By stewartb

The RCN is not a small, not a new, inexperienced organisation. Far from it! It has a long track record of advocacy on behalf of the nursing profession. Its continuing use of the name – the Royal College of Nursing – seems like an attempt to raise its status with the public as something other than ‘just’ a trade union.

The document that is the subject of the main blog post is loftily described by the RCN as a ‘Policy Report’. It has been relatively well resourced: it has two authors plus no less than 15 other named contributors. And it has received substantial media coverage today. So it is entirely right and proper that someone should assess the ‘evidence’ it presents on NHS Scotland, including through a critical appraisal of the research methods involved. As so often in such cases, it is TuS that steps up to provide that public service. What’s happened to paid, well resourced journalism in public service and other mainstream media organisations?

The main TuS blog post asks: ‘.. how big was the Scottish sample?’ and answers ‘The UK sample was 11 000 so you might think 1 000 pro rata? There are 65 000 nurses just in Scotland. So, in a self-selecting, ‘squeaky wheel’, unscientific sample, only 1.5% could be bothered?’ The other ‘answer’ is that the authors of the RCN report opt not to share this most basic of statistics with readers and (of course) no mainstream media journalist in Scotland is likely to be bothered to ask before amplifying the report’s content.

Candidly that estimate of 1,000 responses to the question of ‘corridor care’ may be overly generous! The RCN document indicates that its online survey had 11,000 respondents but a substantial portion of these work in settings that CANNOT experience ‘corridor care’ so how would they know what’s happening e.g. RCN members working in call centres. Stripping these out, the report explains that 37% of respondents – we’re told this is ‘equivalent to 2,935 people’ across the UK – agreed that care took place in corridors. So 2,935 must come from a valid sample of just 7,932 people UK-wide.

Adopting the same pro-rata assumption, 9% of a sample of 7,932 would suggest 714 respondents from Scotland. And 714 respondents out of a population of 65,000 nurses in Scotland equates to just 1.1%.

(And if the sample from Scotland is significantly greater than this estimate, then the the samples being used to draw conclusions for the other parts of the UK simply become more problematic. Why did the RCN not simply follow good research practice and give the sample sizes? Concerned that too much transparency might undermine its conclusions?)

If the sample size estimate for Scotland is reasonably accurate and given that the RCN reports that just 38% of respondents from Scotland agreed that care was indeed taking place in ‘corridors’, that could equate to just 271 RCN members out of 65,000 nurses in Scotland, or 0.4% – and a self-selecting i.e non-randomised 0.4% at that!

Is this evidence-based advocacy from the RCN? Is this a contribution to evidence-based policy making? The RCN’s attempt to present this as evidence in something it calls a ‘Policy Report’ should be an embarrassment to any professional concerned with social research to inform policy making!