'Mountain To Climb' For NHS Boards

There are not enough nurses in the NHS to implement the government's guidelines on winter care.

Yesterday, the Scottish Government set out its plans for the coming months, including provisions for extra beds to ensure patients can be discharged at weekends and bank holidays.

But the Royal College of Nursing Scotland says health boards will struggle to put these measures into practice because they're under too much pressure.

RCN Scotland Associate Director Ellen Hudson said: “What these reports both show, again, is that the NHS is under huge pressure.  As we have repeatedly said, change is desperately needed and this requires a frank debate about the real situation on the ground. While the report on the winter of 2014-15 highlights the additional number of nursing staff this does not give the full picture – vacancies were up, the use of agency nursing and midwifery staff increased by over 50% and the cost for bank nurses also went up by £11.4m between March 2014 and March 2015.

“Given these figures, we do question how health boards are going to be able to put into practice the guidance issued today by the Scottish Government. Patients, quite rightly, expect health boards to plan for winter and it is good that the Government is focused on this serious issue.  But the scale of local reform expected, even before the Scottish Government’s own national reviews on issues such as out-of-hours care are complete, will be a mountain for already over-stretched health boards to climb before the end of October.”

Letter of concern

Meanwhile, a staffing crisis has threatened to close the intensive care unit at Kirkcaldy's Victoria Hospital.t's been reported that the unit did not have enough of the required qualified staff to deal with demand on Saturday.

Cowdenbeath MSP Alex Rowley has written to the Health Secretary Shona Robison to raise concerns about the issue:

Dear Cabinet Secretary
 
I am writing to follow up my previous discussions with you about the ability of NHS Fife to recruit staff to meet the health and social care needs of the people of Fife.
 
I was somewhat taken aback when you answered my written question last month and stated there were 53 consultant posts unfilled in Fife.  This had actually risen from the previous year despite the fact that NHS Fife had told me they were doing better at recruiting for some posts.
 
You are well aware of the impact of this position, not just on budgets but also on the care that my constituents and others across Fife fail to receive as a result of this position.  I am therefore requesting a meeting with you so you can update me on what is being done to try and address this problem of not being able to recruit doctors and consultants.
 
I am also today writing to the Chief Executive of NHS Fife to raise with him my concerns about the staffing levels in Victoria Hospital Kirkcaldy.
 
It has been brought to my attention that over the weekend the Intensive Care Unit was full but there was not enough of the required qualified staff for the Unit.  I am told that the management team thought it was acceptable on Saturday to use nurses from elsewhere in the hospital to staff the ICU.  It has been suggested to me that these nurses had no experience and one ended up with a ventilated and dialysis patient and no skills to look after this patient.  This nurse was in tears by the end of the day.
 
These are the sickest people in Fife.  Their care was left in the hands of untrained nurses.  It was put to me that management thought this was acceptable and refused to bring in trained agency staff.
 
I am advised that on the Saturday evening the ICU consultant gave his view of the situation in no uncertain terms and threatened to close the Unit unless they had trained staff.  Agency nurses were then contacted and brought in.
 
Again staff are speaking privately about the levels of stress and pressure they are working under and this, they say, is leading to sickness levels rising.
 
I am requesting that these matters are investigated and that a report on staffing levels in Fife is made available so we can build a picture of the issues in order to move forward and find solutions.
 
I look forward to hearing from you.

'Standard of care'

Helen Paterson, NHS Fife Director of Nursing said: “NHS Fife are committed providing patients with the best possible standard of care and it is important to reassure the public that we are operating at staffing levels which are safe and appropriate across our services.

“Regarding the situation in the Critical Care Unit at the weekend, we experienced a high demand for critical care with staffing levels reviewed on a shift by shift basis to ensure that appropriate levels of nursing skills were available within the unit and that patients continued to be provided with the best standard of care.

Rona King, Director of Human Resources and OD, Deputy Chief Executive said: “NHS Fife, in common with other Boards across Scotland, experiences some challenges in recruiting to consultant posts.  It is, however, important to highlight that many of these vacancies are covered by other means and I can confirm that we have appointed twenty consultants who will start in NHS Fife over the next few months.”