10. Submission by Ms Morris, KC

Ms Morris: Good afternoon, my Lady, I represent the Royal College of Nursing. I have a few observations to make which are relatively high level and then one or two more specific points arising out of the points which have been made by my colleagues.

The Royal College of Nursing has a membership of almost half a million registered nurses and more than 300,000 of those work in the NHS. Members are also midwives, health visitors, nursing students, healthcare assistants and nurse cadets, and so the College is the voice of nursing across different jurisdictions of the UK and the largest professional union of nursing staff in the world.

The College of Nursing is both the professional body for nursing and a trade union and campaigns on the issues of concern to nursing staff and patients, including pay and terms and conditions. It influences health policy and it promotes excellence in nursing practice.

Of central importance, with a view to the Royal College of Nursing’s role in the Inquiry, is that nursing is the largest safety-critical profession in healthcare. It’s vital to patient safety that there are the right nurses and other members of the nursing family with the right skills in the right place at the right time and the pandemic highlighted the critical role that nursing plays in protecting, improving and sustaining health.

So throughout the pandemic nurses worked in hospitals, schools, care homes, GP surgery, prisons and homes, and the College of Nursing supported their members there.

Just to give a few examples of its work that have particular materiality for the work of the Inquiry, the RCN provided support services and ran a call centre where nursing staff from across the UK sought advice and accessed specialist representation. Since the start of the pandemic it’s received 25,500-odd calls to do with issues on Covid-19, and the Inquiry will see the vividness of what those calls show.

It’s also given the Royal College of Nursing a particular insight into the day-to-day frontline experiences of nurses and other allied healthcare professionals, the challenges they faced and the pressures that they were under.

In order to support nurses, the RCN also compiled extensive guidance and advice both in anticipation of and in response to key emerging issues to support nurses through the pandemic in relation to their clinical roles, employment and, to pick up a thread from my learned friend who just preceded me, their mental health and well-being.

This included a Covid-19 workplace risk assessment toolkit to support healthcare professionals consider and manage risks associated with the transmission of respiratory infections, specifically Covid-19, and aid local decision-making as to the level of PPE required to protect them whilst at work.

The RCN also undertook influencing and campaigning. For example, it led a coalition of health experts to demand that the Prime Minister urgently tackle the inadequate protection of nursing staff from Covid-19. It undertook engagement with its members in order to inform its work and also it developed research and compiled data, and therefore played a key role in furthering scientific understanding, through research, to inform UK health guidance. For example, the RCN commissioned an independent review of guidelines for the prevention and control of Covid-19 in healthcare settings in the UK and in evaluation and messages for future infection-related emergency planning.

In this way, the Royal College of Nursing represents the voice of nursing and its members have unique story to tell of their experiences working during the pandemic. They are the largest staff group in the NHS, they are predominantly women, and nearly 25 per cent of them are from a black and minority ethnic background. They were and remain the frontline response.

Of the College’s hopes for the Inquiry, there is a particular focus on the future. It is imperative for the nursing profession, its leaders and its patients, that the failures of Government and other agencies must be identified and reported on and lessons learned.

Nurses and healthcare workers will be on the front line of the next pandemic, and the RCN has a responsibility to ensure anything that went wrong, things that could be improved, are reported on and acted upon in the interests of nurses and the patients to whom they provide care.

The Royal College of Nursing has identified a number of issues as being critically relevant to Module 3. It’s not an exhaustive list but it reflects the state of its evidence gathering.

First of all, the obtaining, provision and supply of PPE.

Secondly, the transfer of patients from hospitals to care homes. Now, a number of things have been said about this today but the position of the Royal College of Nursing is that it’s not easy to sever the issue of those in care homes from those in hospitals because, certainly, nurses were present in both locations and also that that movement didn’t mean that somebody suddenly changed their status in a way which meant either the previous one or the later one became irrelevant and, therefore, we would ask the Inquiry to think carefully about whether it wishes to move that issue out of this module.

The other area where we make a particular submission is in relation to recruitment, retention, pay and conditions of nursing, and we adopt that which was said by Ms Gallagher KC just now, in that it is particularly, given the critical condition of healthcare services today and given the need for the Inquiry to focus on the future, an issue which requires to be addressed in this module, not only in the interests of consistency and its inclusion but also because it is such an urgent contemporary imperative.

The other issues which the Royal College of Nursing would highlight are the infection and death rates for nurses and healthcare workers, and particularly those from particular minority communities; the provision of death in service benefits and the removal of the NHS surcharge for non-UK healthcare staff; and the requirement for RIDDOR reporting, Covid-19 related occupational illness and death; the patient experience of healthcare throughout the pandemic and recovery planning; and the impact of the pandemic on the mental and physical health of the nursing and healthcare workforce, including professionals who were pregnant, clinically vulnerable, or redeployed.

The Royal College of Nursing hopes that the Covid-19 Inquiry will increase awareness of the need for proper staffing to ensure safe and effective patient care and promote its provision. The Royal College of Nursing’s principles for staffing for safe and effective care are as follows. Accountability: we want it to be clear whose job it is to make sure there are enough nurses to meet patients’ needs. Numbers: we want the right number of nurses with the right skills to be in the right place at the right time, so patients’ needs are met. Strategy: we want a vision for tackling nurse shortages and making sure nursing helps meet the whole country’s health needs. Plans: we want clear plans for getting the right numbers and skill mix of nursing staff, and we want checks to make sure it really happens. Finally, education: we want governments to educate enough nursing students and develop its existing staff so that they can meet patients’ needs.

That’s the conclusion of my submissions .

Lady Hallett: Thank you very much indeed, Ms Morris. We share the same hope, which is looking to the future, and it is why I came out of retirement to accept this role. So I hope, with the assistance of the Royal College of Nursing, we can make some sensible recommendations for the future. Thank you.

It is now time to take a break. I shall return at 3.35, please.

(3.20 pm)

(A short break)

(3.37 pm)

Lady Hallett: Mr Stanton.