Promises outlined by health secretary Frank Dobson for the next 50 years would not materialise unless the acute nursing recruitment and retention crisis was halted, Royal College of Nursing general secretary, Christine Hancock warned.

She told the conference that cost cutting exercises and re-engineering experiments 'helped devalue the work of nurses' and exacerbated the workforce crisis.

'As we celebrate this 50th anniversary I think the shortage of nurses is the biggest crisis facing the NHS,' she said.

'The secretary of state can't cut waiting lists unless you have the theatre nurses to care for those patients.

'There is no point in opening new beds if there are no nurses to work on those wards,' Ms Hancock warned.

'Nurses are leaving the NHS at the moment because they feel they can't do the job they trained to do.

'As a professional, it can be the most frustrating thing in the world knowing you can't give the high quality of care you know is possible.'

Doctors and nurses did not come into the health service to leave patients waiting overnight on uncomfortable hospital trolleys, Ms Hancock said. 'They don't want to watch standards of care decline before their eyes.'

Nursing skills of care, empathy and communication were at the heart of the NHS, she said.

There was evidence that where nurses were given a higher level of control over their work, so that decisions were made closer to patients, mortality improved, Ms Hancock told the conference.

'Research in American hospitals shows that where nurses are given greater professional autonomy and control in organising patient care, death rates have reduced by 5 per cent and recovery times have significantly improved.'

Ms Hancock also issued an immediate response to Mr Dobson's announcement on the National Institute for Clinical Excellence and the Commission for Health Improvement.

'As a nurse I know that change only ever really works in the NHS when we put patients first.

'I believe the proposals in the government's quality consultation paper can bring about real quality improvements because they do just that. They also have a right balance of cost effectiveness and clinical value,' she said.

'But as well as the new structures and policies which can ensure we never have another Bristol babies tragedy, we have to make sure we also improve on the basic details of care that can make such a difference to patients.

'I keep reminding people that we have a health service which can transplant major organs but cannot get hospital windows clean .

'The health secretary has set a tough agenda for managers and healthcare professionals on clinical quality which is much welcomed. But it mustn't be left to patients to point out that our hospitals should be cleaner and that mixed wards are unacceptable.'