Welcome to my Blog. I hope you find the posts interesting, informative and perhaps even entertaining(!). I'll update this Blog with my responses to topical stories of the day, important news and tales of my travels up and down the UK, meeting our inspirational nursing staff.

The RCN represents almost 400,000 nurses in the UK and is the country's largest nursing union.

Wednesday, 23 December 2009

Christmas message

For many, Christmas is a time to take stock of what has come and New Year is a time to contemplate what the year ahead may hold.

2009 saw the RCN take its first bold step into the world of new media and I took my own leap into the blogosphere. However, while our means of communicating may have changed somewhat, the values at the very heart of nursing have not. We will continue to champion care, defend dignity and support society’s health.

From whistle-blowing to an all-graduate nursing profession; staff shortages in Mid-Staffs to swine flu; recession to assisted suicide, nursing has been confronted with diverse challenges and diverse difficulties in 2009.

There have however also been victories and I am tremendously proud to represent an organisation which has been a voice for nursing for over 90 years. We have recovered more than £5 million in compensation for our members, secured the third year of a pay deal for our members and launched a whistle-blowing hotline to help our members speak up where they see poor care.

More than simply being a voice for members, the RCN aims to support members in being a voice for high standards of care.

Christmas is also when we take time out to be with friends or family. Every year, I and other RCN staff visit hospitals on Christmas Day to offer our support to staff who continue to offer care throughout the Christmas period.

There are also those who are even further from their families at this festive time, and I am touched by the bravery and self-sacrifice of the military nurses and healthcare assistants who are far from home in the line of duty.

I have only one resolution in the coming year, and that is that the RCN should continue to be a voice for our members, a voice for nursing and a voice for healthcare. May I wish all my blog readers a very Merry Christmas and a Happy New Year.

Finally, if you’re interested in hearing the latest RCN podcast, a round-up of the year’s top health stories, you can listen on the RCN website or by visiting iTunes and searching ‘Royal College of Nursing’ http://bit.ly/4SbCcZ

Wednesday, 16 December 2009

‘From good to great…’

The Department of Health has recently outlined its 5-year plan for transforming the health service from ‘good to great’. Its strategy is to make the NHS ‘preventative, people-centred and productive’.

The huge amounts of change that have already taken place in the NHS are a tribute to the hard work of healthcare professionals and policy-makers. Whether it has been the vast reduction in waiting times, or lowering mortality rates from cancer; we have seen huge progress and significant change already in the NHS.

However, an NHS that does not react to the changing needs of the patients and potential patients is an NHS that stands still. We must be constantly aspiring to advancement and improvement and questioning how we can make a good health service into something great.

I believe that it is through front-line staff and front-line services that great healthcare can be achieved. This is why it is so crucial that in the 5-year plan, the NHS has included a dedication to not cutting front-line services.

As demands on the health service continue to increase, we must never compromise care for cuts. The increasing burden of preventable health problems means that we must offer prevention rather than just cure. Alcohol and smoking each cost the NHS £2.7 billion a year and obesity cost £4.2 billion in 2007, a figure which is expected to rise to £6.3 billion in just five years.

The DH plan recognises that a forward-thinking health service must be patient-centred, focusing on care, compassion and choice. Together we can go from good to great, with nursing at the heart of this progress.

You can read the RCN response to the plan here and read the full 5-year plan on the Department of Health website.

Wednesday, 25 November 2009

Dealing with Dementia...

Last week, the Alzheimer’s Society released an eye-opening report about the care received by people with dementia in our hospitals. Some of the 700,000 individuals living with dementia in Britain today experience an unacceptable variation in the quality of care and the number of those who suffer from the illness is expected to rise significantly over the next few years.

The report studied the responses of carers, nurses and ward managers. The results are clear - patients with dementia stay in hospital for longer periods of time, which in turn has a detrimental effect not only on their general health, but also on their dementia.

54% of carers said that being in hospital had a detrimental effect on the symptoms of dementia and 47% said that patients’ health was negatively affected by their hospital stay.

A huge proportion of nurses will at some point care for a patient with dementia, but most do not feel able to properly care for these patients.

In our general election manifesto, the RCN has been bold in making improved care for people with long-term conditions one of our key priorities. We are calling on all political parties to guarantee that anyone suffering from an illness like dementia gets the specialist nursing care they require. Patients suffering from dementia should be cared for by experts who know how best to look after their patients and who understand what treatments are needed. Numerous reports have shown that patients who recieve this level of care have fewer complications and rarely need to be readmitted on a regular basis.

Dementia is an illness which touches almost everyone. The ticking time-bomb of an ageing population and increased demands on the health service means that now is the time to invest in better training for all nurses if every patient is to be given the quality of care they deserve.

See the report: http://alzheimers.org.uk/site/scripts/download_info.php?downloadID=356

Wednesday, 11 November 2009

The future of nursing...

This week I had the real pleasure of launching the RCN Student Bus. The bus will travel across the UK from university to university promoting nursing as a career and giving advice to those already focused on our profession.

The UK’s nursing students deserve all the support and assistance we can give, not least because 200,000 nurses are due to retire in the next decade.

No one denies the difficult balance between the huge cost of studying and the amount of work required. It’s no surprise that a quarter of student nurses drop out of their studies because of financial worries.

Despite all the challenges, nursing is one of the most rewarding careers on the planet; a job in which a person has to use their heart as well as their head.

No other career offers the sheer possibility and potential, the huge range of specialisms and the very special feeling that you have made a real difference.

It’s clear from the work the RCN has been undertaking and conversations that I’ve had with students that we need to properly support those seeking to become nurses.

In England, the bursary system is wholly inadequate and often means students have to get second jobs, which directly impacts how much time they can spend studying. The RCN has consistently called for a liveable, non means tested bursary of £12,000 for every nursing student so that they can get the support they deserve.

As our population gets older and healthcare demands increase, we will need more and more nurses. Any government wishing to improve the healthcare provisions of the future must look at the problems faced today.
At the launch of the bus I met a number of dynamic, hopeful and energetic people hoping to become the UK’s next generation of nurses. We need to be as keen to help them as they are to help patients.

You can follow the RCN Student Bus on Twitter @RCNStudentBus. If you see it on the road, tell us – there are prizes to be won…

Monday, 2 November 2009

The Swine Flu vaccine

On Monday, I visited the Chelsea and Westminster Hospital in London to receive the swine flu vaccination. I cannot emphasise enough that the vaccine is safe and has been thoroughly tested. Unlike other flu jabs, the virus is ‘inactivate’ so there is no risk of getting flu from the vaccine.

The pandemic has already affected thousands across the UK and as winter temperatures set in, these numbers will undoubtedly go up. Many of us could be affected by the virus and not simply by becoming ill ourselves, but by seeing family members and friends trying cope with the symptoms.

For healthcare staff, I believe that it’s particularly important that they take up the vaccine. Staff run the risk of coming in contact with the virus or of passing it on to patients. So, for the benefit of both professionals and patients, it’s crucial that our workforce is fighting fit to deal with whatever lies ahead.

I’ve been shocked to hear healthcare workers tell me that they will consider the vaccination programme successful if just half the supplies get used. Whilst getting the vaccine is of course a matter of personal choice, I urge people to weigh up the very real benefits. Now is the time for preparation and action by health staff for patients.

Our health service is all about striving for the best for patients and I know that health workers are dedicated to giving their all for vulnerable patients. The nursing profession is about care, protection and dignity; to offer this we need a ready and robust workforce.

Monday, 19 October 2009

Raising concerns, raising standards...

On Monday we learnt that struck off nurse Margaret Haywood would have her punishment reduced to a one year caution and she is therefore now allowed to return to work.

Margaret had helped in the undercover filming of a Panorama documentary to expose shocking standards of patient care. She was struck off by the NMC in April for breaching patient confidentiality. Whilst we believe that patient confidentiality is exceptionally important, so too is the ability to speak out against poor care, free from fear of retribution.

Margaret was a dedicated nurse with an unblemished career who simply wanted to get back to nursing, so we were very happy with the result.

In May this year we launched its ‘Raising Concerns, Raising Standards’ hotline (0345 7726 300) which gives RCN members the opportunity to register patient safety concerns after following the normal internal procedures. The hotline is confidential and will protect our members who call and make sure the appropriate action is then taken.

This is undoubtedly a good start and I’m proud that the RCN has taken the lead on this hugely important issue, however – more needs to be done.

Over the weeks and months before the next General Election, the RCN will be calling on all political parties to protect those who speak out about patient safety. We believe that all healthcare organisations should be required to hold a register of staff concerns that must be reported to their Board regularly and made available to the public.

If we’re going to protect those who seek to improve patient care we need a united approach that helps all healthcare workers, not just RCN members.

Thursday, 8 October 2009

Care before cuts...

This is a comment piece that appeared in the Guardian this week...

Earlier this year, the RCN undertook a Freedom of Information request that revealed the NHS spends at least £350 million a year on management consultants; a figure that we suspect could be much higher.

If anything pointed out the waste and inefficiencies that could be cut from an NHS budget, this was surely it.

Of the huge figure spent on these consultants, 78% (or £273 million) was spent on projects that did not directly affect patient care. These include re-branding trusts, changing logos or re-naming organisations to make them more attractive to potential patients.

The RCN has nothing against management consultants, but when one considers that the money spent on them could pay for 330 fully staffed medical wards, one has to question the virtue of this expenditure.

If the NHS is to look to ways to reduce spending, which in today’s climate appears inevitable, then we must look at costs like these. What we mustn’t do is wield the axe towards our front line services and the areas that comfort, cure and care for patients.

One can only imagine how demoralising all this must be for our nurses, doctors and others; to see such vast sums spent on consultancy when they fear their own services may face cut backs and budget reductions.

Cuts to our front line would see waiting lists soar, standards plummet and a quality of care that no patient deserves. Efficiencies can be made, but they must be made intelligently and to areas of spending that don’t impact on the dignified and quality care that all patients deserve.

Thursday, 1 October 2009

The next step...

Having recently departed from the Labour party conference, one issue in particular stayed with me. Both the Prime Minister and Andy Burnham, the Secretary of State for Health, made mention of the Social Care Green Paper; one of the most important pieces of work being undertaken right now.

Last year we celebrated the 60th birthday of our national health service and now we must turn our attention to ensuring an equally fair and available social care service.

The current framework for adult social care is now widely recognised as confusing and outdated. Patients often find themselves on a ‘revolving door’ between health and social care – the current system needs a radical overhaul.

The Government admits the status quo isn’t good enough. This status quo ranges from more money being taken from those who have saved to a postcode lottery for quality care.

A far greater percentage of the population are now cared for in their own homes, which can only be a positive move. However, many care services in the community remain fragmented. Moving the care of vulnerable people into local areas will require significant investment in community nursing services, along with community matrons, district nurses and specialist nurses.

What’s more, effective preventative measures can have significant long-term gains; such as investing to prevent falls, which can mean people not having to experience an unplanned admission into hospital or into residential care.

There is much to discuss and your involvement is crucial. ‘Big Care Debates’ are being held up and down the Country so please go to the event being held near you - http://careandsupport.direct.gov.uk/

The RCN is looking in detail at the Government’s green paper consultation that closes in early November and as usual will help shape the crucial health decisions that will follow. Members have till the end of October to contribute to our consultation, find out more on the RCN website (www.rcn.org.uk).

Please do contact the RCN to share views with us at policycontacts@rcn.org.uk

Wednesday, 23 September 2009

RCN: Fit for the Future

This week is an important time for the RCN itself. In the next few days our members will receive voting papers from Electoral Reform Services.

Members are being asked to vote on a crucial amendment to the RCN Royal Charter enabling us to change our legal structure and set up our charity as a separate organisation. It’s a small but important change – important because it will ensure that we meet Charity Commission requirements and legislation governing charities.

You may well have heard discussion in the media lately about how the Charity Commission is reviewing organisations such as independent schools which have charitable status. Consequently, RCN Council approached the Commission last year about changing our legal set-up to enable us to meet its requirements whilst ensuring we could carry on business as usual. The Charity Commission has agreed we can proceed on the basis we proposed.

The proposal will not affect the services we offer to our members and will enable our professional and trade union activities to carry on hand in hand as they do now in one organisation. We will, however, have a separate charitable foundation which will fund our charitable activities through grants.

It is very important that our members vote and return their voting paper in plenty of time for the closing date of Monday 26 October, two days in advance of our AGM which is being held at RCN headquarters in London.

More information about the AGM vote can be found on our website at www.rcn.org.uk/agm2009

Wednesday, 16 September 2009

The importance of the school nurse...

As anyone who listened to BBC Radio 4’s ‘Case Notes’ yesterday evening http://bit.ly/b4r8d will know, the role of the school nurse has changed dramatically over the last few decades.

We heard how they used to act as ‘hand maids’ whose duties included checking for nits and preparing notes for the onsite doctor.

Their role now could hardly be more different. Today, across the UK, school nurses are leading, not following, and spend their time inoculating, advising and mentoring hundreds of thousand of school children every day.

Whether it’s running sexual health clinics, providing the important immunisations or writing detailed care plans for those with chronic conditions – the school nurse is an essential part of child health.

For those children lucky enough to have easy access to a school nurse, they are an invaluable tool. They can highlight the dangers of alcohol, smoking and obesity at an age where prevention is more powerful than cure.

However, not all children have the access to school nurses that they need or deserve. A recent RCN survey found that two thirds of school nurses felt overstretched and unsupported by their rising workload, and that government targets to increase the numbers of school nurses are unlikely to be met by the deadline next year.

Furthermore, we found that the average school nurse now looks after more than seven schools, with a quarter looking after more than 10. One nurse questioned looked after 26 schools.

The RCN has campaigned for every child to have access to a school nurse and we will continue to do so. The current shortage must be addressed and we mustn’t allow current financial constraints to threaten this investment.

School nurses are the best tool we have in fighting some of the biggest health issues facing our country and we must be bold enough to invest in them now.

Tuesday, 8 September 2009

A response...

I just wanted to write a short note as way of reply to the comments posted on the blog of late.

The stories of poor patient care described here are of course heartbreaking and should never have happened. My point in earlier posts however was that these examples of poor care represent the minority of cases. The vast majority of nurses are good, hardworking and dedicated people.

The stories posted here represent the unacceptable 2% of patients that experience poor care and of course more must be done to reduce that figure further.

Thank you to all those who have posted.

Thursday, 3 September 2009

Maternal Mortality

One of the best things about working for an organisation like the RCN is that you get to meet some brilliant people undertaking some very important work.

Yesterday I visited 10 Downing Street to meet with Sarah Brown and other members of the Maternal Mortality campaign team.

Maternal Mortality is a campaign that the RCN has been proud to support and the meeting was very productive and informative. It’s only when you look at the facts surrounding maternal mortality that one realises just what an important topic it is.

Every minute of every day, a woman dies of pregnancy related complications, totalling more than half a million women each year. By the time you’ve read this blog, somewhere in the world a child has been born who will never know their mother.

When I say ‘somewhere in the world’, there’s a 99% chance that the mother will die in a developing country. In sub-Saharan Africa, a mother has a 1 in 8 chance of dying in childbirth; in Western Europe that figure is just 1 in 8000.

Almost half of all women in developing countries deliver their babies without a nurse, midwife or doctor present.

The simple truth is that these figures are an international scandal and we need real action now.

The Maternal Mortality campaign have set themselves a number of key objectives in order to ensure that this problem gets the recognition it deserves. To find out all about the campaign and what it’s calling for, visit the website - www.whiteribbonalliance.org

Please, get involved and support this incredibly important cause.

Thursday, 27 August 2009

The real picture

We will see from the papers and rolling news coverage today that nursing care has been criticised by the Patients’ Association.

Now, the examples of care that they describe in their report are totally unacceptable and I won’t for a moment defend poor care.

However, I believe that it must be made clear that whilst this report does provide some unacceptable examples of care, they are not representative of the healthcare service as a whole or the experience of the vast majority of patients.

This is reflected in the fact that last survey of patients by the Care Quality Commission found that over 90 per cent rated the care they received as good, very good or excellent.

Here at the RCN, we have urged patients and their families to raise their concerns if they encounter substandard care so that investigations can take place.

I said in a press statement today, everyone in the NHS must remain focussed on care, compassion and empathy - NHS and nursing values - in order to improve the quality of care for patients.

Wednesday, 19 August 2009

The health of our health workers...

The Interim Boorman Review has been published today and it exposes worrying facts about the health and well-being of NHS staff. Dr Steve Boorman, who led the report, found a large number of staff suffer from work related stress.

I must say that despite the fact these findings are deeply worrying, they are not surprising. NHS staff are routinely found to be some of the most stressed workers in Britain. A report in April found that NHS staff are four times more likely as people in other occupations to be absent from work due to stress. The data showed that in 17 trusts, stress and related problems made up 15% of all sickness absence in 2008.

The reports in the papers today point out that if the sickness levels in the NHS were reduced by one third, it would save £555 million. However, this problem isn’t just one of finances and efficiency savings – it’s about the health of the people who save lives and treat the sick. Investing in the health of NHS staff has an undeniable link to the delivery of quality patient care.

As I said in a press statement today, the NHS has a legal and moral duty to ensure that staff are protected from the work related causes of ill health and are given opportunities to improve their own health.

We’ve heard much over the last week about how much the NHS has done for the people of the UK. We need to ensure that the staff who do so much for us are given the treatment and support they deserve.

Thursday, 13 August 2009

A health service to be proud of...

As anyone who keeps an eye on international news will know, the debate on healthcare in the US has dramatically heated up, with both sides clamouring to be heard.

Over the last few weeks we’ve heard much from our friends across the pond about our own healthcare system. There have been a number of untruths and myths touted about how our system refuses to treat the old, denies care when it’s needed and considers cost before care.

I hope the truth is heard eventually and that President Obama’s proposals are not defeated by erroneous claims and fanciful misinformation. The NHS in the UK may have its flaws but it is an institution that we can be hugely proud of. It’s an organisation that has saved the lives of millions, irrespective of their age or salary.

As Mahatma Ghandi famously said ‘the best test of a civilized society is the way in which it treats its most vulnerable and weakest members’. I can only hope that those currently shouting down a fair system of healthcare for all heed this message.

Friday, 7 August 2009

De ja vu...

This commentary piece appears on the Telegraph website

When the nursing workforce reads that long term vacancies in the NHS have risen for the first time five years, I expect that they’ll feel an uneasy sense of de ja vu.

The statistics released show vacancies across the health service have increased, with no signs of the trend reversing. The situation today will worry some that we are returning to the shortages of the 1990s. Waiting lists were long, cancer screenings were delayed and the overall level of care to patients was far poorer than it should have been.

At a local level, every recent report into dire hospital failings has exposed worryingly low levels of nursing staff and a refusal to fill vacant posts, largely for financial reasons. This has led to terrible examples of healthcare and a poor standards for patients. Inadequate staffing levels can never an excuse for poor care, but they are a cause.

A leaked NHS planning document in early 2008 predicted a shortfall of 14,000 nurses by 2011. RCN figures have consistently stated that 200,000 nurses will retire over the next ten years and with no increases in recruitment, there will be no one to fill their shoes.

Put simply, nurses have been here before. When vacancy figures were last like this, they indicated dire consequences were to come. The past ten years has seen exceptional investment in the NHS and real progress for patients. Vacancy gaps like these threaten to undermine all this good work More must be done to recruit and retain nurses and politicians must realise that our health service is only as strong as the people on the ground.

Wednesday, 5 August 2009

Last orders please...

Today the RCN, alongside Alcohol Concern, the Royal College of Physicians and the Faculty of Public Health, released a survey of the opinions of public sector workers on alcohol abuse and regulation.

The results were clear: public sector workers believe stronger rules are needed and healthier options must be offered to consumers. It also revealed that the majority of doctors, nurses and police officers backed proposals by the Chief Medical Officer for a minimum price for alcohol.

Take a look at some of the findings –

62% think that there should be a minimum price per unit for alcohol to stop deep discounting in supermarkets, off-licences and shops

77% believe that price promotions in pubs, bars and clubs that encourage excessive drinking should be banned

94% say that customers should always be able to buy alcohol in smaller measures (e.g. 125ml wine, 25ml spirits) if they wish

Of those statistics, those in the public sector are most united over giving drinkers a choice to consume less alcohol. It seems absurd that at the moment people can’t always have a small glass of wine if they want it.

As I said in today’s press statement, alcohol misuse is our national disgrace. We have some of the worst alcohol abuse figures in Europe and it’s about time real action was taken.

Our message is clear – there must be tighter regulation on the sale, labeling and advertising of alcohol and what’s more - people must be given healthier options and alternatives.

We need to call time on our dangerous drinking culture and we need to do so now.

I would like to hear what you think, so make a comment below or tweet your views to me at www.twitter.com/drpetercarter

Friday, 31 July 2009

That's what I call a great start...

It’s been three days since the RCN unveiled its new social networking tools and I have to say, I’m staggered at how successful it’s been. The launch video was watched by 10,000 people after just 24 hours on the RCN website. As I write this, it stands at over 15,000.

Plus, of the people who are following me on Twitter, a huge number appear to be signing up for the first time, helped by the launch instructions.

This is a great start to a very exciting new way of interacting with members on the ground, in the wards, with the patients. The RCN only exists because of the amazing nurses who keep our healthcare service working. The fact that these new tools can allow us to hear their comments, get their feedback and take their opinions is very encouraging.

Yesterday I was at the RCN Wales Conference, the theme of which was ‘Leadership and its legacy’. I gave a speech on leadership and met a number of inspirational delegates who are leading our profession through these tough times.

I’m off to Anglia Ruskin University today to meet with their Vice Chancellor, David Humber. The university has an exceptional Health and Social Care faculty and, judging from their website, they’re really promoting nursing as a varied, diverse and rewarding profession – which, of course, it is.

I’ll blog again next week so have a very enjoyable weekend and come back soon.

Tuesday, 28 July 2009

The first blog post...

Well here it is…my first blog post. Today marks a real step forward in the way the RCN interacts with both its members and the general public. If you’re reading this then you way well have already watched the launch video on the (revamped) website.

Both I and the RCN have joined Twitter. If you were able to find this blog, then Twitter is a piece of cake. It’s a great resource for keeping up to date with what interests you.

That’s perhaps what’s best about all of this new technology – the power is with the people. You can get the news when you want the news, read updates when you have the time and interact with people and organisations of your choosing.

In this blog, I’ll write short updates about what I’m up to in and around the RCN. I meet inspirational nurses up and down the UK all the time and I’d like to share those meetings with the world and tell people about the amazing work that’s being done.

I’ll also post my thoughts and responses to the topical news stories of the day. We’re currently in an election year and with our economy in crisis and public spending cuts in discussion, the nursing voice has never been more important.

That’s where you come in. The RCN is as strong as its members; so get involved on Twitter and make sure your voice is heard.

I’ll blog regularly so make sure you come back soon…!