RCN says patients are at growing risk as nurses report unsafe staffing levels

NURSING leaders have warned that collapsing growth in the registered nurse workforce, combined with increasingly complex patient needs, is creating a “deadly mix” for patients.

The Royal College of Nursing said staff across hospital and community settings are being left struggling to keep people safe, with more than a quarter saying nurse numbers on their last shift were so far below what was needed that there was a high risk of harm.

The warning comes from the RCN’s latest Last Shift survey, which gathered responses from more than 13,000 nursing staff across the UK.

Professor Nicola Ranger, the RCN’s General Secretary and Chief Executive, is expected to tell more than 3,000 frontline nursing staff at the union’s annual Congress in Liverpool that governments are failing in their duty to keep patients safe.

She will say that widespread registered nurse vacancies are always unsafe, but that the risk is now being made worse by an ageing and sicker population with more complex needs.

Four in five nursing staff said clinical complexity had increased over the past two years, while only one in ten said staffing was at the right level to meet all patient needs. More than two thirds said they were being forced to make difficult decisions about which care to prioritise.

In Wales, nurses and health care support workers described growing pressure across wards and community services.

A nurse working on an older people’s ward in the NHS in Wales said: “We need to increase the agreed establishment; nurse to patient ratio due to increasing acuity, dependency and complexity of patients’ condition and presentation.

“More and more patients are now presenting with worsening cognitive function and often display challenging behaviour.”

A health care support worker from an inpatient mental health unit in Wales said: “Our ward has been bombarded with high acuity for around a year now and staffing levels have barely seen an increase.”

The RCN said the findings also show the toll on staff wellbeing. More than three quarters of respondents said they felt emotionally exhausted on their last shift, with exhaustion highest among those who said their shift was understaffed.

RCN Wales Executive Director Nicola Williams said: “Nursing staff across Wales are telling us clearly that staffing levels are not matching the complexity and intensity of care patients now need.

“Too many shifts are operating without enough registered nurses to deliver safe and effective care.

“When more than a quarter of nursing staff describe staffing levels as unsafe and nearly half report compromised care, we need to listen and take action to address it.”

She said members were “going above and beyond every day” but were demoralised, missing breaks and having training time cancelled.

Ms Williams added: “They cannot continue carrying the burden of workforce shortages indefinitely. Emotional exhaustion is becoming normalised across the profession and that is dangerous for staff, patients and the future sustainability of services.

“The newly elected Welsh Government must urgently invest in growing and retaining the nursing workforce, ensure they have the training they require, alongside delivering safe staffing levels that are properly planned and enforced.

“Without action, patient safety risks will continue to grow.”

The RCN said the survey showed an urgent need for workforce investment, robust nurse staffing plans based on patient need, and action to improve recruitment and retention across Wales.

More than 300 professionals sign open letter calling for prevention-focused care and urgent reform

OCCUPATIONAL therapists across Wales are urging the new Welsh Government to act before pressure on the NHS and social care system deepens further.

More than 300 members of the Royal College of Occupational Therapists in Wales have signed an open letter calling for a major shift towards prevention, early intervention and care closer to home.

They say too much support is currently arriving only after people have reached crisis point.

The therapists argue that earlier help in the community could reduce hospital admissions, ease pressure on overstretched services and improve lives across Wales.

Occupational therapists work across the health and care system, supporting premature babies and families in neonatal care, helping children take part in school, enabling adults to stay in or return to work, and helping older people live safely in their own homes.

The Royal College says the profession is often overlooked, despite playing a vital role in keeping people independent and reducing demand on hospitals.

Its members are calling for five key changes, including embedding occupational therapists in every community healthcare cluster, improving workforce planning, putting prevention at the heart of health policy, ending inconsistencies in provision, and opening leadership roles to occupational therapists.

Paul Smith, RCOT Policy and Public Affairs Lead for Wales, said: “Wales can’t afford to keep waiting for a crisis to happen.

“Occupational therapists are already preventing hospital admissions, easing pressure on stretched services and supporting people to do the occupations they want and need to do.

“But they need to be positioned to provide the right support at the right time to make maximum impact.”

The call comes amid continued concern over waiting times, delayed discharges and pressure on hospitals, including in rural parts of Wales where patients often face long journeys for care.

RCOT says ministers, health boards, councils and sector leaders must now work with the profession to ensure people receive the right support earlier, closer to home, and before problems spiral into crisis.

Health bosses promise better joined-up care — but patients will want assurances over Withybush and travel distances

PEMBROKESHIRE patients are likely to be asking what a major NHS shake-up means for the future of hospital services closer to home after a new regional health body formally took over planning across south west Wales.

Health chiefs this week confirmed that regional working has formally transferred from ARCH (A Regional Collaboration for Health) to the South West Wales Regional Joint Committee (RJC), bringing together Hywel Dda and Swansea Bay university health boards under a new leadership structure.

The move is being presented by NHS leaders as a way to improve coordination, reduce waiting times and strengthen specialist healthcare across the region.

Key programmes expected to continue under the new body include cancer care, stroke services, vascular treatment, orthopaedics, pathology and eye care.

But for many in Pembrokeshire, the announcement may trigger familiar concerns about whether “regional working” could eventually mean more services being delivered further east, requiring patients to travel longer distances to Carmarthen or Swansea.

Withybush Hospital remains fiercely valued by local communities, and previous changes to hospital services have often sparked strong public reaction.

For patients in more rural parts of Pembrokeshire — including St Davids, Fishguard, Newport, Crymych and Tenby — access to healthcare can already involve journeys of 40 to 60 miles or more for appointments and treatment.

While health officials insist the new structure is about improving care and making better use of expertise across the region, questions are likely to be asked locally over how Pembrokeshire’s voice will be represented in decisions affecting frontline services.

Among the issues patients may want clarified are whether services currently provided at Withybush could be affected, how travel difficulties for rural communities will be considered, and whether the new regional approach will improve care locally or lead to greater centralisation.

The Regional Joint Committee replaces ARCH, which since 2015 brought together Swansea Bay University Health Board, Hywel Dda University Health Board and Swansea University to support healthcare innovation and service planning.

Health leaders say the new committee will continue to support research, technology and partnership working, while involving patients and communities in shaping services.

But in here Pembrokeshire, many will this plan weaken Withybush, not strengthen it.