Britain’s nurse leader has told how she quit the NHS because it was forced to allow “disastrous” corridor care.
Former hospital cleaner Professor Nicola Ranger worked her way up to become one of the country’s top nurses and now leads the world ’s biggest nursing union. The Royal College of Nursing’s new General Secretary said she ended her glittering NHS career running frontline nursing early after realising she would have been forced to oversee changes that would “take years to recover from”.
The 58-year-old also told the Mirror NHS strikes remain “on the table” after nursing pay was cut by around a quarter in real terms since 2010, and warned “don’t think that nurses won’t bear our teeth – because we will.”
The mother-of-two told of the guilt felt by her and other nurses who were staying in hotels during the Covid-19 pandemic, on the occasions they could go home to their families, for not being there to help on wards which had become like a “horror film”. But it was her crushing experience of the changes following the pandemic that made her quit frontline nursing in 2022 when hopes of an NHS recovery appeared to be dashed.
She explained: “I honestly thought I would stay in the NHS and retire as a senior nurse but that summer there was a big push on ambulance waits and unloading the ambulances. People were waiting far too long for 999 calls and this mantra of ‘spreading the risk – putting extra patients on the ward – was beginning to get traction.
“I can remember thinking I absolutely knew from many years of experience this was going to be a disaster. We were being asked to move patients to a ward whether we had a bed or not, whether they had oxygen, suction, resuscitation equipment or proper curtains for their privacy and dignity. I remember saying at the time, if we do this, we will open up care that is so substandard we will take years to correct that. And that is what has happened.”
It comes in the month the RCN published its harrowing 460-page report on “corridor care”, saying it is the worst it has ever been. Testimony from 5,000 nurses laid bare the consequences of a decade of NHS under-funding with patients spending hours slowly dying on trolleys in busy corridors and a dead patient being found under a pile of coats in a waiting room. Seven in ten nurses said they were daily delivering care in over-crowded or unsuitable places like corridors, converted cupboards, bathrooms, cloakrooms, paediatric recovery rooms with children in and even car parks – something that had previously been a temporary measure for emergencies.
Professor Ranger went on to run the nursing and midwifery units at some of the largest NHS trusts as a troubleshooter, sent to hospitals placed into Special Measures by the regulator. Her first nursing role was as a summer job in a nursing home when still a teenager which was followed by her first NHS job doing a short stint as a cleaner at her local hospital in Farnham, Surrey. Initially she really wanted to be a social worker but decided to take a nursing placement “to get some life experience”.
During a wide ranging interview at the RCN’s headquarters in central London she explained how she “fell in love with nursing” after consoling a young man in his final moments who had opted not to have a then-pioneering but risky heart transplant operation. She said: “At visitor time then we would never let someone be on their own so if they didn’t have anyone a nurse would sit with them. So every visitor time I would sit with him and we’d talk. I built up a strong relationship and was with him on the day he died and I remember thinking after that what an amazing job and a privilege nursing is.”
During her 20s Professor Ranger delivered nursing care in villages in Pakistan and vaccinations on the Afghan border before working her way up to a nursing leadership role in the US at hospitals first in New York then Washington DC. Then she returned to the NHS and became chief nurse at Frimley Health NHS Foundation Trust and then Brighton and Sussex University Hospitals NHS Trust.
A record NHS funding squeeze under the Tories saw standards plummet from 2015 onwards. Hospitals were crumbling even before she took up the post of Chief Nurse and Executive Director of Midwifery at King’s College London where she describes having to put a towel at the bottom of her office door to stop the mice getting in. She decided she could not stay because instead of “solving the problem” they were being forced to spread it around the hospital.
She said: “Don’t mitigate this problem by making it so much harder for the nursing staff and making it shocking for patients. Doctors, physios and other staff can see a patient and then move on to the next patient. Of course, it affects them, but the people that can’t move are the nursing staff on 12 and a half hour shifts. It’s you trying to keep the patient safe.
“You’re going to be the one that’s there if the patient deteriorates and there’s no oxygen or even a call bell to tell you they want you to go to the toilet. You’re the ones trying to keep them safe. You’re the one trying to apologise to the patient knowing it’s absolutely not the care you would not want for your own loved ones. And it’s nurses having to face the family so the disproportionate effect on them is enormous.”
NHS England responded by saying “building a health service that is fit for the future is a key priority for the NHS and government”. A spokeswoman added: “Increasing levels of demand have resulted in extreme pressures on services, particularly over recent months and one of the toughest winters the NHS has experienced. The impact this has on the experiences of patients and staff should never be considered the standard to which the NHS aspires.”
Professor Ranger’s driving belief in a properly funded NHS was reinforced during her time nursing in New York where she witnessed first hand the unfairness of a US system that treats only if patients have means to pay. One woman in her 20s, left paralysed after being pushed off a balcony by her boyfriend, had to live in a care home for the rest of her life because she didn’t have health insurance to cover the cost of a wheelchair and home adaptations. One father who suffered a brain haemorrhage told her he would be “better off dead” because of the financial burden he would become for his family.
Prof Ranger, who has a masters degree in medical ethics and law, said: “The first winter I came back to the NHS was really difficult, we ran out of intensive care beds and had terrible flu. And then the Labour government came in in 1997 and what I loved is they took that really bad winter and used it as an opportunity to say ‘we’re not going to run out of beds again’.”
Prof Ranger was confirmed in post last July just days after Labour won a General Election again by a landslide. It came after her predecessor Pat Cullen had led RCN members into the biggest strike in the union’s history in December 2022, when around 100,000 nurses walked out in a dispute over pay. But she came under huge pressure from nurses after her leadership recommended members accept a 5% pay rise for 2023/24, plus a lump sum of at least £1,655, at a time of soaring double-digit inflation.
A faction within the union, known as NHS Workers Say No, successfully led a push to vote the deal down, which members did by 54% to 46%. It was seen as a strategic failure by Prof Cullen because it was followed by a second RCN ballot to continue strikes but this failed to meet the legal turnout threshold of 50%. It was felt that Prof Cullen had failed to explain to members why she wanted to go back on strike over a deal she helped negotiate and nurses were left angry at receiving another below-inflation pay award for 2023/24. Junior doctors – who then remained out on strike right up until the General Election – eventually received a 22.3% pay rise over two years including 2023/24 and 2024/25.
The RCN announced in September its members in England had rejected a 5.5% pay award for 2024/25. She says this was “a warning shot to the government” and a message that “nursing is not solved”, adding: “We can’t say [strikes] are ever off the table. Nurses are now getting to the stage where they can’t look after patients well or properly so they will be prepared to raise their voice not just for themselves, but their profession and patients, and I don’t think that should be taken for granted at all. So don’t think that we won’t bear our teeth, because we will.”
There was record turnout for the consultative ballot to determine the strength of feeling and if the Government doesn’t agree to more cash nurses are likely to receive a legal ballot for industrial action. Speaking at the time, Health Secretary Wes Streeting said: “We know what nurses have been through in recent years and how hard it is at the moment. That’s why, despite the bleak economic inheritance, the Chancellor awarded them with an above inflation pay rise. For the first time in a long time, nurses have got a government on their side, that wants to work with them to take the NHS from the worst crisis in its history, to get it back on its feet and make it fit for the future.”
It remains unlikely that these warm words will be enough to placate the nation’s nurses who went through so much during the Covid-19 pandemic and who are bearing the brunt of the current NHS corridor care crisis.
A spokesman for the Department of Health and Social Care said: “It is shocking that corridor care has become a feature of our NHS. Despite the best efforts of staff, patients are receiving unacceptable standards of treatment. It will take time, but we are committed to breaking the cycle of annual winter crises as we deliver the reform and investment to fix the NHS through our Plan for Change.”
