Mental health nurses in short supply as NHS struggles to fill vacancies

Community-based teams care for 97% of mental health patients. And nurses play a pivotal role, building up trust between patients and their families.

However, since 2010 the total number of NHS mental health nurses in England has dropped by 15% – in parts of London, about 20% of job vacancies are unfilled. Helen Gilburt, a fellow in health policy at thinktank the King’s Fund, says: “Community mental health teams are supporting people to stay well, so if you haven’t got sufficient workforce to deliver that care, people are more likely to relapse.”

The nursing shortage is caused partly by an ageing workforce that is not being replaced quickly enough. In 2013, more than 32% of mental health nurses were aged over 50, and the abolition of bursaries for student nurses may also have had an adverse effect on the number of new recruits.

As a result, individual nurses are taking on a higher caseload. Research last year found that some community mental healthcare coordinators – not all of whom are nurses – have caseloads as high as 50 patients.

Ben Hannigan, reader in mental health, learning disabilities and psychosocial care at Cardiff University, who co-authored the study, says: “You will firefight with that number of people – it’s very difficult to do all the things you would aspire to.” Therapeutic care, aimed at helping people to recover, will be harder to provide, he says.

The shortage is affecting the whole service; a 2015 report by the Care Quality Commission revealed that only 14% of mental health patients said they received appropriate care in a crisis. And a review of psychiatric care by the Commission on Acute Adult Psychiatric Care found that 16% of patients per ward could have been treated in an alternate setting, including crisis houses and rehab services, if they had been available.

Trusts are struggling to deal with the shortages. Many, says Neil Brimblecombe, director of nursing at South London and Maudsley NHS foundation trust, are employing agency nurses, meaning that patients “have less opportunity to develop long-term relationships with individual nursing staff”.

Instead of “chasing an increasingly diminishing pool of nurses”, Brimblecombe believes trusts should take a different approach to workforce design. His own trust has joined two neighbouring trusts to develop a new assistant practitioner role to take on some of the work traditionally carried out by registered nurses.

In the long term, Brimblecombe believes the community mental health workforce should include more peer workers with “lived experiences of mental health problems” and more occupational therapists: “There will be an increasing range of new roles. The days when we have doctors, nurses and social workers, and that’s it, have gone.”

Mental health nurses in short supply as NHS struggles to fill vacancies

NHS to fast-track nurses as record EU staff leave service after Brexit vote

NHS England is to launch a new nursing training programme to help plug the gap created by the record number of Europeans leaving the service in the wake of Britain’s vote to leave the European Union.

Simon Stevens, the chief executive of NHS England, acknowledged that the service relies on international staff, including more than 12,000 nurses who are EU nationals out of the 315,000 nurses on its payroll.

Speaking on the BBC Radio 4’s Today programme before the launch of a five-year plan for the NHS, he announced a training programme to “grow the workforce from within this country”.

The moves comes after new figures revealed that a record 17,197 EU nationals, including doctors and nurses, left the NHS last year.

Asked if he was worried about the impact of Brexit, Stevens said: “The NHS has always relied on international staff as well as staff from this country. It is about 4% of our nurses who come from the rest of the European Union. We are grateful for the work that they do.”

But he suggested newly trained British nurses could help fill the gap left by EU nationals once Britain leaves the bloc.

Stevens said: “We have got a curious situation where many more people in this country would like to train to be nurses than we have nurse training places. So we want to expand the number of nurse training places and the routes into nursing so that we can grow the work force from within this country as well.”

He said the new training programme would be modelled on an initiative to recruit more teachers.

“We are announcing a new programme called Nurse First, which is the equivalent of the Teach First programme, whereby new graduates can fast-track into nursing alongside other apprenticeship routes … so that we can expand the number of nurses we have.”

The programme will boost the number of newly qualified nurses by up to 2,200 more a year in 2019 when the UK is due to leave the EU.

In a wide-ranging interview, Stevens denied he was abandoning the 18-week waiting time target for non-urgent operations by relaxing the deadline for hospitals to meet the deadline.

He said: “Fifteen years ago you might be waiting 18 months for your hip or your knee operation, now for nine out of 10 people it’s 18 weeks. The average wait for an operation is 10 weeks. Over the next couple of years we want to have more funded operations on the NHS, but we recognise that the rate of growth is probably going to have to be a little bit slower than it has at points in the past, because we also want to make big improvements in cancer care, in GP services and in mental health services as well.”

The Royal College of Surgeons said the new guidelines amounted to “waving the white flag on the 18-week target”.

Asked if the target had been jettisoned, Stevens said: “It hasn’t. The reality is that there are pressures right across the health service. Under those circumstances we have to make a start on sorting out particularly those pressures in A&E departments which we have seen over the course of the last winter. But over the course of the next several years we want to continue to expand the amount of surgery that is being done, so that waiting times stay low.”

He also announced that all major A&E hospital departments will have to provide GP services to help emergency medics focus on the sickest patients. Steven said: “You can find about 60 hospitals right now that have got this arrangement. This is going to be rolled out to all major A&Es.”

Stevens confirmed that the NHS wanted to stamp out an estimated £4m spent on homeopathic medicine. He dismissed homeopathy as a “placebo at best” and said it was a “classic example of what we want to see less of”.

NHS to fast-track nurses as record EU staff leave service after Brexit vote

EU nurses no longer want to work in Britain. Brexit is poisoning the NHS | Suzanne Moore

How will Brexit impact the NHS? It already has. Nurses from the EU are much less keen to come and work here. Today the Times reported that in the last four months of 2015, an average of 797 EU nurses per month signed up to work in the UK; over the same period last year, that number fell to 194 a month. We currently have a huge shortage of nurses, with 24,000 jobs unfilled in England alone.

You can see this shortfall any time you go into a hospital. There is pressure on beds, on doctors and on nurses. Often there just aren’t enough of them, and they are overstretched. Some A&E departments that used to have 20 nurses are now down to half that number, and staff feel at breaking point. The five Cs that nurses are taught in their training – commitment, conscience, competence, compassion and confidence – are impossible to practise properly in the circumstances many are working in.

There have long been warnings of these shortages but a complete lack of long-term planning, now combined with Brexit, is bringing the situation to a head. We have an ageing population with complex needs. One in three nurses is set to retire in the next decade. The introduction of loans instead of bursaries for training means a 23% drop in applications for nursing and midwifery. Anyone could have predicted that taking away bursaries would prompt this result. No one goes into nursing for the money, so why did George Osborne decide to make it even harder? Why, when we need more nurses, are we not reinvesting in training?

This shortage had been plugged by about 7% of our nurses coming from the EU. If we fail to train nurses that’s how it has to be. This is where so much Brexit rhetoric falls apart. While Theresa May talks tough, refusing to guarantee EU nationals a right to stay, these nurses feel neither wanted nor welcome and will understandably go elsewhere. As Janet Davies, chief executive and general secretary of the Royal College of Nursing, has said: “The government is turning off the supply of qualified nurses from around the world at the very moment the health service is in a staffing crisis like never before.”

When in hospital we are at our most dependent. There may be those who complain about immigration but most people have experience of being cared for by someone who has come here to work. Our NHS could not function otherwise. Is May going to further exacerbate the nursing shortage by making the UK so hostile and unwelcoming to EU nurses they will go elsewhere? Well, this is already happening; people won’t take jobs here in such uncertain times. Yet we continue not to train enough nurses and have made it more financially difficult for them. Where is the joined-up thinking on this? The toxic discourse about “foreigners” stealing jobs may not have been intended for the nurse who washes you after your operation, but that’s how it pans out. We can choose to make people feel welcome or not, but it turns out we need them more than they need us.

EU nurses no longer want to work in Britain. Brexit is poisoning the NHS | Suzanne Moore

Record numbers of EU nurses quit NHS

The number of EU nationals registering as nurses in England has dropped by 92% since the Brexit referendum in June, and a record number are quitting the NHS, it can be revealed.

The shock figures have prompted warnings that Theresa May’s failure to offer assurances to foreigners living in the UK is exacerbating a staffing crisis in the health service.

Only 96 nurses joined the NHS from other European nations in December 2016 – a drop from 1,304 in July, the month after the referendum.

At the same time, freedom of information responses compiled by the Liberal Democrats from 80 of the 136 NHS acute trusts in England show that 2,700 EU nurses left the health service in 2016, compared to 1,600 EU nurses in 2014 – a 68% increase.

The haemorrhaging of foreign staff is being blamed by the Royal College of Nursing (RCN) on the failure of the government to provide EU nationals in the UK with any security about their future. May has claimed that Britain cannot act unilaterally to guarantee residency as it would weaken her hand in the coming article 50 negotiations over Brexit.

Janet Davies, chief executive and general secretary of the RCN, said the government’s tactic was backfiring, and now threatened the sustainability of the health service.

“The government risks turning off the supply of qualified nurses from around the world at the very moment the health service is in a staffing crisis like never before,” she said. “As she pulls the trigger to begin negotiations, the prime minister must tell EU nurses and those in other occupations that they are needed and welcome in the NHS. Sadly, it is no surprise that EU staff are leaving – they have been offered no security or reassurance that they will be able to keep their jobs. Few are able to live with such uncertainty.

“The government has failed to train enough British nurses and cannot afford to lose the international workforce on which the NHS so heavily relies.”

There are an estimated 57,000 EU nationals working for the NHS, including 10,000 doctors and 20,000 nurses. On Saturday the Liberal Democrats passed a motion at their spring conference in York calling for a guaranteed right to live and work in the UK for all EU citizens working in the NHS and care services.

The former Lib Dem health minister Norman Lamb said that the government’s attitude to EU nationals in the UK was “deeply damaging”, and that the creation of a so-called “NHS passport” could be a vital step. “These shocking figures show you can’t have a strong NHS and a hard Brexit,” he said. “The government’s refusal to guarantee that nurses from the EU can stay here is not only morally unjustifiable, it is deeply damaging for the NHS.

“Theresa May must urgently give EU nationals the certainty they need before we see an even bigger exodus of nurses on whom our health service relies.”

Joan Pons Laplana, a Spanish national and a senior nurse at the James Paget Hospital in Great Yarmouth, who came to the UK 17 years ago, told the Observer that he had personally witnessed the collapse in morale of foreign nurses.

“Since Brexit, I feel like a second-class citizen,” he said. “My son asked me if I was going to be forced back to Spain and my daughter doesn’t want to visit her grandparents because she fears I will not be able to come back.

“The UK is no longer the first choice for EU nurses. The uncertain future means many they are starting to leave. We are people with feelings, not a commodity at the Brexit table.”

The NHS is already under pressure because of a long-term failure to hire enough people. Applications for nursing courses plummeted by almost a quarter in a year after the government axed bursaries for trainees in 2016. Numbers fell by 9,990 to 33,810 in 12 months, according to figures released in February by the university admissions service Ucas. Meanwhile, one in three nurses is due to retire in the next 10 years and there are 24,000 nurse jobs unfilled, RCN figures show.

The Department of Health said: “While the stock of nurses is broadly stable, some of the changes described are owing to the introduction of more rigorous language testing. The secretary of state has repeatedly said that overseas workers form a crucial part of our NHS and that we value their contribution immensely.

“We continue to invest in the frontline, with 13,400 more nurses on our wards since May 2010 and over 52,000 nurses in training.”

MPs vote to reject Lords amendments to Brexit bill

Record numbers of EU nurses quit NHS

Talk about death, be kind and trust your instincts: tips for new nurses

Don’t be afraid to question senior doctors

Never be scared to question a doctor, however senior they may be. We are our patients’ advocates and can protect them from potential mistakes. A good doctor will respect you for this. If you feel something isn’t right but are not confident enough to challenge a situation yourself, go to someone you know, trust and respect – watch how they deal with it and learn.
Emma McLellan, staff nurse in the ICU, Manchester

Learn to trust your gut instinct

I believe good nurses are really tuned into their gut instinct and new nurses should learn to trust it. A nurse’s gut instinct is their deeply grounded knowledge base developed in practice, their critical awareness and what they have learned from previous situations plus an overall sense of knowing the patient well. You’ll just know something doesn’t add up, or you may convinced there’s something more going on, so make sure you go that extra mile to cover all bases. Maybe, for example, all of a patient’s baseline observations are normal, but you just sense that there is still that underlying thing you can’t put your finger on – monitor them really closely because you’ll often be right.
Zoë Hartwright, community mental health nurse, Shropshire

Death is a part of nursing – talk about it with patients

Death is a regular part of nursing. Patients need someone to talk frankly about death. We plan births for nine months, but talking about death always seems awkward and hard. One of the best things you can do for a patient who is nearing the end of their life is to give them opportunities to talk about their death and how they would like it to be. Being able to give advice and support to help them get their affairs in order can relieve a lot of their pain and worry. It is possible to have a good death but the conversations have to be had.

When death is unexpected this is very hard to deal with. I worked in an accident and emergency department for 10 years and learned that life and death is unpredictable. I have seen many patients and nurses struggle with the last words that they said to that person, so I try to adopt the approach of being kind. Really think about what you say during emergency situations – it is likely that patient can hear you right to the end – even if the rest of their body is not responding. Use their name, talk calmly to them, explain everything you do as you are doing it. Speak to them as if they are awake.
Christine Bushnell, advanced nurse practitioner, nurse partner in a GP surgery and trainer, Harrow

Don’t treat patients you don’t like differently

It’s OK not to like some patients. That’s bound to happen, and some patients really won’t be very likeable. Just be aware of yourself; notice that you don’t like the patient and make sure you’re not treating them any differently. Maybe confide in a trustworthy colleague and ask them to let you know if you are behaving differently towards that patient. And draw on other people, often you find that another colleague works well with a patient you just can’t seem to get along with; make the most of that by getting them to tell you the good qualities of the patient, or even letting them take the lead.
Elizabeth Cook, clinical charge nurse, south London

Be kind to patients’ relatives

It’s very hard not to take it personally when relatives are difficult with you. As a nurse in paediatrics, I found it tough at first as a newly qualified nurse without any children of my own. Now that I am older and I have my own children, it is different. When dealing with emotional or difficult relatives, try to put yourself in their position and understand that they do not have anything against you – they are just desperately worried about their child, for example, and you may be the nearest person to them and so they might take it out on you. It is important to listen without judging and, if treated with hostility, try to respond with kindness. Speak to your manager if certain behaviour from a family member is bothering you, but ultimately try to be understanding.

Don’t say, “I know how you feel” when you have never been in that situation. Instead you can say something like: “I can’t begin to imagine how worried you must be, but we are doing everything we can, if you have any questions please ask and if I can’t answer them I will find someone who can, etc”.
Sally al-Habshi, paediatric emergency nurse, Leicester

Be nice to healthcare assistants

Always be nice to healthcare assistants, they’re amazing. Make lists of jobs you need to do – a good list helps everything. And always remember that when you’re having a bad day, your shift will come to an end and you can go home and eat pizza.
Laura Thompson, ward manager, London

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Talk about death, be kind and trust your instincts: tips for new nurses

"Lots of nurses have already left": EU workers head for exit

Since news of the UK’s looming departure from the European Union hit, lots of industries have spoken out about fears of losing European workers. On Monday academics from Oxford University said staff would go if they were not reassured about their future. It comes amid news that EU citizens working in the NHS are thinking of leaving in the next five years.

We asked you about how the loss of European workers may affect, or is already affecting, your sector. We heard from a variety of people, including professors and doctors, who expressed concern that workers are already leaving. Here are a selection of your stories.

Construction worker

John, 51: The unwelcome atmosphere is turning people away from construction

I am an Irish national who has lived and worked in London for nearly 30 years. I’ve made my life and family here. I’ve added to the community and to the industry. Throughout the UK, there is a lack of adequate training or interest from many in joining the construction industry. There has always been a strong interest from migrant communities. In my experience, the unwelcome atmosphere is turning people away and we do not train or encourage people into this industry. We need migrant workers.

Photograph: Martin Dalton/REX/Shutterstock

Financial consultant

Andy, 39: We had a large number of Europeans working here but now they are nearly all gone

I work for a medium-sized financial provider who deals with a very diverse client base from around Europe. I am an EU citizen myself, but I am still in the UK. At work we had a large number of Europeans working in our customer support and sales teams but now they are nearly all gone (they have either progressed somewhere else in London or have left the country). We have now two non-Europeans who both can speak French in customer support. Only one guy in the sales department speaks German. He now does everything for the German client base. If he is sick or on holiday we have no German front office. We have no more Spanish or Italian speakers. The sad part is that overall we have actually increased the number of EU employees, just not in the UK. Around 40-50% of the overall workforce has left as we moved technical departments and finance functions (even director positions) abroad to keep access to our European markets. Most of those who lost their jobs were English. And with every job that moves abroad the London office loses relevance.

The doctor

May, 43: I predict many doctors will leave, especially those now in training

EU nationals working in the NHS express significant concerns regarding their right to stay and their careers. London used to be a world-open and liberal place, welcoming and supportive. Working in the NHS was stimulating and exciting. The outlook for the future is bleak. And there is zero reassuring communication from the UK government. I predict many doctors – especially in training – will leave. I have worked for the NHS 16 years. I have personally spoken to many doctors and midwives who are strongly considering leaving. I know of people who did not renew research contracts but I have not met anyone who has left already.

European people working for the NHS feel utterly disappointed and disillusioned.

May

The team spirit in the NHS was and is stimulating. However, it is mainly created by the multinational teams that have in common a love and dedication to their specialty and medicine in general. British people hugely benefited. With the Brexit vote it feels that this effort, hard work and dedication is completely unappreciated and ignored. It is no surprise European and non-European people working for the NHS feel utterly disappointed and disillusioned. They will go where their work is appreciated.

Photograph: Peter Byrne/PA

The entrepreneur

Gerard, 31: I plan to shut down operations in London for Berlin. I don’t want to deal with Brexit

I work for an internet startup across London and Berlin. I see both cities competing already for tech talent. London will definitely lose that battle long-term. I haven’t left yet, but I plan to shut down operations in the UK when article 50 is triggered. I’m lucky enough to have clients in Europe or unlucky enough to have them there – whatever the case I don’t want to deal with Brexit.

Since then I’ve been taking fewer UK clients knowing I will leave. I just feel sadly unwelcome now.

Gerard

I loved London and I will always remember refreshing the Guardian website while counting the referendum results. It was like everything I was building fell apart. Since then I’ve been taking [fewer] UK clients knowing I will leave. I just feel sadly unwelcome now.

The professor

Simon, 51: I am moving to another EU country to take up another university post

I work in the university sector and the lifeblood of our work is provided by academics and researchers from all over the world, particularly from the EU. In addition, many of our students come to the university to study from abroad. The European Union’s framework funding programmes including Horizon 2020 have been key to ensuring that the UK punches well above its weight in research and development. The loss of EU workers and access to the networks provided by the EU will have a devastating effect on the UK higher education sector.

I am a UK national who has decided to leave. I am moving to another EU country to take up another university post. Although Brexit was not the only reason for this move (the new role will be an advancement in my career), it was a decisive factor in making me apply for the job given the future uncertainties in the UK higher education sector.

The nurse

Karen, 40: Five nurses have left already

Before [the] Brexit [vote] we used to have hundreds of applicants in nursing. Now we hardly see 50. All staff are tired and worried about what will come next. In my department 60% of nurses are EU citizens and already five of them have handed in their notice. I am an EU citizen myself and I’m already making plans to leave UK for good. The healthcare sector will collapse and I don’t want to be part of it.

Web designer

Ben, 25: A European worker recently left. It was a big loss for the team

I work in web design and development. We’ve benefited greatly from the expertise of EU workers in our team. But now one of our main designers, responsible for delivering engaging websites, print media, presentations etc for clients has left. Her husband is in research of some sort (I’m not sure exactly what it is) and his funding was moved out of the UK. Given that she wasn’t feeling welcome in the UK any more, it was a no-brainer for them to simply move. It is a big loss for the team.

• Some names have been changed

"Lots of nurses have already left": EU workers head for exit

New recruiting drive for more nurses – 3 March archive, 1970

The Government is today launching a major recruiting drive for nurses, to combat what is now officially recognised as a grave national shortage.

At the same time, an independent committee is being set up to look at the future role and training of the nurse, so that her scarce skills can be used to best advantage.

Mr Crossman’s announcement of these plans in the Commons yesterday came a fortnight after nurses had won pay increases of up to 20 per cent but, as he said, wages are not the only problem.

He has already tackled regional hospital boards on two more of the outstanding grievances: they are being asked to ensure that their senior nursing staff have a clear part in management, and told that it is essential for nurses to be relieved of the domestic chores which now take up so much of their time.

Boards have also been firmly told that although there is to be no extra money, they must not use lack of funds as an excuse for not recruiting. Cutting down on nursing staff, Mr Crossman said earlier yesterday, was not an economy that the National Health Service could afford.

The recruiting campaign, whatever Mr Crossman’s plans for improving the nurses’ conditions, still relies heavily on the traditional vocational pull: “You’re someone special when you’re a nurse,” the advertisements will say, but at least they can add: “And now you’ll be better off too!”

The campaign will cost £250,000 over the next year and the Department is not sure what it is aiming at. It has set no target for its recruitment because it actually has no figures on the gap between need and the present situation and therefore assumes that recruitment can be unlimited.

The last time the Department spent a lot of money on this sort of programme, it had something like 200,000 inquiries but has no idea how many of these turned into signed contracts. This campaign will at least have a follow-up element.

The shortage of nurses at least is incontestable in many parts of the country. Even London teaching hospitals now have to rely heavily on agencies to get staff, and intake has been dropping. The national wastage from training schemes is around 35 per cent of all who start a course.

Cheap labour
The chaos of the present system of treating young nurses as an uneasy cross between student, apprentice, and cheap labour is one of the problems that the new committee will be looking at.

It will be chaired by Professor Asa Briggs, Vice-Chancellor of Sussex University and a historian. He said yesterday that he hoped the inquiry would take about 18 months, and he was anxious to tap current feelings among nurses rather than rely on published reports.

He wants to look at the education of nurses in relation to the whole development of educational patterns, as well as trying to rationalise manpower for a future where hospital and community work will be much more closely linked.

New recruiting drive for more nurses – 3 March archive, 1970

Why are there so few male nurses?

Efforts to promote gender equality in workplaces of all kinds may be widespread, but the number of men in nursing remains stubbornly low. Last year just 11.4% of registered nurses in the UK were male, according to figures from the Nursing & Midwifery Council – only a marginal increase from five years earlier, when they made up 11% of the workforce.

And the proportion of nursing students in the UK who are men hasn’t shifted either, according to the Higher Education Statistics Agency: in 2016 it stood at 11.6%, compared with 11.5% a decade earlier.

“It’s disappointing,” says Janet Davies, chief executive of the Royal College of Nursing, “because we’ve promoted nursing for men. I think it’s good to match the balance in the communities we’re working for. And also we don’t want to lose those people who would make fantastic nurses.”

She believes continued stereotyping about what a nurse looks like is partly to blame – despite the presence of male nurse characters in TV dramas. “When people think of a nurse perhaps they do think of a woman. Some of the details don’t help – the term matron is weird – but it’s about the job, and in my experience men take it in their stride and work with it.”

Davies questions whether it is the work itself that doesn’t attract men, or whether other factors are to blame: “Is it something about people being conditioned at school? Is it suggested by careers officers? It isn’t the best paid job in the world and I think people do look at salary and feel perhaps they want more than that.” And yet once men are working as nurses, Davies says, the role is accepted by the vast majority of people. “I don’t think anybody bats an eyelid anymore,” she says.

At Queen’s University Belfast, a campaign to increase the number of male nursing students that includes targeting all-boys schools – which are more common in Northern Ireland – has prompted a rise from 6% three years ago to 10% today.

Prof Donna Fitzsimons, head of the university’s school of nursing and midwifery, says: “Nursing is all about the empathy and caring that people show, but those traits are not exclusively female and it’s very important for patients that we have diversity on all levels.”

Paediatrics is one field where that’s especially apparent, Fitzsimons says. “Boys, in particular, can find it hard to relate to women at times. Sometimes a male nurse can really bring out a side of a child that helps to lift their mood and allows them to feel more comfortable in a hospital setting.”

The department now tests nurse applicants in five-minute simulated clinical scenarios, as well as interviewing them. “Men seem to have benefited from that exercise,” says Fitzsimons. “Men might find it harder to put into words their caring and compassionate qualities, but can demonstrate them more easily.”

Davies believes that strong role models and encouraging school-age children to think about nursing as a career are key. “It really is a superb job,” she says, “and men are fabulous nurses.”

‘It’s now more recognised that men can do the job in the same way fathers can parent’

I made my mind up that I wanted to be a nurse when I was 14 or 15. My mum’s a care assistant so, subconsciously, that influenced me quite a bit. I did work experience in a school for children with learning disabilities, where a lot of the pupils had epilepsy, and that inspired me too. I knew I wanted to be in a caring profession.

I received a little bit of teasing from my friends, but no one ever questioned why I was doing it. And once I started my training they became more and more interested. That’s always been the case.

I’ve been a nurse most of my working life, so being outnumbered by female colleagues is what I’m used to; I don’t really notice it. Earlier in my career I had a few comments where patients seemed to have expected that the nurse caring for them was going to be a woman, but men were already becoming more commonplace in the profession when I qualified.

Now I’m in a more senior role, patients occasionally assume I’m a doctor if I’m addressing a complaint or helping them with an issue. I correct them, but I don’t challenge them as to why they think that – it wouldn’t be very useful for the caring relationship. And it doesn’t bother me. Occasionally a female patient has preferred to have a female nurse look after her care needs and that’s understandable, especially with elderly patients.

When I was a ward manager, or sister, I did get some people saying: “Shouldn’t you be a brother?” But, actually, no one has ever commented on the fact that I’m a matron and a man. I’ve worked on shifts where it’s been predominantly male nurses, and a lot of the wards I’ve worked on have had a good balance of men and women. It’s now more recognised that men can do the job, in the same way that fathers are getting more involved looking after children.

Once you see a nurse in action giving you excellent care – that’s when the gender disappears.

Dan Wicks, 38, cardiology matron at Guy’s and St Thomas’ NHS foundation trust

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Why are there so few male nurses?

Brexit could make NHS shortage of nurses worse, says report

Brexit is set to cause a severe shortage of nurses in the NHS, which is already facing a chronic lack of them in many hospitals, research suggests.

Britain’s decision to leave the EU could deprive the health service of nurses from countries such as Spain, Portugal and Ireland, from which it has recruited heavily in recent years, analysis by the Institute for Employment Studies found.

A growing reluctance among EU nurses to come to work in the NHS could pose serious difficulties for hospitals, some of which get as many as 20% of their nurses from the European Economic Area.

The potential of EU nurses could also prove problematic because it would coincide with a spike in demand for care caused by a growing number of over-85-year-olds in the population, putting even greater strain on the NHS, according to the IES.

“The current and projected shortage of nurses has left the NHS nursing workforce in England particularly vulnerable to any disruption to its recruitment pipelines, both from the EEA and outside of it,” says the study, which was led by Dr Rachel Marangozov.

“Whatever form Brexit eventually takes, it could well lead to a reduced supply of labour from the EU. Given the current uncertainty around the status of EU workers, many EU nurses may voluntarily choose not to take up positions in the UK, while those already working here could make plans to return home if they feel unwelcome or no longer see a future in the UK.”

Non-UK EU nurses make up almost 5% of the total NHS nursing workforce in England. Hospitals in London, the Thames Valley and east of England will be hardest hit by EU nurses no longer coming to Britain because they rely so heavily on them, the IES says.

For example, 20.3% of nurses at the Royal Brompton and Harefield specialist heart and lung trust in London are from the EU, as are 18.4% of nurses at Queen Elizabeth Hospital in King’s Lynn in Norfolk and 15.4% at Papworth, another heart and lung centre of excellence, in Cambridgeshire.

Jeremy Hunt, the health secretary, and NHS leaders have voiced deep unease about Brexit potentially exacerbating the existing big gaps across the health and social care workforce and have praised EU nationals’ contribution to the NHS in an effort to persuade them to stay.

The Royal College of Nursing said the findings showed that problems in nurse recruitment could reach “catastrophic proportions”. It said the NHS was facing a perfect storm of an ageing population and growing need for healthcare coinciding with Brexit and fewer nurses being trained at British universities in the wake of the government deciding to axe bursaries for student nurses.

Applications to study nursing are down 20% for next year. “Coupled with the effects of Brexit, this may become a double whammy for the nursing profession which could make NHS services nigh-on impossible to sustain,” said Stephanie Aiken, the RCN’s deputy director of nursing.

“Patients can be put at risk when there are too few staff,” she added. She called the big drop in nursing degree applications “a very worrying situation that could cause the staffing crisis to deteriorate pat the point of no return”.

A spokeswoman for the Department of Health said: “As the health secretary has repeatedly made clear, overseas workers form a crucial part of our dedicated nursing workforce. They are a crucial part of delivering safe staffing in hospitals, and we want to see their outstanding work continue as we meet the needs of a changing population.”

She said there were plans to train more homegrown nurses, with 51,000 nurses currently in training, to help deliver the government’s promised “truly seven-day NHS” by 2020.

Brexit could make NHS shortage of nurses worse, says report

McGrath Foundation breast care nurses to get $20.5m in new funding

The Turnbull government has announced $ 20.5m in new funding for the McGrath Foundation’s breast care nurses.

The four-year commitment will pay for up to 57 nurse positions in roughly 55 locations across the country, mostly in regional and rural areas. It will provide the funding from 2017-18.

The prime minister, Malcolm Turnbull, and the minister for health, Sussan Ley, announced the decision on Friday.

It came a day after they handed $ 20m in funding to the Zero Childhood Cancer program at the Children’s Cancer Institute at Sydney children’s hospital.

Breast cancer is estimated to be the third most commonly diagnosed cancer and the most common cancer for Australian women. It affects one in eight Australian women before the age of 85.

The McGrath Foundation’s breast care nurses provide physical, psychological and emotional support to people diagnosed with breast cancer, their families and carers.

More than 80% of the commonwealth-funded McGrath nurses are employed in rural and regional Australia.

The Turnbull government’s decision extends a funding commitment from the Rudd government’s 2013-14 budget, which provided $ 19.5m in funding over four years.

Since 2013, commonwealth-funded McGrath breast care nurses have supported about 15,000 Australians and their families.

McGrath Foundation breast care nurses to get $20.5m in new funding

Number of mental health nurses in NHS drops a sixth under Tories

The number of mental health nurses working in the NHS has dropped by almost a sixth since the Conservatives came to power in 2010, new figures show.

The revelation has sparked fresh doubt that government pledges to improve mental health services are being matched by progress at the NHS frontline.

Philip Dunne, the health minister, has admitted in a written parliamentary answer that while there were 45,384 mental health nurses working in England in 2010, there were just 38,774 in July this year. That fall of 6,610 nurses represents the loss of about 1,000 such specialists a year, or almost 15% of the entire workforce providing that sort of vital care to patients over the last six and a half years.

“This is a very worrying downward trend that shows no sign of turning around, despite all the government’s pronouncements and pledges about equality for mental health care compared to physical health care,” said Labour MP Luciana Berger, the ex-shadow health minister who obtained the answer.

The loss of so many posts meant that patients are at risk of receiving lesser-quality care than before and their recovery is being jeopardised by having less contact time with nurses, who were likely to be busier than ever, Berger warned.

The Royal College of Nursing claimed the figures proved that patients were being let down and ministerial pledges of recent years were not being delivered.

“These numbers make it very clear why so many mental health patients are simply not getting the care they need,” said Janet Davies, the RCN’s chief executive and general secretary. “The government has committed to equal treatment of mental and physical illness, but these figures show how far the health system still is from achieving that. Without the right number of nurses, people cannot get the care and treatment they need.”

The ongoing reduction in nurse numbers is also counterproductive because it leads to greater pressure on other public services, Davies added. “Early intervention is the most effective way to tackle mental health problems, but at the moment patients often aren’t being treated until they reach breaking point and problems are escalating out of control. The pressures on mental health services are spilling out into social care, A&E and even police custody.”

Mental health hospitals have seen the biggest fall in nursing staff. A total of 24,581 nurses worked in such settings in 2010 but by July that had dropped to 19,170 – a loss of 5,411 posts (22%).

The number of specialist nurses working with patients with learning disabilities had also fallen by 538 from 2,508 to 1,970, while those in “other learning disabilities” has fallen 44% from 2,628 to 1,483.

The sharp decline shows the coalition government’s pledge in 2014 to bring about “parity of esteem” in NHS treatment of patients with mental and physical health conditions will not be honoured any time soon, Berger added. Urgent action was needed to stem the dwindling numbers before patient care deteriorated further and remaining staff had to cope with even bigger caseloads, she said.

NHS trusts are allowing the number of mental health nurses to shrink because they do not have enough money to employ as many as they need to provide proper care, Berger claimed. Recent freedom of information requests the Liverpool Wavertree MP undertook found that 57% of GP-led clinical commissioning groups, which hold NHS budgets locally in England, planned to cut their spending on mental health this year, despite ministerial pledges that CCGs should increase spending on such services by the same amount as their overall budget rises.

The only area of mental health care to have more nurses working in it than in 2010 is community psychiatry. Some 16,152 such nurses work there now, compared to 15,666 in 2010.

The overall fall in mental health nurses in recent years is even larger – 7,381 rather than 6,610 – if 2009-10, Labour’s last year in power, rather than 2010 is used as the starting point.

The Department of Health said the figures did not give the full picture of the mental health workforce and that the number of both junior doctors and consultants working in psychiatry has been going up.

“Since 2012, the number of trainee doctors working in mental health settings during their foundation programme has more than doubled, we have seen the highest-ever fill rate for core psychiatry training, and mental health nursing trainee places are growing at a faster rate than any other nursing specialty in the NHS.

“This government is determined to address for the first time some of the very deep inequalities that people with mental ill health face, and while we have more to do, progress is being made,” a spokesman said.

Number of mental health nurses in NHS drops a sixth under Tories

Emily wanted to die when her son was taken. Nurses gave her a future

“If my children were ever taken off me, I wouldn’t survive the day,” was my sister’s emotive, yet understandable, comment when we were discussing the impact losing your children could have on your mental health. It made me think of a woman I had worked with, Emily.

Emily had her son taken off her after she had attempted to kill herself. The boy, Jacob, was pre-school, and the decision by social services was made in her best interests. Emily had been in an abusive relationship and was struggling to cope. She had serious mental health problems as well as a history of childhood abuse, so coping was not something she was good at. She had always refused to engage with mental health services for fear that it would result in Jacob being taken away. The tragedy is that engaging with services was probably the only thing that would have kept their family together.

After further attempts to take her own life, Emily was detained under the Mental Health Act and admitted to the mental health ward where I worked. At this point, Jacob had been taken away by social services. Emily was told Jacob would be adopted; she could have phone contact until then and one final visit to say goodbye.

Initially she could not accept this and just wanted to die. It was one of the hardest cases I have experienced. She was right – what did she have to live for now she had lost Jacob? How could she continue feeling this pain and despair for life? As a team – nurses, doctors, occupational therapists and psychologists – we worked tirelessly with her to instil some sense of a future. Jacob was going to grow up loved, in a safe and secure environment unlike anything Emily had ever experienced. Her son had a positive future and she could take some comfort in that.

We focused on preparing Emily for her last contact with her son. She made her own plans about what she wanted for the two of them, and we supported her to achieve it. Emily was brave and made sure she could hold it together until Jacob had left, and then her world came crashing down.

Part of the preparation included talking to Emily about her suicidal thoughts and talking to her about what we could do to minimise the risk. We kept her safe while she grieved the loss of her daughter. We then worked with her to create the positive future she wanted for herself. This started with her keeping herself safe on the ward, one day at a time. We then looked at a longer term placement where she could get the intensive psychotherapy she needed to manage her mental health issues, heal from the hurt of the past and come to terms with losing Jacob.

Every day mental health nurses help people like Emily, who feel they have nothing to live for. Every day mental health nurses save lives. According to a report by the Mental Health Taskforce Strategy (2016) more than 14,000 people who have killed themselves between 2003 and 2013 had been in contact with mental health services; this is only just over a quarter of all suicides in that time. The same report acknowledges that suicide rates for mental health inpatients are declining, but sadly it is only the people we don’t manage to save that make the headlines. I am glad that we were able to help Emily and she hasn’t become another statistic.

Names and some details have been changed

If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.

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Emily wanted to die when her son was taken. Nurses gave her a future

UK nurses lacking skills to treat transgender patients, says research

UK nurses are failing to meet the needs of transgender patients and feel they lack training and experience to treat the growing number of trans people seeking medical treatment in relation to their gender identity, according to research.

A survey of more than 1,200 nursing staff across the UK found 87% of those nurses who have directly cared for a trans patient felt unprepared to meet the patient’s needs.

The survey, which was conducted by the Royal College of Nursing, also found that 76% have encountered trans people during their healthcare work and 56% had cared for trans people directly.

Just one-fifth of all nurses surveyed said they thought the nursing workforce had the skills to care for trans adults and children, while 76% said more training for all healthcare staff was needed.

The survey comes after the Guardian revealed there has been a steep increase in the number of trans people referred to all 14 gender identity clinics around the country, with a number of clinics experiencing increases of several hundred per cent.

Referrals to adult clinics

The Guardian found that healthcare options for trans people at specialist gender identity clinics were inadequate, with an average waiting time of nine months for a first appointment for adults and some patients waiting up to four years for a first appointment.

Trans people also reported they often encounter medical staff who did not know how to engage with them, such as GPs having laughed at them when they said they wanted to transition, having their feelings dismissed as “just going through a phase”and being repeatedly misgendered – referred to by their birth sex, not the sex they identify with.

Kirsty Cass, a trans woman who has worked as a nurse for the last two years, says she has encountered prejudice and misunderstanding from healthcare professionals, most of which involved her being misgendered.

In one instance, several years after she had undergone gender reassignment surgery, she went to her local hospital for a biopsy on a lump on her ear. After the procedure, the porters wheeled her to a male ward and tried to make her stay there.

“To say I was upset was an understatement,” said Cass. “I was inconsolable, I was sobbing my heart out.”

Much of the problem, she added, had to do with a lack of training of medical staff, some thing was that was also identified as a point of concern by nurses in the RCN survey. Just 1% of respondents said their pre-registration training dealt with the treatment of trans patients and 78% said they had no training on the subject.

Tavistock clinic referrals

Louie Stafford, the trans programme coordinator for the LGBT Foundation, said he was unsurprised by the survey results.

“Gender identity issues are considered a speciality field, so unless you’re practising in that field, it’s unlikely you’ll have any training or any guidance. It’s great that the RCN are trying to shine a light on this from the medical perspective, there’s an urgency for academic medical institutions to consider the curriculum and the content that they’re teaching and put some awareness training in there.”

Wendy Irwin, RCN diversity and equalities coordinator, said the college was pushing for training regarding the treatment of trans people to become a mandatory part of pre-registration nursing training as well as part of continuing professional development.

“I think nurses are increasingly aware of the gap in their knowledge,” she said. “All nurses have a deep and personal desire to deliver the absolutely best care for all their patients, what they’re looking for is how to do that.”

UK nurses lacking skills to treat transgender patients, says research

Seven in 10 nurses say young people"s mental healthcare is inadequate

Seven out of 10 specialist nurses caring for the growing number of young people struggling with mental health problems believe that NHS services are insufficient.

Half of all mental health nurses working with troubled young people say child and adolescent mental health services (Camhs) are inadequate and another 20% say they are highly inadequate, according to a poll undertaken by the Royal College of Nursing (RCN) for the Guardian. Only 13% believe they are good or very good, while the rest say they are adequate.

Young people’s mental healthcare survey

The survey found serious concern among frontline nurses that the rationing of access to care and shortage of beds are so acute that young people risk harming or killing themselves.

Of the 631 mental health nurses working in Camhs, 43% said services were getting worse, despite government promises of extra investment and assurances that more young people would be able to receive care.

Young people’s mental healthcare survey

“This vital service has been totally underfunded for years. The pressure on the service is not only appalling for children, young people and their families, but staff morale and mental health too,” one nurse said.

Another nurse said: “Children and their families are suffering due to poor Camhs, support and availability. The criteria for referral means children are having to attempt or threaten to take their own lives before receiving support.”

Asked to list what they saw as the main problems with Camhs, 73% of respondents cited too few nurses, 72% said delays in patients getting appointments, 69% pointed to young people being sent “out of area” to get inpatient care, because of bed shortages in their area, and 59% cited the inability of staff to give patients as many appointments or as much care as they need.

Young people’s mental healthcare survey

Fiona Smith, the RCN’s professional lead for children and young people’s nursing, said the survey showed that services for seriously troubled young people are “completely overstretched” in the face of growing demand for care.

“These results tell us that things are seriously poor. Mental health nurses working in children’s services tell me that they have never known it so bad,” she said.

Young people’s mental healthcare survey

“We are failing young people with mental health problems by not providing services and interventions in a timely manner. It’s foolish of the NHS and the government not to really focus on meeting these young people’s needs, because we know that with [the] three out of four adults with mental health problems, their symptoms began in childhood.”

The Liberal Democrat MP and former health minister Norman Lamb said the findings showed that NHS services for troubled young people “are buckling under the pressure. The truth is that we are letting down a whole generation of young people by failing to invest in essential support.

“We have to end the historic underinvestment in children’s mental health. It makes no sense to spend just 6% of the total mental health budget on children and young people when we know that 75% of adult mental ill health starts before the age of 18.”

Sarah Brennan, the chief executive of the charity Young Minds, said lengthening waiting lists for care and higher thresholds for troubled children to qualify for treatment were likely to exacerbate their suffering.

“Without treatment, problems are very likely to escalate and children are more likely to self-harm or become suicidal, to be violent and aggressive, or to drop out of school, which can ruin their prospects for the future.

“Delays can also have a disastrous effect on families, with parents forced to leave their jobs to look after their children.”

The Conservative-Liberal Democrat coalition government promised to invest an extra £1.4bn in children’s mental health services by 2020. But frontline staff, the Royal College of Psychiatrists and mental health charities are sceptical about whether this funding is being delivered. “Too much of that money has been diverted elsewhere and is not getting through to where it is desperately needed,” Lamb said.

Official NHS workforce figures provided to the Lib Dem MP by the House of Commons library show that the number of consultant psychiatrists working with children in England has only gone up slightly over the past six years, despite the far greater recognition of young people’s psychological and psychiatric issues.

The number of full-time equivalent consultant psychiatrists rose from 622 in May 2010 to 649 in May this year.

The number of non-consultant doctors working in Camhs fell over the same period, from 367 full-time equivalents in May 2010 to 314 in May 2016.

The number of specialist mental health nurses working in NHS hospitals went down by 10% between 2011 and 2016.

Seven in 10 nurses say young people"s mental healthcare is inadequate

Escalating kid health crisis feared due to lack of college nurses

The nursing union has warned of an escalating wellness crisis between youngsters due to a lack of college nurses.

The Royal College of Nursing mentioned college nurses had a special possibility to support increase some of the key issues dealing with children’s wellness, notably the enormous problem of childhood weight problems, with one particular in three youngsters in the United kingdom obese and one particular in five classed as obese.

The RCN cites a current government report suggesting that in the Uk 5 much more children underneath 14 died every day than did in Sweden. It stated that whilst overall health issues facing young children continued to accelerate, college nurses had been at threat of even more depletion since of £200m in cuts to public overall health budgets in England.

Regardless of steadily developing numbers of college pupils, figures have proven a decrease in school nurses given that 2010. The RCN stated the amount of nurses need to have improved throughout this time.

There are now far more than eight.four million pupils attending 24,300 schools in England, with virtually 94,000 more children in principal schools than there were a 12 months in the past – a 2.one% improve.

At the yearly RCN School Nurses conference on Sunday, specialists from across the Uk emphasised the crucial importance of college nurses in enhancing the health of the nation’s kids. They explained that by working closely with young children as properly as their dad and mom and teachers, nurses could have an essential role in helping pupils with their psychological and emotional overall health.

The RCN warned that Health Training England has predicted a 24% vacancy price in this spot of nursing. Regional authorities in London, Staffordshire, Middlesbrough and Derbyshire were already taking into consideration cuts to college nurse funding to plug gaps in other regions of public health, it said.

One in 10 pupils suffer from psychological health problems and the Children’s Society’s very good childhood report 2015 positioned the Uk nearly bottom in an global survey of children’s happiness, the RCN said. A lot of of the 6% of young children who have a disability could also benefit from a school nurse, while it said 15.four% of pupils in colleges in England had recognized particular educational demands, equating to 1.3 million pupils.

Fiona Smith, specialist lead for youngsters and youthful people’s nursing at the RCN, said: “School nurses perform a vital part in the health of our children but their perform is so typically ignored – and undervalued. Today’s conference illustrates the wide selection of problems school nurses tackle on a every day basis, from conditions such as epilepsy to behavioural disorders like ADHD.

“They are talented, multi-experienced nursing employees who deserve immense recognition. In contrast to any other health expert, college nurses operate with young children and education workers on a everyday basis. Nevertheless, investment is fundamental if we are to commence solving this crisis in children’s wellness and construct a healthful and prosperous long term population.”

Escalating kid health crisis feared due to lack of college nurses

Older Nurses To Obamacare"s Rescue, Increase Accountable Care

Registered nurses are delaying retirement, a perform determination that will aid make new accountable care models and the move away from charge-for-service medicine a lot more achievable beneath the Reasonably priced Care Act.

The choices by nurses to continue operating well into their late 60s and longer than they have in the past is assisting boost the nation’s provide of registered nurses (RNs), in accordance to a new study by the RAND Corporation, published on-line this afternoon in the journal Well being Affairs.

Virtually a quarter, or 24 percent of registered nurses, had been working as late as age 69. The trend has helped extend nursing careers by two.five many years soon after age 50 and “increased the 2012 RN workforce by 136,000 folks,” RAND researchers say.

These function alternatives will be vital given the worsening doctor shortage and reimbursement changes by government and personal insurers to inspire the use of more allied well being experts such as RNs, nurse practitioners, doctor assistants and pharmacists to meet the demand of a lot more newly insured Americans below the well being law.

Health insurance coverage companies, employers and government health plans are coaxing Americans a lot more towards a technique of population wellness via patient-centered health-related residences and accountable care organizations and away from classic charge-for-support medicine that encourages pointless tests and procedures. Below the new so-referred to as value-based mostly approaches of accountable care, primary care companies function more difficult, generally as a more coordinated crew, to keep sufferers out of the hospital, ensuring they are taking their medications and receiving care upfront in a doctor’s workplace, a wellness center or even a retail clinic.

ACOs and other new designs of health care delivery, which are pushed by the greatest of insurance coverage companies like Aetna Aetna (AET), Cigna Cigna (CI), Humana Humana (HUM), UnitedHealth Group UnitedHealth Group (UNH) and Blue Cross and Blue Shield strategies, see registered nurses being a crucial component of the staff that helps the physician coordinate care.

“ACA-induced changes in care delivery, mixed with the Medicaid and marketplace insurance expansions that have begun, suggest that there will be an enhance in the demand for RNs in care coordination, management, and ambulatory care positions,” Auerbach and co-authors Peter Buerhaus of Vanderbilt University and Douglas Staiger of Darmouth University wrote in their six-web page article published in the August situation of Wellness Affairs.

The boost in nursing comes from a number of diverse forces this kind of as a main focus on enhancing nurse schooling. That far more than doubled the variety of nurses to 181,000 in 2012 from about 74,000 in 2002, RAND explained.

However much more than 85 percent of nurses under 30 operate in hospitals, RAND researchers say they move to and are interested in doing work outdoors of the hospital as they age.  Hence, employers will uncover this shift a welcome growth.

“Older RNs are far far more probably to work outdoors of the hospital than younger RNs are – and thus the big number of older RNs searching for nonhospital employment could be a welcome improvement for nonhospital organizations that are looking for RNs,” the study’s authors wrote. “Hospital-based mostly RNs are often properly versed in competencies involving patient transitions and care coordination.”

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Older Nurses To Obamacare"s Rescue, Increase Accountable Care

3 nurses charged with wilful neglect

South Wales Police confirmed Lauro Bertulano, 44, Clare Cahill, 41 and Rebecca Jones, 29, have been charged on suspicion of falsifying patients’ notes at the Princess of Wales Hospital, contrary to Area 44 of the Mental Capability Act 2005.

A complete of 13 nurses have given that been suspended, such as the 3 who have been charged.

A dozen of those are from the Princess of Wales Hospital, with the remaining one particular from nearby Morriston Hospital in Swansea.

The hospital spokesman said: “Over the last 15 months 3 nurses have been arrested and provided police bail in connection with police investigations at the Princess of Wales Hospital. We are mindful that the three have now been charged.

“Clearly this matter is now sub-judice and therefore we will not be commenting even more at this stage. We continue to assist South Wales Police with their investigations.”

A police spokesman said the three nurses are scheduled to seem prior to Bridgend Magistrates’ Court on July 28.

The hospital had previously confirmed that its internal programs picked up alleged anomalies final 12 months relating to the record-retaining of a modest variety of nurses.

A complete of 13 nurses have given that been suspended, which includes the three who have been charged.

A dozen of individuals are from the Princess of Wales Hospital, with the remaining 1 from nearby Morriston Hospital in Swansea.

The hospital spokesman explained: “In excess of the final 15 months 3 nurses have been arrested and provided police bail in connection with police investigations at the Princess of Wales Hospital. We are aware that the 3 have now been charged.

“Plainly this matter is now sub-judice and for that reason we will not be commenting further at this stage. We proceed to help South Wales Police with their investigations.”

A police spokesman stated the 3 nurses are scheduled to seem before Bridgend Magistrates’ Court on July 28.

3 nurses charged with wilful neglect

District nurses are crucial to the NHS they have to not be allowed to disappear | Julia Frazzleby

‘We had been constantly conscious that patients would be relying on us and we may possibly be the only make contact with they had with the outside world.’ Photograph: Sally and Richard Greenhill/Alamy

I was saddened to go through that district nurses are dealing with extinction yesterday. I was once a district nurse and extremely proud to be so, and six years in the past, soon after an abscess on my spine I also needed day-to-day visits from district nurses. Having been on the two sides of the fence, I can say this is a crucial service.

I worked in a rural spot as element of a six-nurse staff covering the twilight shift, from 8pm-midnight. Each evening, two nurses would meet at our nearby hospital to go by means of our listing of visits. On common we would have 9 to 10 visits per evening, and although some would be regular visits, most nights we would have additional visits that the day crew had not been capable to make or these when a GP asked us to call in on one particular of their individuals.

The care we presented was varied – we would help in end-of-lifestyle care, put somebody to bed, modify dressings, administer medicine or just assist someone to the toilet. Our nights have been planned with military precision, usually conscious that our patients have been relying on us and that really often we would be the only get in touch with they had with the outside word. Despite obtaining only a few hours to get round this kind of a large area with a lot of sufferers we never rushed, and always made time for those we have been caring for.

A 1948 image of a house go to by a district nurse, 1 of the providers launched by the fledgling NHS. Photograph: Popperfoto/Popperfoto/Getty Images

We would typically be asked to support with what would now be deemed non-nursing duties, this kind of as unblocking a sink, creating a note for the milkman, rehanging a curtain, or taking a piglet to the vets in the middle of the evening. Extremely rarely did we finish at midnight and at the end of every shift we would have to go back to our office to check out that no additional requests had come in, as this was just before the advent of the mobile telephone. Come hail, rain and snow we in no way missed a go to. In bad weather, blankets, a shovel and wellies grew to become a normal part of our uniform. Why? Because we were an important service, one particular that could be relied on.

Nursing is a vocation, and for me it was never about the money. I did not want to sit in front of a laptop filling out countless types or inputting numerous codes into a personal computer accounting for every single 2nd of my time. I desired to be out there supplying important care and guaranteeing that where feasible, a patient could stay in their personal property.

If district nurses are genuinely in danger of disappearing, what will occur to individuals that depend on this essential services? For the older individual who is not mobile and has a leg ulcer, how and the place will they go to have their dressing modified? For the mom crippled by MS who would like to stay inside her personal residence and sustain as significantly independence as attainable, how will she and her family cope? They could not have a pot of money to shell out for private care – will tasks like washing, obtaining dressed, help with personal hygiene now be left to her loved ones to deal with?

There has been a 47% drop in district nurses in the final decade. Support solutions are stretched to the limit, and appointments with practice nurses in GP surgeries are quite challenging to come by. A&ampE and minor injury centres are total to the brim, so what is the substitute for individuals who demand the crucial providers of the district nurse?

District nurses are crucial to the NHS they have to not be allowed to disappear | Julia Frazzleby

Nurses vote against charge for GP services

Medical doctors debated the concern of charging for GP appointments last month. Photograph: Cultura RM/Alamy

Top nurses have shot down the prospect of charging individuals for GP services, saying that the most vulnerable men and women would endure if this kind of an initiative was rolled out.

The Royal School of Nursing’s (RCN) yearly conference in Liverpool debated whether or not sufferers need to be charged for seeing their family medical professionals.

Historically, the RCN has stood behind the belief that the NHS must be free at the level of delivery, but nurses put forward the movement, saying NHS finances have been “not infinite”.

More than nine in ten delegates voted towards the motion, which named for a fixed fee for GP appointments.

Presenting the movement, Andy McGovern, from the RCN’s north-east London branch, mentioned: “As the NHS faces one of the most considerable economic issues in its historical past, this is a debate that we have to have.

“At some level in the potential, regardless of which United kingdom country we live in, there will have to be a option among elevated taxation or paying for public services like well being that we have hitherto expected by proper.

“Consequently the debate for fees for NHS companies like GP appointments has reignited.

“The NHS demands far more sources and the question has to be asked, in which will these resources come from?

“While having to pay for NHS providers is a difficult, and for numerous a taboo topic to debate, we genuinely do have to feel about how we move issues forward.”

Speaking towards the motion, Dave Dawes from the Manchester central branch of the RCN said: “We do not require to imagine some hypothetical world exactly where people seem in their pockets, see how much cash they have got and make a decision regardless of whether or not they can see their GP.

“We utilised to live in that country. We decided we didn’t want to dwell there any far more so we invented the NHS – free at the stage of delivery.”

Lisa Reith, from the south-west London outer branch, added: “When we previously pay for this support via standard taxation it appears unreasonably unjust.”

Heather Henry, also from the Manchester central branch, said he was “shaking with horror” at the imagined of the resolution.

“It would be the worst factor for well being inequalities that we could perhaps propose. The vulnerable would endure. What would occur with screening and immunisations? Our most vulnerable patients would be presenting later on, sicker, or worse and A&ampE attendances will rocket.”

Dr Peter Carter, RCN’s chief executive and common secretary, explained: “Charging individuals for GP visits is a controversial issue – one particular that goes to the heart of what the NHS is and need to be.

“Right now, nurses and healthcare assistants have reaffirmed their passionate belief that the NHS should be cost-free at the point of delivery.

“The potential funding of the NHS is shrouded in uncertainty and we require clear course from our politicians about the way ahead so that clinicians and commissioners can strategy for the future.

“As the general election approaches, the public require to know the place the parties stand on this crucial concern.

“Nurses are passionate about guarding the overall health support and its founding ideas, but they know that it faces problems, that its finances are finite and so they will carry on to address the challenging inquiries.”

Recently, doctors debated the exact same issue. Generating certain patients pay a charge for some companies would “emphasise the worth” of GPs, the British Healthcare Association’s (BMA) neighborhood medical committees conference was advised in Might.

But the proposal was dismissed by a amount of major medics like the former chairman of the BMA’s GP committee Dr Laurence Buckman, who explained it would lead to “survival of the richest, not treatment of the sickest”.

Commenting on the RCN’s debate, a BMA spokesman mentioned: “Charging sufferers for GP appointments is not the way to fix issues dealing with our overall health service.

“Not only would a charging method be complex and pricey to set up, it would also area a restrictive economic barrier to care in front of some of the most vulnerable members of our society.

“A patient’s access to healthcare must be primarily based on their clinical want, not the dimension of their bank stability.”

A Department of Overall health spokesman explained: “We are absolutely clear that the NHS ought to be totally free at the level of use, and we will not charge for GP appointments.

“We know GPs are underneath strain, which is why we’re cutting GP targets by far more than a third to totally free up much more time with sufferers, and are rising trainees so that GP numbers carry on to increase quicker than the population.”

Nurses vote against charge for GP services

Nurses debate £10 fee to check out GP

British nurses are organizing to debate no matter whether GPs must begin charging individuals for appointments.

The Royal College of Nursing’s (RCN) annual conference in Liverpool will go over whether the union backs the thought of charging men and women a fee to see their loved ones doctors.

Typically the RCN has stood behind the belief that the NHS must be cost-free at the level of delivery. But nurses have place forward the motion, saying that NHS finances are “not infinite”.

Andy McGovern, a hospital nurse in London, said he would propose a motion calling for fixed fee to see a GP. Study advised something from 57p to £10, he advised the Everyday Mail. “We want to have a robust and truthful debate about what we’re going to do in the future simply because the cash is not there,” McGovern said.

An RCN spokesman stated clarity was required over how a lot funds the well being services would have in the long term so health oficials could program properly.

Not too long ago medical professionals debated the identical concern. Making particular patients pay out a fee for some providers would “emphasise the value” of GPs, the British Health care Association’s (BMA) regional medical committees conference was advised in Could.

But the proposal was shot down by a number of foremost medics like a former chairman of the BMA’s GP committee, Dr Laurence Buckman, who said it would lead to “survival of the richest, not therapy of the sickest”.

The RCN chief executive and standard secretary, Dr Peter Carter, mentioned: “Nurses care passionately about the NHS and are not afraid to have hard debates about its long term.

“This week we have created it clear that the way to deal with the monetary troubles the NHS faces is not to assault the shell out of devoted personnel who are propping the support up. But nurses also acknowledge that the health service faces huge challenges.

“GP charging is a controversial topic and one that goes to the heart of the debate about what the NHS is and should be. It’s a brave debate to have and an important one particular.

“The political events need to adhere to our lead and make it clear now, as we head in direction of a basic election, what their policies are on potential NHS funding. Now is the time to end the guessing game and commence speaking about viable options and a clear long term vision for the NHS.”

Nurses debate £10 fee to check out GP