Nurse leaders promise ‘proportionate’ oversight during NHS winter crisis

The remarks were made in a joint letter to all healthcare workers about what support is available to them, ahead of what is expected to be another difficult winter in health and care services.

The letter, published on Tuesday (12 December) was co-signed by the Nursing and Midwifery Council chief executive and registrar Andrea Sutcliffe, England's CNO Dame Ruth May, General Medical Council chief executive and registrar Charlie Massey, Care Quality Commission chief executive Ian Trenholm, and Professor Sir Stephen Powis and Dr Emily Lawson of NHS England.

"We ask that you seek support from your organisation if you need it, as well as supporting one another"

Letter from nurse leaders

The letter said: “The past few years have been some of the most challenging faced by health and social care professions.

“With increasing demand as we go into winter and with newly announced prolonged period of industrial action by junior doctors in late December and early January, it is likely that there will be further challenges in the months to come.

“As we did last year, we wanted to ensure you had national recognition of this challenging situation.”

As with the previous winter, the letter was published as industrial action continues to impact health service provision.

Nurses are not striking this year, but junior doctors who are members of the British Medical Association are set to strike in late December and early January.

The signatories of the letter said they were “confident” that clinicians would continue to carry out their duties despite industrial action, but acknowledged the fears some healthcare professionals had about meeting the demands of the job during this time.

The letter said: “We also understand there will be concerns about working under pressure, and that you and your teams may need to depart from established procedures on occasion to provide the best care.

“Please be assured that your professional code and principles of practice are there to guide and support your judgments and decision-making in all circumstances.

“This includes taking into account local realities and the need at times to adapt practice at times of significantly increased pressure.”

The healthcare leaders said that, if a professional complaint was raised against an individual, they would look at the “context and circumstances" in which they were working to decide whether to investigate.

One example of this, the letter said, would be the patient pathways across urgent and emergency care; it said regulators would take into account the immense pressures these departments in particular are under.

“All national regulators will take into account the need to keep regulatory oversight proportionate at this busy time, whilst maintaining the focus on patient safety and protection of the public,” the letter read.

These concerns were echoed recently by Ian Naldrett, newly-appointed chair of the British Association of Critical Care Nurses (BACCN), who said the lack of reprieve during summer made him worry about what December and January may hold.

As well as this, a recent NHS Providers report found that 95% of trust leaders said they were “extremely or moderately concerned” about seasonal pressures this year, with the vast majority expecting this winter to be worse than 2022-23.

The same survey also found that a majority were very worried about burnout and low morale across their workforce over winter.

The letter continued that while health and care leaders must not let standards for patient care slip, they must also look after staff.

Addressing the professionals themselves, the letter added: “It’s also essential that you look after your own health and wellbeing during this period.

“Asking for help from others when you need it is good professional practice, so we ask that you seek support from your organisation if you need it, as well as supporting one another.

“Finally, we would like to thank you again for the large amount of work that has already been done to prepare for winter and to ensure the best possible care for those who need it, and please keep encouraging eligible frontline team members to come forward for their winter vaccines.

“Whether you are providing direct care, supporting colleagues or leading services and teams, all contributions are essential components of providing the best possible support and care to the communities we serve.”