Health Select Committee Concerned Over Nurse Staffing Levels

18 September 2013

Health Select Committee Concerned Over Nurse Staffing Levels

The Health Select Committee has called on hospitals in England to publicly display the number of nurses they have on duty on each ward, and to make clear whether the level of staffing is high enough.

The issue of nursing staffing levels has long been an issue relevant to increasing patient care and has been highlighted in previous inquiries though not directly implemented on a nationwide scale.

The Safe Staffing Alliance had opined earlier in the year that the one-to-eight nurse-to-patient suggested ratio it recommended was not being met and that it was regularly contravened.

MPs in the committee-reporting in response to the Stafford Hospital scandal public inquiry-maintained that the nursing staffing system in itself needed to be more transparent. This openness was not only to be borne out of concern over staffing levels in individual wards, but also the fact the complaints system for patients needed to be more accessible and that gagging clauses on staff should be eradicated so that staff could raise issues regarding patient care unfettered.

The issue of staffing levels-which was also discussed in the recent Berwick Report-has long been one lacking a cohesive governmental response. MPs acknowledged that the issue the government faced was regarding what constituted acceptable and appropriate staffing levels.

The Safe Staffing Alliance includes the Royal College of Nursing, Unison and the Patients Association and had previously said the one-to-eight ratio should be regarded as a minimum acceptable level, but it found that this standard was regularly flouted. An example of how staffing levels were grossly disproportionate was seen at Stafford Hospital where evidence presented to the Nursing and Midwifery Council showed that at times the ratio there reached one nurse to 16 patients during the day.

Although the NHS is aware of the importance of minimum staffing levels, it is also acknowledged that a certain disparity is required with figures as certain specialities, such as critical care, require more staff relative to night shifts, for example.

Health Select Committee chairman Stephen Dorrell said while most patients enjoyed good care there were still too many examples of "poor or mediocre" care.

"It seems entirely true that we will only deliver the right standards of care with the right number of people," he added.

It was Salford Royal NHS Foundation Trust which took the lead regarding staffing levels whereby it started to display on signs the number of nurses and healthcare assistants they had working on wards and if these levels were appropriate. Importantly these figures continue to be updated daily. The Health Select Committee report highlighted this indication of future change which could be implemented nationwide marking a distinct and more proactive stance towards the issue as opposed to public inquiries which only suggested that hospitals should use the best available evidence on staffing ratios when it came to the issue of running services.

Royal College of Nursing general secretary Peter Carter gave his backing to greater transparency on nurse numbers.

"The RCN has called for action to ensure there are safe staffing levels in all healthcare settings, and the committee highlights the importance of this.

"Indeed, there is a growing body of evidence demonstrating how crucial staff-patient ratios are to patient outcomes."

Liz Redfern, deputy chief nursing officer for NHS England, said: "The committee is making some powerful points that all of us in the NHS should listen to."

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