Royal Free to change nursing shift patterns after staff burnout fears

Royal Free staff celebrate the NHS' 72nd birthday in 2020

Royal Free staff in the grounds of the Hampstead hospital - Credit: Royal Free

The Royal Free has confirmed that it will change the shift patterns of nurses and midwives after staff raised concerns the old system was contributing to burnout. 

Rather than work shorter shifts than at other hospitals - 11 rather than 11.5 hours - they work around one extra shift each month. 

In March, staff and the local Royal College of Nurses (RCN) rep raised this among other issues relating to patient safety - in particular on intensive care (ITU) wards.

In response the hospital agreed to consult staff about moving to a more regular shift system, and now the change will be implemented in October. 

RCN London senior officer Millie Simms said: “We are delighted to have secured much-needed and fair changes to shift patterns at the Royal Free.  

"These changes are crucial to supporting good staff morale and retention amongst nursing staff.


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"RCN London supported our members to seek a resolution with the Trust that is not just a good outcome for over 2,500 of the nursing staff but ultimately will help support patient safety and ensure safe and effective care. "

A Royal Free spokesperson said: "The trust has listened to the views of nurses and midwives in relation to their shift patterns.

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"Following a consultation, we are pleased to confirm that from 25 October shift patterns will change to incorporate the feedback we received and to reflect the preferences of those who responded.

"We are hugely grateful for the hard work of our nurses and midwives and their incredible commitment to delivering the very best patient care."

In a March a letter signed by staff and union reps raised concerns that "nurse-to-patient ratios during the pandemic were unsafe for patients and have led to severe levels of burnout amongst nursing staff" and that "the hospital did not do enough to escalate or respond to our concerns about this".

The other issue explicitly raised was that staff-to-patient ratios exceeded what they ought to. 

At the time, the hospital trust said it had "listened and acted on feedback" to improve staff experience at work. 

In written responses to staff questions about the changes to shift patterns and staff-to-patient ratios, Julie Hamilton, the group chief nurse at the Royal Free, wrote in June: "The board are fully aware via monthly conversations on safe staffing of how challenging the past months have been and that all of our staff have gone above and beyond.

"Everyone’s efforts are very much appreciated and I am aware that a financial payment was made earlier in the year retrospectively in relation to overtime and that a process was put in place for the second wave."

She also said "planning is ongoing" in case of a third wave of Covid-19 cases, but while plans were in place to mitigate pressures on staffing - it wasn't possible to confirm that staff-to-patient ratios would not exceed the recommended 1:1 level.

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