Resolution: Overworking

This resolution passed.

Members can view a recording of the debate here.

Unsafe staffing is not a new issue for the nursing workforce and is one that is widespread across the UK health and social care sectors. In March 2022, it was estimated there were at least 50,000 registered nurse vacancies across the UK. 

This ongoing shortfall means that nursing staff are often leaving work well after their shift has officially finished. They feel compelled to stay late to complete tasks, such as writing up notes after handover or finishing medication rounds. 

In findings mirrored across the UK, three-quarters of respondents to the latest RCN employment survey regularly worked beyond their (commonly 12-hour) shift, often unpaid. In some organisations, working unpaid overtime is expected and taking time back can be difficult. 

All this points to an intensification of work across every sector of health and social care, and a reliance on nursing staff to make up for staffing shortages. 

Research by Dall’Ora and Griffiths (2017) found an association between working overtime and an increased likelihood of making errors and burnout among nursing staff.

Hall et al (2016) found that poor staff wellbeing had a negative impact on patient safety with more chance of near misses occurring. 

A 2021 survey for the House of Commons Health and Social Care Committee found that almost half of nursing staff in England had gone to work even though they were not well enough to be on shift (House of Commons, 2021). 

In the RCN (2021) employment survey, three-quarters of respondents stated they went into work when they should have taken sick leave. In Northern Ireland, almost half of those surveyed had not taken their full annual leave entitlement, the highest percentage in the four UK countries.

How can we change this culture, which is not only unsafe, increasing the risk of mistakes being made, but also detrimental to staff wellbeing? 

Staff wellbeing plays an important role in patient safety. It makes sense, therefore, for health care organisations to provide a work environment that protects the health and safety of their staff and, consequently, patient care.

In light of these factors, and to enable this meeting of RCN Congress to investigate the health and wellbeing of members working over their shift or contracted hours, we ask: should overtime be allowed? Should staff not be encouraged to rest and recuperate on their days off? In extenuating circumstances (a pre-determined list to avoid staff working overtime to cover staffing shortages) and occasions when working over hours cannot be avoided, should time off in lieu or overtime hours be given to staff?

Reading lists for each agenda item can be found here.

References

Hall L H, Johnson J, Watt I, Tsipa A and O’Connor D B (2016) Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review, PLoS ONE, 11(7), p. e0159015.Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938539/

House of Commons Health and Social Care Committee (2021) Workforce burnout in the NHS and social care. Available at: https://committees.parliament.uk/publications/6158/documents/68766/default/ [Accessed 20 April 2022]

NHS England (2021) Safe staffing adult in patient evidence review Available at:: https://www.england.nhs.uk/wp-content/uploads/2021/05/safe-staffing-adult-in-patient-evidence-review.pdf

Royal College of Nursing (2021) RCN Employment Survey 2021 | Publications | Royal College of Nursing. Available at:; https://www.rcn.org.uk/professional-development/publications/employment-survey-2021-uk-pub-010-075 (Accessed 20 April 2022)

Skills for Care (2021) Registered nurses. Available at: https://www.skillsforcare.org.uk/adult-social-care-workforce-data/Workforce-intelligence/publications/Topics/Nurses-in-social-care.aspx (Accessed 20 April 2022)