Loss of senior nurses is major threat to success of seven day working, warns RCN

The NHS has lost more than 2,000 senior nurses, including ward sisters and specialist nurses, who will be vital to the success of seven day care, the RCN has warned.

Ahead of a debate on seven day working at its annual congress, which started on Sunday in Bournemouth, the college has said that a drop in the number of expert nurse posts in the past five years is putting the government drive for a seven day NHS at risk. 

The NHS Pay Review Body (RB) is also due to report next month on barriers and enablers in the Agenda for Change (AfC) system for delivering services every day of the week. A commitment to delivering seven day services was included in last month’s Queen’s Speech.

The RCN said Health and Social Care Information Centre figures show that between April 2010 and January 2015 there were 2,295 fewer nurses working at bands 7 and 8.

These bands encompass roles such as ward sisters, charge nurses, clinical nurse specialists, nursing team managers in the community and nurse or midwife consultants.

A report by NHS England medical director Sir Bruce Keogh in 2013 said death rates were 16% higher for patients with emergency conditions admitted on Sundays compared to those admitted on Wednesdays. 

The RCN has already indicated its support for moves to ensure patient safety and outcomes are as good at the weekend as they are during the week. 

But the college insists that existing senior roles must be filled, the numbers must be expanded as needed and ‘the next generation of nurse leaders’ must be developed to make seven day working a success.

Peter Carter, who will be attending his final congress as RCN general secretary and chief executive, said: ‘Nursing roles will be at the heart of a seven day NHS, but we can’t fall into the trap of thinking that by stretching the roles we have more thinly that it can be delivered to the standard patient's need. 

‘All nursing roles have care at the centre and investment is needed in training, development and senior roles.

‘The NHS will find itself in a double bind if it has a lack of senior experts now, and no one to plug the gaps in the future.’

The college said that experienced nurses help patients to live with long-term conditions and therefore avoid hospital admissions, prescribe medication and supervise, mentor and train newer staff. 

The RB was invited to make observations on how the AfC system can deliver seven day services ‘without increasing the existing spend’.

In its submission to the RB in December, the Department of Health said one option could be to scrap unsocial hours payments altogether.

At congress, RCN members will vote on a resolution to reject the 2010-15 government’s premise that unsocial hours payments should be scrapped.