On Friday 17th April, mental health nurse, Stuart Jordan, wrote to Chief Nursing Officer Ruth May citing the duty under the Nursing and Midwifery Council Code to escalate patient and public safety concerns. He argues that the many workers across the health and care sectors have no right to occupational sick pay and cannot afford to follow public health advice to if they need to self-isolate. This creates a situation where the people least able to follow the public health advice if they need to self-isolate are caring for those most likely to die if they are infected by Coronavirus.


Figures from the GMB union suggest over 400,000 care workers have no occupational sick pay. “Without occupational sick pay it is likely that some care workers will come to work with signs of Coronavirus infection. Many of my patients who are dependent on social care have underlying health conditions and are supposed to be shielding. The only people they see are people least able to follow the government’s public health advice.”

Low wages and the lack of occupational sick pay for health and social care staff means many more vulnerable adults will be infected with Coronavirus than is necessary.

Having become aware of this major patient and public safety issue, each nurse, including the Chief Nursing Officer, has a professional duty to escalate concerns. If you are a nurse, act without delay.

Write to Ruth May at chiefnursingofficer@nhs.net and to other senior nurses, such as the lead nurse in your Trust. If possible give examples from your own experience of speaking to colleagues about their sick leave entitlement. Make the broader arguement about the lack of occupational sick pay for over 400,000 social care workers. See Stuart’s letter below. Let us know how you get on.

Dear Ruth,
The NMC code of conduct states that we must “raise and, if necessary, escalate any concerns you may have about patient or public safety, or the level of care people are receiving in your workplace or any other health and care setting and use the channels available to you in line with our guidance and your local working practices.”
I wish to bring to your attention a serious and widespread risk to patient safety within the NHS and other health and care settings that could be mitigated by employer and/or government action.
At my place of work I have met  several members of staff who have no right to occupational sick pay or are unaware of their right. These include agency staff employed to backfill vacancies by Serco who have a contract for security, reception, and domestic services, cleaners employed by G4S and bank staff who are unable to access full paid leave to selfisolate because of the way this provision is organised. These workers are low paid and many have told me that they would struggle to cope financially if they or a family member developed Coronavirus symptoms and they had to take time off to selfisolate. Some of them might take the financial hit and follow the government advice. But across the NHS there are many individuals in this situation and some of them will continue to work. There have been several newspaper reports of individuals coming to work with symptoms because they cannot afford not to, including in a NHS 111 call centre. Any workplace where there are workers without entitlement to full paid sick and selfisolation pay, are workplaces where there is a heightened risk of Coronavirus infection. In the NHS that means a heightened risk of death for staff and patients.

Moreover, some of my patients live in care homes or are reliant on home carers. My patients require the services of these workers to maximise their independence and allow them to live fulfilling and dignified lives. However the local provider who organises a care package does not pay occupational sick pay. Again, without occupational sick pay it is likely that some care workers will come to work with signs of Coronavirus infection. Many of my patients who are dependent on social care have underlying health conditions and are supposed to be shielding. The only people they see are people least able to follow the government’s public health advice. A recent survey by the GMB union found that 55% of care workers have no right to paid sick leave: that is over 400,000 keyworkers.

Myself and colleagues have raised these concerns locally and yet the risks we identified persist. However these problems are not limited to my workplace, the risk exists throughout the health and social care system. It is a risk that can easily be mitigated by government and/or employer action to ensure the right to full sick and self-isolation pay for all workers.

I hope that now that you are aware of this risk to patient and public safety you will fulfil the duty to act without delay to escalate these concerns.
Yours sincerely,
Stuart Jordan
Community Mental Health Nurse

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