I am a nurse, a midwife and a health visitor and have worked in the NHS since 1985. I have seen over those years massive changes in how we fund vital services such as cleaning, laundry and nursing care. I have seen the loss of trained nurses in favour of "skill mix" and have been on wards where the heavy workload has had to cope with the decrease in nursing staff numbers to "save money".
In all this I have seen patient care and standards go downhill and shouted against many changes unsuccessfully. I have watched as ward domestics have their hours cut and seen the same domestic change uniforms several times as she undergoes yet another change of employer.
In all this time I have seen wards get dirtier, patient care go downhill and qualified nurses unable to find work.
Don't get me started on how many times I have thrown out huge amounts of "headed notepaper" and other paperwork because the Trust has gone through yet another change of name and is paying for a whole new load of paperwork.
Surely all this money we have spent on changes would have been better spent in patient care, ensuring the wards are CLEAN and on staff able to give skilled care. I am not for one moment here dismissing HCAs as they are brilliant but there is not enough of them out there. As part of the nursing team they are rushed off their feet and fighting the same rubbish the qualified staff are.
I feel we have lost sight of what we should be doing in the NHS which is caring for people who are sick. I said on another thread about the Liverpool Care Pathway that caring for sick people is not rocket science. People who are sick need to kept clean (and that includes their surroundings), they need adequate food and fluids, they need their medication, they need companionship and compassion and they need those things with warmth and a smile.
We have lost our way in the NHS and are now so target driven that we have lost sight of what is important.....the patient who needs our care.
I can remember as a student nurse cleaning commodes...we would take them apart to do the job properly. We would clean beds and lockers....there was a regular "cleaning round" which was on top of what the ward domestic used to do. We would talk to patients and crucially we had time to do so because staffing was not cut to the bone. You can learn a great deal about someone from having to time to have a simple chat.....and symptoms they may have kept quiet about might well come up in conversation simply because the person has got to know and trust you.
Market forces have no place in the NHS....I am not suggesting that it becomes a bottomless pit but what does come in must go back to being used for patient care and adequate admin to do so.
This morning I find my local hospital is in the five new ones to be investigated.....as a front runner in all the market force changes I am not surprised. They spent too much time and money on their "corporate image" and not enough on patient care.