Raising concerns and corridor care template letters
Due to the current unsustainable pressures across the UK health and social care sectors and the shortage of nursing staff, you may have concerns about issues that will impact patient care or safety.
In order to do this, you can use one of our two letter templates below. The first is for raising concerns more broadly, whereas the second deals with corridor care specifically.
Remember, you can always contact us for advice and it is important to do so before escalating your concerns externally.
Raising concerns template letter
To: [your line manager/person you report to]
Suggested copy to: Service manager/Registered provider (registered care homes), and/or Director of Nursing (where applicable), and your RCN Office for information
Start your correspondence with this paragraph:
As an NMC registrant I act to deliver high-quality nursing care to every patient/client. I strive to uphold the highest professional standards possible. However, it is my professional opinion that patient/client care is being compromised. Whilst I continue to do everything I can to try to ensure the delivery of safe, effective, and compassionate nursing care, as an NMC registrant I am obliged today to bring the following concern(s) to your attention:
What issue is specifically causing the concern? For example:
- Staffing shortages in terms of numbers and skill mix – This might not just be about registered nurse or nursing assistant/healthcare assistant numbers – it can be about any staff required to deliver care, treatment, or support services and might be compounded by increased patient acuity/dependency, and/or increased inpatient, outpatient, or community caseload numbers.
- Staff competency – This could be staff in substantive posts, temporary staff, or bank/agency staff.
- Service design/delivery
- Lack of resources – What is lacking and in what way. Include numbers if possible.
- Environment – This could be something unsafe or inappropriate about the environment including lack of capacity.
- Suspected malpractice – If so, detail what, when, and who was involved.
- Suspected fraud – If so, detail what, when, who was involved.
- Repeated requirement to raise similar concerns.
I have tried to address this/these concern(s) by taking the following action(s):
[List the actions you have taken – this should include discussing issues of concern with your line manager/person you report to.]
However, despite taking this/these action(s), concerns around my ability to deliver safe, effective, and compassionate nursing care persist. I provide the following evidence that has led to me formally raising this/these concern(s):
This could include things like:
Details of the agreed staffing complement
- In terms of number and skill mix (as set out in the relevant Delivering Care phase, where applicable) vs actual numbers of staff in post/available to work
- Details of continued vacancies
- All types of planned and unplanned leave
- The required skill mix
Rotas
The number of times duty rotas have been changed at short notice, including cancelling annual leave and planned training to fill shifts - provide a defined time-period, for example, x times in the last week(s)/month(s).
Shifts with inadequate staffing
The number of shifts without the required number of staff with specialist knowledge/experience/training to deliver safe and effective care - provide a defined time-period, for example, x times in the last week(s)/month(s).
Patient acuity and numbers
Details of increased patient acuity/dependency, and/or increased inpatient, outpatient, or caseload numbers.
Staff training
Difficulties in ensuring staff can keep up to date with mandatory and skills development training - provide details from a defined time-period, for example, x times in the last week(s)/month(s) - how many staff require training in a specific area/topic, etc.
Incidents
Noted increases in errors, accidents, or adverse incidents - provide comparative data from periods where the concerns you have raised were not an issue.
Outcomes
Noted decreases in audit and quality indicator outcomes, for example, infections, falls, patient nutrition - provide comparative data from periods where the concerns you have raised were not an issue.
Performance and care delivery
Noted task-driven performance and inability to deliver nursing care as set out in care plans – provide examples of care left undone and details of the frequency this occurs.
Reliance on families
An inappropriate reliance on relatives to deliver aspects of personal care to patients – provide a defined time-period, for example, x times in the last week(s)/month(s).
Complaints
Noted increases in the number of complaints (verbal and written) related to delivery of safe, effective and/or compassionate care – provide comparative data from periods where the concerns you have raised were not an issue.
Sickness absence
- Increased levels of sickness/absenteeism, low morale or an increase in signs of work-related stress within the team.
- Details of the number of times (and dates where available) that similar or compounding concerns have been raised both verbally and in writing (including via incident reporting processes).
This/These concern(s) is/are having the following impact on the delivery of safe, (and/or) effective, (and/or) compassionate nursing care:
This could include things like:
- Staff performance, morale and delivery of safe, effective and compassionate nursing care compromised by changes to duty rotas.
- Safe and effective nursing care and patient/client experience compromised by deficits in staff numbers with the required specialist knowledge/experience/training/competence.
- Safe and effective nursing care and patient/client experience compromised by difficulties in ensuring staff have completed mandatory and skills development training.
- Compassionate, dignified and respectful holistic nursing care compromised with potential impact on patient/client human rights – note particular human rights articles that must be considered.
- Actual or potential harm as a result of an inappropriate or unsafe system or working condition.
End your correspondence with this paragraph:
As a Registered Nurse, I always act to deliver safe and effective care to patients and uphold the highest professional standards. I have done all I can, however care is currently being compromised which now becomes a risk.
I intend to share a copy of this letter with my professional body and trade union, the Royal College of Nursing.
Yours sincerely,
[Insert name]
Corridor care template letter
Dear [send to line manager and their manager or Director of Nursing],
I am writing this letter to raise a concern about looking after patients in an inappropriate place such as [corridors/waiting rooms/additional beds in bays/additional chairs/rooms not designed for clinical care/car parks/other – delete as appropriate].
As a Registered Nurse, I have an obligation under the 2018 Nursing and Midwifery Council code to raise and escalate any concerns about issues that will impact patient care or safety. As my employer, under health and safety legislation (Health and Safety at Work Act 1974) you have a duty of care towards your staff and the patients they care for and should therefore take all reasonably practicable steps to address these concerns.
My professional body and trade union, the Royal College of Nursing (RCN), has published a report, Corridor care: unsafe, undignified, unacceptable. This report highlighted the negative impacts of corridor care on patients and on the nursing staff delivering care in such environments. The 2021 RCN Nursing Workforce Standards support a safe and effective nursing workforce to provide excellent care. Standard 13 states "the nursing workforce is entitled to work in healthy and safe environments."
As a Registered Nurse, I always act to deliver safe and effective care to patients and uphold the highest professional standards. I have done all I can, however care is currently being compromised and that is why I have raised this concern
I intend to share a copy of this letter with my professional body and trade union, the Royal College of Nursing.
Yours sincerely,
[Insert name]