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From my (possibly simplistic) point of view I wanted to know 2 things when my mother was very ill last year (and unable to fight for herself).

1. Who is in charge of / responsible for running the ward?
2. Who is responsible for my Mum's treatment?

I never got a satisfactory answer to either question. Apparently nobody was accountable for anything.

The 'bean counters' face immediate scrutiny if there are any financial problems in a Trust but not if there are quality issues.

Quality of care should be the priority.

".......but do think we also need to look at nursing training. "

I agree tim I saw a real difference in attitude (from some not all nurses) returning to the wards after 10 years.

The big thing that came out of the francis report for me was that despite complaints from patients and concerns raised by staff. Nothing was done, they just weren't listened to or it was brushed under the carpet.
As a nurse I have never felt so ignored. It feels like our experience is not valued at all.
We are the ones working with the patients, we are the ones trained in patient care and yet ours is the weakest voice when it comes to making decisions about the service that's provided.
Its totally frustrating to come on shift and have low staff numbers and yet managers are forcing us to take admissions or to carry out non emergency surgery, because they dont want to have to register a 'cancelled op' on their statistics, when we tell them its not safe, you are basically told to get on with it and 'just cope'.

Did the hospitals have a drastic shortage of nurses?

It almost sounds like a mafia with a code of omerta where it was discouraged to report what amounts to crimes. It is disgraceful and frankly resignations are nowhere near enough, there should be jail sentences.

SauvignonBlanche. you just nailed it. that's totally true.

Something else has just occurred to me. Where were the unions in all of this ? If I was forced to work in conditions that drove me to behave so badly and no-one would listen to me I would consult my union.
Or are they completely powerless these days ?

I've spent too many years working in the NHS Meddle.

Stafford did yes.
They had 10% of vacancies unfilled and on the wards the skill mix in some areas was 40:60 with the 60% being untrained staff

The unions are about as effective as a limp noodle

Somebody on the news today said she thought the unions were in with the management.

Claig - I agree.
Sadly I think it will keep happening. I am totally in favour of minimum nurse ratios, but I also think attitudes need to change. While I was being treated for cancer, my call bell was simply left hanging out of the wall by a nurse because I had the cheek to use it to ask for pain relief after major abdominal surgery. Stress or no stress, I don't know how people like that sleep at night. The sheer terror of ending up back in a place like that is one of the main reasons I have since left the UK.

The unions are pretty powerful but their priority, naturally, is their members.

But how well trained do you need to be to wash someone or prevent a fall? Surely that is common sense & compassion??

I actually disagree that it's education for registered nurses that is the problem. Registered nurses have a duty of care / to advocate for a patient. It is drummed into students that they have a duty to report poor or unsafe care. I think the culture of a work environment with good leadership is far more important. Newly registered nurses need nurse leadership to set an example of how concerns are taken seriously and dealt with. If you start your first nursing job where you see poor care, raise the issue and it's swept under the carpet or more experienced members of staff are disillusioned by reporting their concerns, as a new member of staff, you will very quickly "fall into line" with the ward culture. No amount of improving education for new nurses will change the ward culture - it needs ward management to lead the way and set the standard that more junior members of staff will follow and feel supported to higlight concerns they have.

I guess it depends how many other patients you are expected to wash and prevent falling at the same time. The ratios are shocking at times.

Everything Meddie said with bells on!

They absolutely must introduce minimum safe staff to patient ratios and recruit to the many jobs currently frozen.

This business structure and target ledness needs to revert back to good old fashioned patient focused care not a conveyer belt of as many discharges as there can possibly be irrespective of safety

Management should be held more accountable for leaving wards grossly understaffed and guilting nurses to work well over their hours for time in leu if it's ever staffed enough to take it.

Cameron is an absolute TWUNT!
Hourly nurse rounds are a fabulous idea if there's any staff to do them.

A midwife on the news today said she would recommend young people to go into midwifery but not in the UK. How did it come to this in our nation?

Andrew Neil said today is it still right to call the NHS the envy of the world? Maybe the envy of the thitd world, but not th envy of Europe.

see this is were I have an issue with untrained staff being the ones who now do all the basic care.
I was trained to use this to assess my patient. Their skin condition,are they showing signs of skin breakdown, do we need to increase their pressure area care,their level of nutrition,are they dry? under nourished? to observe their colour, their breathing, to use that time to chat to them about any concerns.
Instead you have someone (not all) who just see it as giving someone a wash,
The trained nurse has to hope and pray that the HCA doing this can recognise problems and report them to her, or otherwise she is nursing blind.

Pandera - the thing is, having a wash is never just "having a wash" - it's assessing self-care skills, pressure areas, skin care, nutrition amongst other things and you while you don't need training to wash someone, you do need to be trained to know what you are assessing at the same time and why. That's the same for all sorts of other "basic care" - but you need to have education to ensure you understanding what you information you are gaining from doing "basic care"

What surprised me is how many of these hospitals are 'foundation' hospitals.

There is a general attitude in this country of moaning and letting things slide without actually targeting the problem, and dealing with it.

There is no structure and no one knows what on earth is going on except in a few lucky areas.

Was patient care not just as good if not better years ago when nurses had less training? Has training really improved care? Genuine question.

I would like to see a hospital similar to those shown in the "doctor" films of the 60's and the " Carry on " films.
Clean bright wards with a Strict Matron in charge, and doctors doing the rounds every day. Lots of nurses scurring round.