The health of the health service

Is the UK’s NHS at breaking point? A new report suggests it might be, as Tim Gibson explains

For many, it is the jewel in the crown of the UK public sector – an institution of which the entire nation can be proud.

But according to a recent survey by a leading public sector trade union, the National Health Service (NHS) is “under severe strain”, with frontline workers unsatisfied with staffing levels in hospitals throughout the UK.

The survey, published by UNISON in a report entitled ‘Running on Empty’, reveals that 65 per cent of care staff say they do not have enough time with patients. More than half claim that care is left undone, even though many work through breaks or beyond the end of their shift.

UNISON says that it wanted to chart a “typical day in the life of the NHS”. A prevailing theme of its findings is understaffing, with 60 per cent of those questioned saying there are insufficient numbers of people working to give patients appropriate care.

The statistics reveal that 45 per cent of nurses care for eight or more patients – a figure the union describes as “shocking”. The NHS does not currently operate with a mandated staff-to-patient ratio.

Coming as it does in the wake of the high-profile failings at Mid Staffordshire hospital, in the Midlands region of the UK, the report raises serious questions about the quality of care being delivered by the NHS. In fact, 48 per cent of respondents told UNISON that there is a risk of a similar situation to Mid-Staffs in the hospital they work in, or that such a situation is already happening in parts of their hospital.

UNISON claims that its report demonstrates “a clear link between appropriate patient-staff ratios and patient mortality.” It continues: “…when a nurse or healthcare assistant is responsible for eight or more patients, harm is occurring.”

Speaking about the report, UNISON’s head of nursing, Gail Adams, said: “It’s clear that despite nurses working through breaks and beyond their hours, they simply do not have enough time to give patients the care and attention they need. This is distressing for patients and for the staff trying to care for them. The [UK] government needs to face up to the damage it is inflicting on patients and staff by not introducing enforceable nurse-to-patient ratios, and take urgent action.”

Another issue that the report addresses is the NHS’s reliance on agency and bank staff in hospitals. Almost a half of respondents claim to work alongside one or more temps, and UNISON says that their “regular use is not cost effective or in the best interests of patients.”

In a response to the report, a spokesman from the Department of Health told the National Health Executive: “The NHS now has the highest ever number of professionally qualified clinical staff since census records began. [There are] over 4,200 more nurses on our wards since 2010, greater transparency, and compassionate care replacing tick-box targets as the major focus on boards and wards.”

There is clearly some disagreement between the UK government, UNISON, and healthcare workers themselves concerning the state of the NHS. But one thing is plain: if it is to live up to its status as the UK’s flagship public-sector institution, the National Health Service needs to take better care of itself, as well as its patients.

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