I beg to move,
That leave be given to bring in a Bill to make provision about National Health Service bodies establishing nurse staffing levels.
I start by declaring an interest as a nurse and a member of the Royal College of Nursing, which is leading the campaign for safe and effective nurse staffing. Nursing is one of the most underestimated professions in the country, if not the world, because while everyone loves a nurse, with colloquial terms such as “angel”, “having a vocation”, “hero” and “caring or compassionate” being used to describe us, the true impact of nurses and nursing on the nation’s health has never been recognised. We are more than just a doctor’s assistant. Whether an experienced nurse who holds a patient’s hand as they die while assessing their level of pain or symptom management, or an advanced nurse practitioner in places such as the Royal Marsden Hospital’s clinical assessment unit who can treat patients with acute ascites and manage them by inserting a drain to deal with the symptoms or can look for the first sign of sepsis, nurses are truly saving lives.
There is increasing evidence that the right number of qualified nurses can improve patient outcomes in terms of mortality, morbidity and quality of care, and that, conversely, insufficient nurses can have a potentially life-threatening effect on patients. A study by Aiken et al reported in The BMJ looked at discharge data from hospitals for over 275,000 surgical patients in 188 hospitals across Europe, finding that a greater number of professional nurses was associated with lower odds of mortality. Likewise, Bridges et al also found in The BMJ only last year that the addition of qualified nurses makes a difference to patient outcomes—not simply the addition of healthcare workers, but qualified and experienced nurses. There is something in the skill and experience of qualified nurses that improves mortality rates, morbidity rates and quality of care.
Record numbers of nurses have joined the Nursing and Midwifery Council register, with 8,000 more nurses and midwives now registered to work in the UK, but over 43,000 nursing vacancies remain in England alone. The RCN staff survey in 2017 reported that that is having an impact on the ground, and nurses are reporting that care is going undone as a result. That is why, as a nurse and a member of the RCN, I am bringing this Bill forward to establish legally enforceable nursing staffing levels in the NHS in England, as was done in Wales in 2016 and in Scotland in June this year, when the Health and Care (Staffing) (Scotland) Act was passed.
The Bill has four main aims. First, we need to make the Government accountable for nursing levels in England. No one is accountable for nursing numbers, which is why we have such a high vacancy rate and a lack of strategic action to address the situation. How are we going to increase student nurse numbers via degree apprenticeships, which are working so well in places at the University of Brighton in my constituency, where student nurses earn while they learn in clinical placements? How are we to increase the numbers returning to practice when return-to-practice courses are difficult to access and expensive, with nurses often having to pay for them themselves? Nearly a third of our nurses in practice today are likely to retire in the next 10 years, so how are we to address early retirement? Without someone taking responsibility, none of those issues will be addressed. While individual trusts do their best to mitigate recruitment and retention challenges, no one is taking responsibility for the sheer scale of the issue across England.