Guidelines to ensure safe staffing levels in the NHS fall short The Nice guidelines omit recommendations for minimum nurse staffing levels and much more is needed.
In July the National Institute for Health and Care Excellence (Nice) issued guidance on safe nurse staffing for hospitals in England. This work was commissioned by the government in response to recommendations in the Francis inquiry into the mid-Staffordshire NHS trust. Nice recommended a systematic approach to matching nurse staffing to patient need, using red-flag indicators to detect staffing shortfalls. A ratio of 1:8 is cited as a high-risk level that should trigger urgent review. But it did not offer guidance on the minimum nurse staffing levels needed to deliver safe or high quality patient care.
Writing in the Guardian, economist Graham Cookson says that to do so would have been a mistake. In contrast Roy Lilley, an experienced NHS manager describes Nices failure to do so as ridiculous. Legally binding minimum levels, adjusted for specialty, that can be flexed up (but never down) are essential, he argues; we have minimum ratios for airlines, crèches, and football grounds, so why not hospital wards? Certainly the call for minimum nurse-to-patient ratios in the UK is getting louder. The Royal College of Nursing congress has voted for mandated minimums, and a Unison survey found 92% supported minimum staffing levels. A new law on minimum nurse staffing levels is now proposed in Wales. So did Nice get it right in not setting minimums for England, or is their guidance, as Roy Lilley puts it, as useful as a chocolate tea-pot? Continue reading... The Guardian
In July the National Institute for Health and Care Excellence (Nice) issued guidance on safe nurse staffing for hospitals in England. This work was commissioned by the government in response to recommendations in the Francis inquiry into the mid-Staffordshire NHS trust. Nice recommended a systematic approach to matching nurse staffing to patient need, using red-flag indicators to detect staffing shortfalls. A ratio of 1:8 is cited as a high-risk level that should trigger urgent review. But it did not offer guidance on the minimum nurse staffing levels needed to deliver safe or high quality patient care.
Writing in the Guardian, economist Graham Cookson says that to do so would have been a mistake. In contrast Roy Lilley, an experienced NHS manager describes Nices failure to do so as ridiculous. Legally binding minimum levels, adjusted for specialty, that can be flexed up (but never down) are essential, he argues; we have minimum ratios for airlines, crèches, and football grounds, so why not hospital wards? Certainly the call for minimum nurse-to-patient ratios in the UK is getting louder. The Royal College of Nursing congress has voted for mandated minimums, and a Unison survey found 92% supported minimum staffing levels. A new law on minimum nurse staffing levels is now proposed in Wales. So did Nice get it right in not setting minimums for England, or is their guidance, as Roy Lilley puts it, as useful as a chocolate tea-pot? Continue reading... The Guardian
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