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Nurse campaign calls for minimum 4:1 staffing ratio


A campaign has been set up to lobby government to introduce a mandatory minimum staffing ratio of four patients to each registered nurse.

Members of the 4:1 Campaign said they were “acutely aware of the pressures experienced by staff everyday through understaffing and the negative consequences this has on direct patient care and experience”.

“We believe a mandatory minimum staffing ratio of 4:1 should be introduced by the government to ensure that patients are cared for safely and effectively,” they state in a letter to Nursing Times.

“Research articulating the link between high patient-nurse ratios and poor patient health outcomes is strong and the experience of 1:4 ratios from California and the Australian state of Victoria demonstrate the immense benefits to patients and hospital staff where mandatory staffing ratios have been implemented,” they add.

The campaign has been set up by a group of nurses in London but has a growing support across the country, a spokesman told Nursing Times. Members of its founding committee include both newly-qualified and experienced nurses, and also healthcare assistants.

It follows similar calls from the Safe Staffing Alliance, which was set up last summer and wants a minimum ratio of eight patients to every nurse. The group’s members include the Royal College of Nursing, Unison and the Patients Association.

The Francis report recommended minimum staffing levels be drawn up for each specialty, but stopped short of calling for an overall mandatory staffing level. The government has consistently rejected introducing a mandatory minimum nursing ratio, arguing that local flexibility is needed.




Readers' comments (17)

  • I really hope the 4:1 campaign get their way as I think it is the only true way to ensure patient safety, but I think a patient/nurse ratio of that order would mean most Trusts having to quadruple their qualified nursing numbers, which in the current climate, I doubt there is enough money to do.

    Again, best of luck and I hope minimum patient/nurse ratios are on the way!

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  • Could be funded by surplus saved last year and handed back to treasury. I would be v worried should this be applied to all areas though, needs more specific application.
    4 acutely ill people in A&E to 1 nurse is not safe. On a ward this would be different.

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  • Could be funded if Trusta would get 'rid' of the highly paid managers who, in a lot of cases, do very little..

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  • Tinkerbell


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  • Blimey, I regularly try my best to look after 14 patients. Fingers crossed.

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  • I can show you the evidence of the difference this nursing ratio makes to both patients and to staff satisfaction. However, just a few problems with this, where are all these extra nurses coming from? We will probably going to have to consider the two tier nurse that we had in the past to get round this, the cost will be enormous, where is the money coming from? Get rid of all these project managers and wasters that sap the trust pockets in the name of so called innovation and development!

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  • Tinkerbell

    yes what a difference it makes to have 'enough' staff to do a proper job. When we 'inadvertently' booked too many staff i use to keep them. Sometimes it is easier to ask for forgiveness than it is to ask for permission.

    As you say where are they all coming from, nowhere, as the workforce is ruthlessly trimmed to the bone, sad. The future appears very bleak for us all. Let's keep signing those petitions though and hope we are still living in a democracy despite indications to the contrary.

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  • Good Luck, I too will sign.

    I normally look after 8 acutely ill patients with a Care Assistant I share with another nurse. These patients are elderly and at least six of them cannot change their position without 2 people to help.
    Usually only one can get to the toilet independantly and at least two need feeding as they are unable to do this themselves.
    Besides all the Basic Activities of living, all need assistance with medication. IVI, Ulcer Dressings, Discharge, Admission, Documentation, Family & Friends questions, doctors's request, cleaning commodes. This is too much for any nurse in a shift.

    Get senior nurses in management back with the patients where they can make a direct difference to improve care and motivate the rest of the staff. Give the paper work clerk/secretaries.

    Money can be found for less important things, lets shout loud at the top of the hills to be heard.

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  • Nurse campaign!! - no chance!! Who listens to us anymore?

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  • Yup, signed.

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