An overwhelming 98 per cent of primary care and community nurses acknowledge quality of care could be improved in practice and community settings, but warn key barriers to overcome include insufficient qualified nurses and inappropriate use of skill mix.
Following the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, exposing an NHS in need of 'cultural change', Independent Nurse's online survey of 351 nurses found 39 per cent view the lack of skilled nursing staff as the number one issue undermining patient care in community settings.
This was followed by 'the focus on targets' (18 per cent) and 'ongoing organisational change' (14 per cent).
Just a quarter of respondents believe care can improve while the Nicholson Challenge (to save £20 billion by 2015) is in place in the NHS.
One nurse respondent commented: 'The NHS cannot be run properly while there are unconscionable 'money saving' measures being taken by the government.'
New commissioning structures have been developed since the inquiry into care failings in Mid Staffordshire, but less than a quarter of nurses polled believe these will improve care standards.
However, despite voicing concern about practical barriers to change, Independent Nurse readers support the report's key recommendations, including mandatory annual appraisals for nurses (84 per cent), the introduction of nurse revalidation (64 per cent) and pay linked to 'delivery of excellent care' (70 per cent). A total of 84 per cent support regulation of healthcare assistants and 60 per cent back separation of the RCN's professional and union roles.
Crystal Oldman, chief executive of the Queen's Nursing Institute, said: 'The report highlights our main concern, which is the shortage of community nursing staff with the right skills.'
Jenny Aston,a Norfolk-based advanced nurse practitioner and chair of the Royal College of GPs' Foundation Nursing Group, added: 'Revalidation of nurses would need to be meaningful and will help them remain competent. But it is a massive piece of work and I'm doubtful the NMC will achieve this by 2015.'