Ward ratio of 60:40 is low as you can go, CNO tells Mid Staffs inquiry
England’s chief nursing officer has admitted the NHS is at a time of “heightened risk” due to the twin challenges of reorganisation and the need to make £20b of efficiency savings by 2015.
Giving evidence to the Mid Staffordshire Foundation Trust public inquiry, Dame Christine Beasley said she doubted a similar situation – where the trust was short of 120 nurses after slashing £10m from its budget – would happen today.
“The refrain [around the NHS] is often: Are we sure we’re not in a Mid Staffs situation,” she said.
Dame Christine suggested the Care Quality Commission could look at what processes organisations had in place for determining and monitoring there staffing levels as part of its licensing process but rejected calls for statutory guidance on staff numbers and skill mix.
She conceded that a 60:40 registered to unregistered was as low as you should go in an acute hospital ward but said her “concern” with mandating minimum staffing levels from the DH was that “instead of becoming the floor they become the ceiling.
She criticised former Mid Staffs nursing director Helen Moss, who arrived at the trust to find skill mix as low as 40 registered to 60 unregistered on some wards, telling the inquiry she couldn’t think of any circumstance where that skill mix “would be acceptable”.
Asked if she shared concerns expressed by Nursing and Midwifery Council chief executive Dickon Weir-Hughes at an earlier hearing that the abolition of strategic health authorities would lead to a loss of professional support for nurses she said she did.
England’s 10 SHAs are in the process of clustering to form four organisations.
Dame Christine said: “We are still keeping an SHA role but covering much bigger areas. I have lived through so many changes of that sort of level and what nursing is very, very good at is that they a very strongly networked profession and in my experience when the changes happen they regroup around whatever the structure is.”
Dame Christine is one of a number of high profile figures appearing before the Mid Staffordshire Foundation Trust public inquiry this month.