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Staffing Levels A Primary Issue-Berwick Report
6 August 2013
There has been universal unanimity amongst numerous unions and healthcare organisations that NHS staffing levels is a key area that needs to be addressed urgently, with cuts to nursing posts a particularly alarming feature of governmental cuts. While the recently published Berwick Report urged a focus on having the correct number of registered nurses and support staff to care for patients, a willingness to foster continuing investment into staff and maintaining appropriate levels was paramount.
While NHS England plans to implement a 2 per cent increase in the recruitment of nursing staff next year-4,100 nurses-there is concern by health watchdog Monitor that this recruitment drive sought only to allay staffing concerns short-term and would in fact be followed by further cuts to nursing staff over 2014-15 and 2015-16.
While Health Secretary Jeremy Hunt was particular in his reactionary comments to the report in refusing to mandate national minimum safe staffing levels, Labour felt that the rate of staff cuts was becoming “dangerous”.
“All the experts are now telling the Government to get a grip on staffing levels,” said shadow health sectary Andy Burnham. “David Cameron must now urgently intervene to ensure safe staffing levels in our hospitals.”
Dr Peter Carter, chief executive of the Royal College of Nursing said: “This is the latest in a series of thorough reports by well-respected experts which is urging a focus on having the right number of registered nurses and support staff to care for patients.”
While Professor Berwick did not recommend the introduction of minimum staffing levels or ratios, he did recommend “a new general offence of wilful or reckless neglect or mistreatment applicable to both organisations and individuals.” Sanctions under the new law would include disqualification from future leadership roles, public reprimand and in extreme cases, financial sanctions for organisations and up to five years in prison for individuals.
In any organisation, mistakes will happen and problems will arise, but we shouldn’t accept harm to patients as inevitable. By introducing an even more transparent culture, one where mistakes are learned from, where the wonderful staff of the NHS are supported to learn and grow in their capacity to improve the NHS, and patients and are always put first, the NHS will see real and lasting change,” he said.
The Royal College of Nursing said it welcomed the report’s “positive, and practical, recommendations” and that it could represent a “great leap forward” for the NHS.
Further to his comments, RCN chief executive and general secretary Peter Carter said: “This is the latest in a series of thorough reports by well-respected experts which is urging a focus on having the right number of registered nurses and support staff to care for patients.”
He added: “We’re particularly pleased to see the focus on creating and supporting a culture of learning, to motivate staff, and making sure leaders are visible and approachable and understand the realities of patient care.
The Berwin Report highlighted the need for staffing levels to complement high quality patient safety care, the Union reinforced this by saying:
“Ward sisters have a vital role to play in that visibility; giving support, guidance and supervision to their teams to ensure an open culture and a high performing ward.”
Unison head of nursing Gail Adams said: “We are pleased that the review recognises the link between patient safety and having enough staff, with the right skills on the wards.”
The Royal College of Physicians opined in a statement Professor Berwick was “right to identify cultural change as the most important factor in reducing harm to patients”.
But it added: “An emphasis on appropriate staffing levels would also help the NHS cope with the increasing strain it is under due to the inexorable rise in emergency admissions, the increasing proportion of inpatients with dementia and comorbidities, poor continuity of care, out-of-hours care breakdown and a looming medical workforce crisis.”
British Medical Association chair Dr Mark Porter echoed the RCP’s views on culture and staffing.
“We firmly believe that there must be a change of culture across the NHS and we support Professor Berwick’s call for patient care to be made paramount and for a culture of support, not blame, to empower staff,” he said.
“We need to examine further the proposals for new criminal offences and work with the Department of Health to see if these add anything further to the existing sanctions.”
But he added: “The government must also ensure that their programme of cuts across the NHS does not lead to any further reductions in the number of NHS staff whose role it is to provide care.”
If you have experienced any form of medical mistreatment at any of the mentioned trusts or hospitals, or want to better understand exactly what your patient rights are, Mistreatment.com are pleased to offer advice and support to you. Our specialists have wide experience of providing advice and support across a number of areas relating to potential medical mistreatment, such as misdiagnosis and delay and surgery errors, for example.