrange to take over from a member of staff in A&E.”
UNISON is part of the Safe Staffing Alliance, and supports the Francis recommendation for a minimum ratio of staff to patients. There is growing evidence that where these are set and enforced, patient outcomes are better and, more importantly, safer.

UNISON is calling for the National Institute for Clinical Excellence to begin working with other organisations, including patient bodies, to identify a UK model of nurse-to-patient ratios in all healthcare settings.   

Thursday, 18 April 2013

Involve staff in health and social care integration or watch reform fail

UNISON yesterday warned that changes to services for the most vulnerable people must do more to involve staff or watch reform fail.
The public services union also said that Scottish Government plans to integrate health and social care services must maintain democratic accountability.
Speaking at the Scottish Trades Union Congress Annual Congress in Perth, UNISON Scotland Convener Lilian Macer listed four key principles for the STUC General Council to take to the Scottish Government:
Any attempts to open up the NHS to privatisation must be stopped; quality services, not cost-cutting must be a principle of integration; service users and staff must be at the centre of decision making; and democratic control is fundamental.
Lilian warned: "Real change comes when staff and service users work together planning how services should be delivered.
"All evidence shows that top down reorganisation won’t produce real integration. The focus must be on joint outcomes –agreed with local partners and relevant to their local circumstances.
"The proposals must have at their core the desire to improve services, not cut costs."
And she blasted proposals for the new Community Health and Social Care Partnerships, to be run by a single individual – the Jointly Accountable Officer, responsible for a multi million pound budget of public money.
Lilian said: "Technically accountable to both the local authority and the health board the so-called jointly accountable officer will in reality be accountable to no one."
UNISON has urged the Scottish Government to set in place a broad staffing framework, based on best practice, to cover a range of issues when public services are reformed.
These include: staff transfer, pensions, secondment, training and development, equality duties, governance and procurement – covering the protections that should prevent setting up a two tier workforce when services are contracted out.

UNISON’s submission to the Scottish Government consultation on the integration of adult health and social care in Scotland is at