Nurses worried over quality of care

The research found that 56% of NHS nurses feel they are too busy to provide the care they would like, an increase of 8% from 2005. Just one quarter believe there are sufficient staff in their workplace to provide a good standard of care.

More than 80% also viewed their workload as too heavy and their pay poor in comparison to other professional groups.

The findings come at a time when there is increasing reliance on nurses to provide services - such as out-of-hours care - in the NHS. However, nursing leaders have warned that a target-driven culture is having a detrimental impact on staff.

Anne Thomson, acting deputy director of RCN Scotland, argued that those in charge of running the health service had different priorities from those working in it.

"There is a lack of staff, constant change and government pressures around what they want delivered, as opposed to asking staff what they think needs to be delivered," she said. "This can manifest itself in things like the emphasis on clearing waiting lists, whereas a nurse or a doctor's priority is to provide the best possible care to someone who is ill."

She added: "It is almost as if it is about the quantity and volume - rather than about the quality - of patient care."

The survey of more than 700 RCN members also revealed that a quarter of nurses working in community settings are aged over 50, compared to 17% working in hospitals. Thomson said this raised concerns over proposals outlined in the Kerr report, which was published two years ago, as the future "blueprint" for the NHS.

"There are a lot of nurses coming up to retiral, particularly in the community," she said. "That is a big worry, because if we look at the Kerr report it is about shifting the balance of care from acute to community settings, so that is where we really need to invest in nursing.

"We need to do something about positively regarding our older nurses and keeping them in the workforce - for example, phased retirals or perhaps taking them away from the frontline into more supervision roles."

Last week, a report from Audit Scotland warned that the decision by nearly all GPs to opt out of treating patients outwith surgery hours had increased pressure on other parts of the NHS. It said nurses, paramedics and the telephone helpline NHS24 were now being relied upon to help provide out-of-hours care.

Mary Scanlon MSP, health spokeswoman for the Conservatives, said that many of the issues raised in the RCN survey were not new.

She added: "Given the Audit Scotland report on the out-of-hours service, it is very worrying that more and more is being expected of nurses, but without them being valued and financially rewarded for many of the tasks they are expected to do.

"Quite an unfair burden is being put on nurses and other healthcare professionals such as paramedics, as they are not being given the support by the NHS to carry out these tasks."

However, Labour MSP Andy Kerr, the previous health minister, said the recent pay reform known as Agenda For Change had offered the opportunity to better recognise and reward staff.

He added: "The Scottish Executive has invested in the NHS to a significant degree with more doctors, nurses and professionals than ever before. Likewise, Labour invested in the skills of those staff."

Shona Robison, minister for public health, said that the ratio of nurses per head of population in Scotland was better than any other part of Britain.

She added: "Significant investment has been made in recent years to increase staff numbers in the NHS - for example we have record numbers of nurses and midwives in post as well as record numbers of students in training.

"This is helping to ease the burden on nursing staff and share the workload more evenly."