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Trusts were wrong to make 'trade-offs' on staffing, Hunt tells nurse leaders

The health secretary has admitted that some NHS organisations have made the “wrong” decision to cut staff in order to try and make financial savings.

Jeremy Hunt said the government’s new measures on staffing, announced in its response to the Francis report on 19 November, should prevent trusts making similar “trade-offs” in future.

He also acknowledged that it had been a “very difficult year for the NHS”, due to the publicity surrounding the Mid Staffordshire Foundation Trust public inquiry.

In a speech to the chief nursing officer for England’s summit last week, Mr Hunt gave more detail on the government’s response to it, especially on the need to embed a culture of compassion.

He acknowledged that showing compassion was “sometimes harder than it should be” when nurses were busy. He said it was job of nursing directors and other leaders to identify and remove “barriers to compassionate care”.

Mr Hunt also admitted that “for many years” there had been a “decline in nursing numbers”. He said 12 months ago workforce projections showed trusts were intending to lose another 7,000 nurses over the next few years, but they now wanted to recruit an additional 4,000 nurses.

“That’s a very big change, that’s happened as a result of everyone starting to think about the implications of compassionate care,” he told delegates.

His comments echo the views of workforce experts who recently told Nursing Times that the NHS was undergoing a “Francis affect” as trusts sought to recruit more nurses in order to maintain patient safety in the wake of Mid Staffordshire.

“It’s not possible to give… compassionate care unless you have the right numbers of staff on all the different wards,” Mr Hunt told delegates.

The government response to the Francis report included guidance that requires all trusts to publish ward staffing levels each month, starting in April, together with the percentage of shifts considered safely staffed. By the end of 2014 this will be done using models approved by the National Institute for Health and Care Excellence.

Ministers rejected calls for a national minimum staffing level on the basis of varying patient acuity between ward types, but Mr Hunt claimed the idea had been looked at “very carefully and discussed endlessly”.

They opted instead to copy models already used by trusts with strong safety records, such as Salford Royal Foundation Trust. He said mandating trusts to publish ward nursing levels in the same way was an attempt to “make sure that we don’t make false economies on staffing”.

“I have to be honest, that is going to put pressure on hospital finances because hiring more staff is an expensive business,” Mr Hunt said. But he added that some of the previous financial “trade-offs” been made by trusts “have been wrong”.

“In particular, there has been a temptation in some parts of the NHS to reduce nursing levels on geriatric wards,” he said. “We need to make sure there are lines that can’t be crossed.”

Mr Hunt told delegates that he hoped the staffing data combined with other patient safety information, like complaints, would act as an “early warning system” that we would “find out much more quickly than we did in the case of  Mid Staffs if we’ve got a problem with staffing ratios”.

Ruth May, NHS England’s director of nursing for Midland and the East, led the development of the new guidance for boards on staffing. She told the summit it should be seen as a “giant step forward” to “normalise” what is already “business as usual” in some of the best NHS organisations.

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Readers' comments (43)

  • It is worth remembering that for every cut in nurse staffing there was a so called "nurse leader" assuring a board that the "savings" could be easily achieved with no reductions in the standard of patient care!


    Go and look at the topic relating to single handed nurses being expected to care for wards full of patient at night ! This is happening now, today, tonight , every day of the week in a hospital near you!



    Many of the "nurse leaders" are personally responsible for putting patients at risk !
    Time they were struck from the register !

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  • if there had been open discussion at every level about where cuts could be made before reductions in essential staffing and putting patients at risk, and support provided for services in difficulties such a crisis could have been averted. it is all down to excellence in communications which always includes clarity, openness and total transparency and a relationship of trust. Surely good managers, leaders and politicians should not need reminding of this and no such comment should need to be written as it is all too obvious and included in the teaching of any good management training!

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  • Jenny,

    You've hit the nail on the head as always.

    I notice that the PSA has taken issue with the Outrageously lenient way in which the NMC dealt with that 'nurse leader' of Mid-Staffs; their decision just proves how out of touch the NMC has become - its got to go!

    Like you say, these nurse leaders need to be held to account for their decisions, people need to be struck-off and locked up!

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  • michael stone

    Notice that Hunt - having 'outsourced decision making away from the DH' - is now explaining how other people (i.e. not him) have made 'wrong' decisions.

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  • Is the NMC now also one of these privatized companies with vested interests?


    'NHS SOS - How the NHS was betrayed?'
    Jacky Davis, Raymond Talis, eds
    Oneworld, 2013"

    book of 212 pages, and a must for all hc profis and commentors. easy, interesting and enlightening read on what is already known and with other shocking revelations about the NHS reforms.

    next and final stage of the destruction of the NHS preducted to become a commissioner of private services rather than a provider itself and the Americanisastion/privatisation of the system is the introduction of private insurance and the withdrawal of many more services, especially affecting the elderly and tax payers, which were originally free at the point of delivery. this was postponed for fear of the risk of political suicide if introduced earlier with preference to introducing new concepts by attuning the public more gradually, hiding the truth where necessary and by stealth which is thought by politicians (who severely underestimate the intelligence of their electorate and only they know what is best for them as individuals) to be less noticeable until it is too late just like the reforms bill of 2012. Private companies are exempt from the freedom of information act!

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  • An apology of sorts but a bit late for the poor sods who lost there jobs apparently through no fault of there own

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  • Jeremy Hunt talking about and lecturing us on compassion? ........... to the fawning Chief Nursing Officer and her cronies?

    Oh how those in their ivory towers enjoy telling us all how to care and blaming us for the problems in the NHS. Nothing to do with funding and cuts, cuts, cuts and the continual point scoring posturing.

    I don't expect to see Jeremy Hunt, or indeed any of this multi millionaire bullingdon club public school businessmen in the Government waiting on a trolley in a corridor any time soon; nor squashed into the corner of a ward with little privacy waiting their turn to use the commode.
    Shame. May bring them all down to earth a bit.

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  • Agree with "Jenny" above.

    The nursing leaders who were cosy at home whilst junior nurses were trying to cope with unmanageable work loads should be held to account. And those nasty people at the NMC should be given their marching orders, they are not fit for purpose. To think we are paying for them! Nurses aren't betraying the NHS, the management, nurse leaders and the government are.

    Oh, and 1 nurse for a ward full of dependent patients is common place in "private" hospitals and nursing homes, and has been for many years. Somehow they seem to get away with this year after year. Doesn't suit the Daily Male mob though to criticise their businessmen friends who own these establishments. The only benefit of going private is having a private room. I know where I would rather take my chances

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  • tinkerbell

    I watched Jeremy Hunt on the CNO conference live web thingy. For a moment he nearly had me believing that he was a nice, genuine bloke, just an ordinary guy who uses the nhs for himself and his family and that he had all our best interests at heart. Then I was reminded of their track record by my husband and that everything they say is 'meaningless' and that it wasn't more c's we needed but more 'n's'.

    Like a fool I asked what are 'n's?'

    'Nurses!'

    Oh yeah. I think that Jeremy Hunt must have mesmerised me there for a minute.

    Back to reality!




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  • Aaron Rudd

    Finally...all these months of shouting and he finally shows signs he can hear.

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  • Don't believe this guy for one minute. The government has distanced itself from responsibilty and accountability in the day to day running of the NHS in England. This government knows exactly what it is doing and this 'apology' is staged and meaningless. Look at the reality on the ground. 'Eyes', 'wool' and 'pulling' spring to mind.
    They lied about the top down reorganisation of the NHS. They are destroying the NHS behind your back. Don't believe this guy or his government cronies.

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  • why would you ever trust the tories with the nhs!!!!!!!

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  • Anonymous | 1-Dec-2013 9:19 am

    Labour are just as culpable as the Tories and the sellout Lib Dems. None of them have been able to keep their paws off the NHS. Privatisation started in 1983 with Thatcher's lot, but New Labour did noting to reverse her policies and embraced further measures of fragmentation, laying the road for Cameron and his thugs. Bevan must be spinning in his grave. He said that the NH would exist as long as there were people of courage willing to fight for it. The way that the Medical and Nursing professions, unions and professional organisation have stood impotently by, should be a source of deep shame for us all.

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  • perhaps if the governments had laid down their plans in a clear and concise manner from the outset there would not be all the shambles and uncertainty and total lack of trust there is now in healthcare delivery, resulting in serious human suffering of patients and employees alike. Open and clear communications are simple and usually result in better collaboration of all involved and more efficient planning and execution. Fudging and lying to benefit the pockets of the few on the backs of the most vulnerable and often the poorest does not fall into this category and the public, patients and NHS employees are not as stupid as they seem to be given credit for by the increasingly autocratic and paternalistic governments.

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  • "He acknowledged that showing compassion was “sometimes harder than it should be” when nurses were busy".
    And impossible when wards are chronically understaffed as they have been for years. What a burke, as though it wasn't known that wards have been understaffed. The RCN have been telling the government this for year but they haven't taken any notice. Hunt is another bully like David Nicholls and I cant see anything changing for the better under his watch. He has done nothing since he was appointed but run down nurses and doctors. He should practice some compassion himself. His lips move but only ***t comes out.

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  • "“It’s not possible to give… compassionate care unless you have the right numbers of staff on all the different wards,” Mr Hunt told delegates". He should tell that to Jane Cummings, CNO, who seemed to think that all the health care ills could be solved with her 6C's. She has steadfastly refused to acknowledge over the years that under staffing was an issue. Not fit for purpose.

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  • Ministers rejected calls for a national minimum staffing level on the basis of varying patient acuity between ward types, but Mr Hunt claimed the idea had been looked at “very carefully and discussed endlessly”.
    It was rejected because it would have got in the way of cutting nursing numbers and this equally applies today

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  • They are politicians!!! Telling lies and feathering their own nests is what they do.

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  • Jeremy Hunt 'told the Nurse leaders'. I'm stiffling a chortle here. Seems analogous to telling clown 'your make-up is running'?
    The Nurse leaders jumped into action then?
    Do the right thing and excise the above article from your memory.
    Absolutely no idea why I'm posting this comment?
    D.

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  • All but admitting the governments knee-jerk reaction over staffing, and conveniently ignoring the pressure they put on trusts to save money, ignoring the means.

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