Urgent action is needed to improve working conditions for nurses and midwives

This content relates to the following topics:

New minimum standards to improve working conditions and a review of 12-hour shifts are needed to address exhaustion and burnout among nurses and midwives, according to a new report from The King’s Fund, commissioned by the RCN Foundation.

The report finds that staff stress, absenteeism and turnover in the professions have reached alarmingly high levels. This has been compounded by the Covid-19 pandemic, which has laid bare and exacerbated longer-term issues including chronic excessive workload, inadequate working conditions, staff burnout and inequalities, particularly among minority ethnic groups.

New analysis carried out for the report suggests that this is having a significant impact on staff retention, with around a quarter of nurses and health visitors joining the NHS leaving within three years of starting.

Many nurses and midwives routinely work long shifts without proper breaks and with limited access to food and drinks. A worryingly high proportion also face bullying and discrimination in the workplace, and verbal and physical abuse from people in their care.

Following a comprehensive examination of the evidence, new analysis of key data and interviews with staff at all levels, the report sets out eight key recommendations to support the wellbeing of nurses and midwives across the UK, including those working in adult social care, GP practices, community care and other settings.

Among the recommendations is an urgent call for a review of how 12-hour shifts affect staff mental health and wellbeing and patient safety. Although some staff prefer them as they allow for more flexible working patterns, evidence shows that 12-hour shifts are associated with poor sleep and wellbeing among staff and lower quality of care for patients.

Other recommendations include suggestions to improve working conditions, shift patterns, workplace culture, team-working, support for new staff, supervision and learning opportunities.

‘The current system is not sustainable,’ says Suzie Bailey, Director of Leadership and Organisational Development at The King’s Fund. ‘An urgent review is needed to investigate alternative shift patterns and look at mitigating the impact of 12-hour shifts on staff wellbeing, care quality and safety. This may include providing rest areas for staff to decompress during shifts or to sleep after a night shift before driving home.

'Nursing and midwifery are fantastic professions, full of skilled, caring and dedicated people. We hope our recommendations will inspire positive changes to enable nurses and midwives to thrive and provide the compassionate, high-quality care that they joined the profession to deliver. The pandemic has brought many challenges, but in response we’ve seen new ways of delivering care and supporting staff that could bring benefits beyond the crisis.’

‘We need to create environments and cultures where nurses and midwives can flourish,’ says Professor Michael West, Senior Visiting Fellow at The King’s Fund. ‘Unfortunately, this isn’t where many frontline staff find themselves at the moment, with increasing numbers facing working conditions that are damaging to their health. Major issues include chronic excessive workload, bullying, inadequate supervision, discrimination and poor teamworking. We need to see a concerted effort to tackle these root problems, to transform work life experience for nurses, midwives and thereby the quality of care for the communities they serve.’

Deepa Korea, Director of the RCN Foundation, says:

‘The mental health and wellbeing of the nursing and midwifery profession is a key priority for the RCN Foundation. We are pleased to have commissioned this compelling report which delivers a powerful message about the urgent transformational change that is required to enable nurses and midwives to thrive in their workplaces. Importantly, this report provides a blueprint for the actions that are needed to tackle the issues which have long faced the profession. We look forward to working with a coalition of partners to help deliver the change that is needed. This will have an impact not only on the wellbeing of the nurses and midwives, but also that of their patients, residents and communities.’

Notes to editors

For further information, or to request an interview, please contact the Press and Public Affairs team on 07584 146035 or mediaoffice@kingsfund.org.uk.

The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.

Related content