Minister claims nurse staffing ratios 'not the answer'
Health minister Dan Poulter has appeared to rule out the introduction of nationally recognised minimum nurse staffing levels, despite them being recommended by the Francis report.
Speaking at a conference organised by health think tank the King’s Fund in response to the Mid Staffordshire Foundation Trust Public Inquiry report, Dr Poulter said he had “not seen the evidence” to support the inquiry’s recommendation.
The report proposed that the National Institute for Health and Clinical Excellence develop nationally recognised minimum nurse staffing levels for a range of different settings. The recommendation was strongly supported by Unison and the Royal College of Nursing.
But Dr Poulter said: “Sometimes when you put in mandatory standards you can have a drive to the bottom… I don’t think staffing ratios is the answer.”
Nursing Times understands the government favours the approach set out by the chief nursing officer for England’s new national strategy Compassion in Practice, which was launched at the end of last year. This calls for existing tools for calculating appropriate staffing levels to be refined to support local determination by nursing directors.
Dr Poulter also told the conference the government’s formal response to the report, due at the end of March, would not involve a detailed consideration of each of the 290 recommendations.
He said: “Our response will focus on common themes rather than be line by line on every one of the recommendations. It will reflect the impact of culture, a greater focus on quality, greater clinical input into policy making and a greater attention to the needs of patients.
Dr Poulter also appeared to suggest that the report was a vindication of the government’s reform of the NHS.
“It’s clear from this report that patient care and safety has suffered… It’s also clear that the system needed to be restructured to put patient safety at the heart [of the NHS],” he said.
The junior minister was asked by Oxford University Hospitals Trust chief executive Sir Jonathan Michael how trusts should handle the sometimes competing pressures to provide quality care, meet performance targets and balance the books.
Dr Poulter, who has continued to work as a doctor since being elected as an MP in 2010, said improved integration with better partnerships between primary and secondary care could help reduce some of these pressures.
However, he insisted there was never an excuse for the failures of care described in the Francis report. “There should be no one trying to make excuses for that,” he said.
Meanwhile, the Scottish government announced this week that a workload measurement and planning tool for determining “appropriate” community nursing levels and skill mix would be available to all health boards from May.
Scottish health secretary Alex Neil said: “The community nursing workload assessment tool has been developed in partnership with community practitioners – district nurses, public health nurses, health visitors and school nurses – to ensure it reflects the needs of community working.”
The tool looks at the number of patients, the complexity of the care provided by community nurses, time required for and mode of travel, and also factors in additional time for unexpected disruptions, or tasks such as administration.