Dr. Peter Carter's Blog

This Blog

2011-04-26T11:43:00.001+01:00

This Blog is now inactive, instead you can read the latest Blogs, News and updates from the RCN's Facebook Page, the Frontline First website or of course, the RCN's website.

Thanks.

2010-10-25T14:32:00.000+01:00

The blog below was originally published on the Frontline First website. Please visit to join in this crucial campaign.

I’m writing this blog having just travelled back from the Conservative Party Conference, where the RCN’s response to the White Paper was a hot topic of discussion.

As many of you will have already seen, the RCN has enjoyed a high profile with the health media over the last two days. I believe this is a testament to how respected and important your voice has become.

We issued our response to the hugely important White Paper on Monday and it’s fair to say it was an honest, frank and intelligent reaction to the radical proposals planned for the NHS. We welcomed the principles in the Paper, such as the drive towards a patient centred health service, greater control for health professionals and more available information on providers and clinicians.

However, all radical changes come with risk; the White Paper is no exception. Couple this with the fact that the NHS in England is being asked to save £20bn by 2014 and the changes look even harder to implement successfully.

One of our biggest concerns relates to the sheer importance of piloting the many proposals within the White Paper. If £80bn is to be handed over to GPs for the commissioning of services, we think it essential that this model is at least piloted to see if it will work.

Then of course there is nurse leadership, which is noticeably absent from the White Paper. The role of the nurse has changed dramatically in the last 15 years, with large numbers taking on important responsibilities for the financial health of organisations. With the planned abolition of PCTs and SHAs, we are very concerned as to what nurse leadership will look like post-White Paper, as these structures have allowed nurses to progress up the career ladder.

If you want more information, you can read our full response and its executive summary from our dedicated White Paper micro-site, as well as watching a video blog with our Head of Policy, Howard Catton.

Despite our concerns relating to the proposals, we can be proud of how loud the nursing voice has been this week and how much it has been heard. Much of this is down to you; through this website you told us what you thought of the changes, and we listened.

The months ahead will be critical for the future of the NHS and thanks to your input and expertise we will ensure that nursing is at the very heart of the debate.

Thank you.

Saving money, cutting waste

2010-07-21T10:26:00.001+01:00

My most recent blog can be found on the 'Frontline First' website talking about cutting waste in the NHS. Please visit www.rcn.org.uk/frontlinefirst for more information.

We know that the NHS is being asked to make billions of pounds of ‘efficiency savings’ over the next few years. The RCN is clear that it is essential these ‘efficiency savings’ do not have a negative impact on standards of patient care.

We believe that the key to saving money is cutting waste. Waste is rife amongst too many parts of the NHS, however we can take very practical steps to cut this back. This is where we need you.

This campaign is all about finding out what’s really happening where you work and where you think improvements need to be made. Already, hundreds of you have written in to speak out about waste. Your evidence is helping us gather the knowledge we need to make the NHS more efficient and to protect jobs.

A number of trends are emerging across the UK. Many of you have pointed out simple practices that waste money, such as ordering medication or dressings which go unused, or leaving electrical equipment plugged in unnecessarily which runs up expensive electricity bills.

There are also examples of IT systems that make nurses and healthcare assistants’ lives harder rather than easier and administration systems that don’t offer the level of support staff need. In many cases these systems are keeping you away from where you need to be – with patients.

We know that these are only some of the many examples of waste that exist and we need your help in identifying more. Nursing staff like you are often best-placed to see what’s happening at the heart of the NHS. We will use your evidence to highlight where money can be saved without damaging frontline care.

Together we can stamp out waste, protect services and improve care.

This is only the beginning

2010-07-14T14:55:00.002+01:00

My latest blog outlines the importance of nurses' participation in our latest campaign, 'Frontline First'. To find out more, visit http://frontlinefirst.rcn.org.uk

We’re already starting to see trends emerge, with a number of organisations putting freezes on recruitment, down banding staff and/or asking specialist nurses to forgo their practice and work in general settings for set periods.

However, with the information that you give us, we can take this data and use it to bring local decision makers to account. We can use what you share with us to force health organisations to justify their decisions and explain their efficiency savings. Do not think for a moment that you don’t have the power to change what’s happening where you work – you do; we just have to make sure we do it together.

So, if you haven’t yet shared your experiences, do it today. If you’ve already told us what you know, share this site with your friends and colleagues and get them to tell us their experiences.

Together, we can put the Frontline First.

Back to the blogosphere

2010-06-14T10:30:00.002+01:00

After a long break, I’m returning to the blogosphere. Many things have changed since I last blogged, but top of the health agenda are the plans the new government has for the NHS.

The College welcomes the pledge of the coalition government to put patients at the heart of the NHS. Patient safety and the patient experience must always come first in the face of public sector efficiencies.

The Health Secretary has already set out his ideas for “patient-centred care”, with a number of ideas for achieving this already in the pipeline.

One plan is to penalise hospitals if patients are readmitted 30 days after discharge. While it is clearly desirable that hospitals only discharge patients when it is safe to do so, it is important to stress that reasons for readmission can be complex. Hospitals must also become responsible for better integration of community and acute health to ensure a more holistic approach to care.

It is also crucial that nurse-led services, such as specialist clinics are not lost as these often provide cost effective solutions for preventing re-admissions. The government must ensure that there are sufficient resources to enable these high standards of care to continue.

Andrew Lansley has revealed that there will be a real term increase in funding for the NHS for the next five years, although the RCN believes that this is unlikely to keep up with the demand for services. We know that the current economic situation means that the reality for the NHS and all public services is that we will have to do more with less. This will mean increasing productivity and reducing waste. More will of course become clear in the Emergency Budget on 22nd June…

We welcome further details as plans for the Health Service unfold. High quality care must always be the standard for the NHS and staff need support in terms of resources, training and time to ensure that the patient experience is always a positive one.

The value of specialist nurses

2010-03-03T11:37:00.001Z

At the RCN we understand the value of specialist nurses. We’re clear about their economic benefits and the overwhelmingly positive impact they have on patient care. So we’re delighted to be launching a report that sets out the reasons why investing in specialist nurses is crucial not just to patients but to reducing costs to the NHS.

Time and again studies highlight the benefits of specialist nurses, including reducing unnecessary re-admissions, the length of hospital stays and the number of post-operative complications that patients suffer.

Specialist nurses were one of the groups hardest hit by the deficits crisis in the NHS in 2005/06. As we head towards another period of constrained funding, we must ensure these healthcare experts are not targeted in the inevitable drive for efficiencies. If you haven’t already, you can show your support for specialist nursing by signing up to the ‘Nursing counts’ campaign today. We’re calling for every patient with a chronic or long-term condition to have the right to specialist nursing care.

Despite the impact that these nurses have on the patient experience, there are worrying signs that history could repeat itself.

The RCN surveyed the UK’s leading health charities and almost 60% said that they were worried that specialist nursing posts would be subject to cutbacks in the ‘near future’. Perhaps more worryingly, over a third (37%) told us that they have already seen evidence of reductions in the funding of specialist nurse posts in the last twelve months.

At this defining moment, we have a real choice in front of us – do we sit back and allow these critically important healthcare professionals to suffer familiar cutbacks and redundancies, or do we take a stand and speak up for what we know is right? We need your continued support, if you’ve already signed up to the campaign you can send it to your friends and family.

So far, over 2,000 people have already sent emails to another 8,000 – ensuring our voice grows louder by the day. You can view our latest film, in which we hear from specialist nurses and the people who they help. People like Lillian, whose husband Tim has suffered from Parkinson’s disease for 30 years, says how she doesn’t know how she’d be able to cope without Carolyn, the specialist nurse.

These stories are not unique, they’re replicated all over the UK and millions of people know how important specialist nursing care can be. You can watch the film from the front page of this website.

Our time is now

2010-02-17T13:40:00.002Z

Two weeks ago we launched our ‘Nursing Counts’ campaign and in the last fortnight, the response has been nothing short of fantastic. As I write this, over 80,000 people have watched our General Election film on both the RCN homepage and the dedicated website, almost 17,500 have signed up to our priorities and our Facebook page has over 2,700 fans.

This is exactly the sort of start that the campaign needed, but we mustn’t stop here. In order for the nursing voice to ring out loud and clear through the corridors of Westminster and beyond, we have to get as many people to speak up as possible. Our ‘Nursing Counts’ campaign will only be as strong as those willing to stand up for patients, nursing and healthcare.
This is where you come in.

Email this page to your friends, mention it in conversations, ask them to sign up, spread the word on Facebook, tweet the links and send in your photos. Our healthcare service stands at a cross roads, we can either chose to limit public spending and compromise patient care, or invest in services that we know deliver results and save lives.

Only last week we saw the latest figures on just how many people suffer from dementia in the UK, a figure that will keep on rising. When a person is diagnosed with dementia, the onus isn’t on the latest medicine or technological advancement, it’s on delivering long term care that will manage the symptoms and improve a lifestyle. This sort of care is delivered by nurses, sometimes in a hospital but more often than not in the patient’s home. The RCN is calling for all those suffering from long term conditions to be guaranteed specialist nursing care.

Our healthcare services will change over the next ten years, there will be more, not less, demand on those providing care. Do we want to cutback and reduce job numbers when we know what lies ahead? Or do we want to take this moment to invest in services that we know will be needed like never before? We must stand up and speak out against any future cuts, we must defend the rights of patients and promote the work of our nursing family.

I know that all of us have conflicting demands and a huge number of things on our to do list, but please, take five minutes to spread the word and start something incredible – our time is now.

Please visit http://generalelection.rcn.org.uk/ to show your support.

Politics counts, votes count, nursing counts.

2010-02-01T10:57:00.000Z

The next General Election is going to matter; not just to your working life as a nurse but also to the lives of your patients. The coming months will see politicians of all parties set out their vision for the care of future generations.

Whatever happens over the next few weeks, the nursing voice must be heard. It's becoming clearer and clearer that after this election, in this new decade; fundamental decisions about the future of healthcare will be taken.

With an average of over 1,800 nurses and healthcare assistants living and voting in each constituency, parliamentary candidates and political parties know that the nursing family is one they cannot afford to ignore.

Whether or not you have a politician knocking on your door, it is up to us as nurses to make our voices heard in the debates over the future of the health service.

To recognise the sheer importance of this election, we have launched our ‘Nursing counts' campaign and with it, this exciting new website. From this site you'll be able to sign up to our manifesto pledges, send them on to friends and family, upload photos, watch our latest films and interact with Twitter and Facebook.

Nurses represent one of the largest and most significant voting blocs in the UK, if we use our voice to stand up for quality care, for sustained investment and for the bright future that we know patients deserve, we will make a difference.

Politics counts, votes count, nursing counts.

Get active now, visit www.rcn.org.uk/generalelection

Save the NHS from alcohol abuse

2010-01-08T11:44:00.003Z

This ‘Comment is Free’ article appeared today on the Guardian website:

We desperately need clearer labelling, tighter laws and better education to tackle the spiralling costs of excessive drinking.

In a seemingly unrelenting stream, new evidence highlights just how serious the nation's problem with alcohol has become. It has been estimated that the number of people being admitted to hospital as a result of alcohol abuse is rising by 80,000 a year, costing the NHS about £2.7bn annually. As the NHS Confederation highlighted last week, if this does not change, the NHS will soon be constrained by financial demands it simply cannot meet.

As well as causing extreme physical and psychological damage to those who drink to excess, alcohol abuse is putting undue pressure on already overstretched frontline healthcare professionals. Nurses, particularly in A&E, are faced with tremendous time pressures and difficult decisions everyday. The fact that more and more people are being admitted to A&E as a result of drinking themselves into a stupor, makes an already tough job even harder.

As anyone who has ever acted as designated driver will know, drunk people are often irrational and illogical. This makes the treatment process even longer than usual. The effects of alcohol can also mask serious problems, such as concussion as a result of a head injury, making the need for thorough investigation even greater. And then of course there's the fact that intoxicated patients often arrive in A&E accompanied by their fellow revellers. While supporting a friend is obviously no bad thing, the arrival of large parties of drunk people in a hospital can be disruptive and intimidating. This not only affects staff, but can create a fraught environment for the other patients arriving in A&E with life-threatening conditions.

Some commentators have argued that those being admitted to hospital with self-inflicted problems, like alcohol misuse, should pay for their treatment. We have always maintained that healthcare should be free at point of delivery for everyone. The widespread alcohol misuse we see today is the result of a historically permissive attitude towards drinking on the part of society as a whole. It is nothing less than an overhaul of the attitudes and habits of society that we need now. But the government does have a role to play in supporting everyone to live healthier lives.

Today the health select committee's inquiry into alcohol has published a report calling for tougher measures to curb the rising numbers of people suffering, or even dying, as a result of alcohol. It also highlights the importance of listening to what those on the frontline have to say about excessive drinking.

As we approach the general election, all political parties must accept the need to take urgent action to stop this dire problem spiralling even further out of control. The Royal College of Nursing is calling for a single mandatory code to ensure the alcohol industry and retailers are properly regulated and socially responsible. There needs to be clearer labelling to ensure consumers realise how much they are drinking, as well as tighter regulation on the advertising and sales of alcohol.

There also need to be more widespread campaigns, using all available channels including social networking, to ensure that everyone realises just how serious excessive drinking can be. Attitudes towards smoking have changed, and so society's attitude to alcohol can too. There needs to be a cultural shift towards safer drinking, especially among younger people, to help the NHS and to improve the health of the nation.

You can visit Guardian comment is free here http://bit.ly/8awvMW

Christmas message

2009-12-23T11:09:00.002Z

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

‘From good to great…’

2009-12-16T15:49:00.001Z

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.

Dealing with Dementia...

2009-11-25T10:49:00.000Z

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

The future of nursing...

2009-11-11T13:57:00.001Z

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…

The Swine Flu vaccine

2009-11-02T09:07:00.001Z

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.

Raising concerns, raising standards...

2009-10-19T16:54:00.001+01:00

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.

Care before cuts...

2009-10-08T15:20:00.001+01:00

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.

The next step...

2009-10-01T14:49:00.001+01:00

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

RCN: Fit for the Future

2009-09-23T13:13:00.000+01:00

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

The importance of the school nurse...

2009-09-16T16:30:00.000+01:00

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.

A response...

2009-09-08T16:24:00.001+01:00

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.

Maternal Mortality

2009-09-03T10:23:00.000+01:00

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.

The real picture

2009-08-27T09:13:00.000+01:00

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.

The health of our health workers...

2009-08-19T13:30:00.001+01:00

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.

A health service to be proud of...

2009-08-13T15:34:00.001+01:00

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.

De ja vu...

2009-08-07T11:22:00.001+01:00

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.

Last orders please...

2009-08-05T09:38:00.001+01:00

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

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

2009-07-31T11:26:00.002+01:00

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.

The first blog post...

2009-07-28T15:18:00.002+01:00

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…!