The Royal College of Nursing (RCN) has announced plans to set up two committees to lead separately on professional nursing and trade union issues, after Sir Robert Francis QC’s report on the former Mid Staffordshire Foundation Trust recommended splitting the RCN’s dual roles. Sir Robert found the RCN did little to address problems faced by members at the Mid Staffordshire Foundation Trust, and that RCN staff did a deal with the trust management to ensure whistle-blower concerns in A&E were not addressed. Commenting on the decision, RCN chief executive Janet Davies said “redesigning the governance structures will enable a stronger nursing voice” and that the changes are about “strengthening the two roles and allowing more members to be involved in our work”.

In other news, the European Union (Notification of Withdrawal) Bill has received Royal Ascent, after the House of Commons rejected the House of Lords’ amendments to the Bill and the Lords agreed not to further block progress. The Government therefore remains on schedule to trigger Article 50 by the end of the month.

Meanwhile, Scotland’s First Minister Nicola Sturgeon has announced plans to hold a second referendum on Scottish independence – a move which she blamed on the UK Government’s lack of compromise over Brexit. She said the vote should take place before the UK leaves the EU, between autumn 2018 and spring 2019. Responding in a television interview, Theresa May did not rule out the possibility of a second referendum but rejected the First Minister’s timetable. She indicated there will not be a second referendum on independence until at least 2021.

Minister responds to questions on continence care

Health Minister David Mowat has answered three written questions on continence care, which were tabled by Rosie Cooper, Labour MP for West Lancashire and Chair of the APPG on Continence Care.
Responding to Ms Cooper’s first question, regarding what duty is on local authorities to ensure home care agencies are providing carers with mandatory bowel and bladder training, Health Minister David Mowat said that responsibility for ensuring staff are properly trained and supported lies with their employers. He also noted that the Care Quality Commission’s Fundamental Standards included regulations on staffing to ensure qualified, competent and skilled professionals are deployed for care duties.

In response to Ms Cooper’s second question, regarding whether the Secretary of State for Health would ensure NHS England and CCGs would provide a choice of single-use catheters for use outside the home for ISC users, Mr Mowat said that commissioning appropriate care for patients lies with individual CCGs, with NHS England holding responsibility in the cases of some directly commissioned services. Mr Mowat added that: “The legislation under which NHS England and CCGs commission services requires them to arrange for the provision of services for which they are responsible, to such extent as they consider necessary to meet all reasonable requirements. For CCGs, this includes offering continence services as part of their obligation to provide community health. Although CCGs often focus on prevention and treatment, we would expect any standard continence service should include access to products.”

In response to Ms Cooper’s third question, regarding whether the CQC is responsible for carrying out inspections as to standards of continence care in hospitals, residential homes and nursing homes, Mr Mowat replied that the CQC is the independent regulator of adult health and social care services in England; that its remit included the regulation of all providers of regulated activities; and that the CQC had advised that a lack of adequate continence care could breach a number of the regulator’s standards. Mr Mowat added that the CQC considers continence as part of inspections whenever appropriate and that if specific concerns were raised, an inspection would focus on the relevant issue in detail.

Report: untreated childhood urinary problems can persist into adolescence

Researchers from the University of Bristol have published a major new report on urinary incontinence, which identifies different patterns of childhood urinary incontinence and examines which patterns are associated with bladder and bowel symptoms in adolescence. The report, based on a sample of 8,751 children, found that those who wet themselves during the day and night aged 4-9 years were significantly more likely to still be wetting the bed aged 14, with a 23-fold increase in the odds of experiencing bedwetting compared to those with normal bladder control during childhood. Children who wet themselves only at night were also more likely to still be wetting the bed in adolescence, with these having a three-fold increase in the odds of experiencing bedwetting.

The study found that children who wet themselves only during the day had a ten-fold increased risk of experiencing the same problem in adolescence, as well as being more likely to report delaying going to the toilet and having hard stools.

Commenting on the report, lead researcher Dr Carol Joinson said that incontinence is a common childhood problem, which “if not managed properly can seriously affect a child’s quality of life and self-esteem.” She added that a “wait and see” approach is not always appropriate and that parents, teachers and GPs should seek help for affected children. She recommended support materials from ERIC, The Children’s Bowel & Bladder Charity, stating that researchers at the University of Bristol have produced teen-friendly materials for the ERIC website in collaboration with young people.

ERIC CEO Juliette Randall said: “the impact of struggling with continence issues can be devastating for children, teenagers and their families and we hope this research will raise awareness of the issue and encourage more people to seek help and support.”

Nursing and Midwifery Council’s draft education plans seen by the Nursing Times

The Nursing Times has seen the draft pre-registration education standards for nurses currently being developed by the Nursing and Midwifery Council (NMC), which set out a range of technical skills which newly-qualified nurses should be competent in. The list of more than 70 technical skills includes urinary catheterisation, nasogastric tube insertion and injection of intravenous drugs; while more than 20 communication skills will be required to ensure nurses can communicate with different types of patients, including those who are depressed or have dementia. In total the plans would expect nurses to be qualified in 95 skills, although these are subject to change before the final standards are published. The NMC also could not confirm whether all nurses will have to be competent in all of these areas, or if it would vary according to whether they are an adult, children’s, mental health or learning disability nurse.

A spokesperson for the NMC emphasised that there has yet to be “specific input from field-specific stakeholders, ahead of a full public consultation in the spring.” Concerns have been expressed that adult nursing could be prioritised over children’s nursing, if suggestions that the new standards could lead to nurses receiving generic training before specialising play out. The draft plans are not yet publicly available.

NHS England urged to support EU nursing staff

NHS England’s Chief Nurse, Professor Jane Cummings, has called on the NHS to support European nursing staff as the UK prepares for Brexit and the NHS looks ahead to a new immigration charge from next month. Speaking at the chief nursing summit in Birmingham this week, Professor Cummings said that nurses and midwives from the EU face an uncertain future in the coming months and will need support, noting that “they help represent the communities we care for and we will continue to make them feel welcome.”

Professor Cummings’ speech comes after the Royal College of Nursing (RCN) and British Medical Association (BMA) wrote to Home Secretary Amber Rudd asking her to exempt health and social care workers from the new immigration skills charge, which is due to come into effect in April. The unions argue that charging employers £1,000 per year for a visa will reduce the NHS’s annual budget by over £5 million. They argued it is inappropriate to divert funding away from the budget for frontline health services and the training of health professionals in this manner, adding that: “While the government has suggested that funds raised from the charge would be reinvested back into the UK workforce and health system, we have been given no guarantees to that effect.”