Wards are seriously understaffed. That’s the message Nursing Times readers gave loud and clear over a year ago, responding to a survey just before the
publication of the Francis report into care failings at Mid Staffordshire Foundation Trust. And when we repeated the survey this year the situation was little improved.
What happened at Mid Staffs was inexcusable and not solely the result of understaffing, but resourcing decisions do leave some hospitals just as likely to fail to provide their patients with safe care.
The point of our surveys was to show the crisis in resourcing. The government may say there are more NHS nurses than ever before, but the frontline view is different - and patient needs are more demanding, and we are playing catch-up as staffing levels have been so desperately low.
So it was with great expectation that the profession awaited the regulations on staffing level data. Part of the government’s response to Francis, this was meant to make transparent what safe staffing looked like in the best trusts and spur others to follow their example.
But it seems this is not to be the holy grail many had hoped for. It appears publication of the number of nurses that should be on a ward and the number actually on shift can be interpreted and displayed differently. It won’t be standardised (for that read could be fudged) and the public (and staff for that matter) will have no greater understanding of whether the ward is safe on any given day.
It appears publication of the number of nurses that should be on a ward and the number actually on shift can be interpreted differently. It won’t be standardised
Don’t get me wrong, there is much to be praised here - it is a step in the right direction - but it falls short of being the patient safety bulwark originally promised. Many reports from organisations such as the National Nursing Research Unit and the Safe Staffing Alliance have shown that cutting nurse numbers puts patients at risk.
I understand all the hyperbole around not wanting to mandate numbers because it becomes “the ceiling and not the floor”, but the facts are this: if you ask a nurse to care for 28 patients on a ward (and this is something we have heard of ), those patients will receive poor care - or worse - no care, with potentially tragic consequences.
Many trusts provide excellent care and ensure teams are well resourced. The only reason the government won’t use those models as an exemplar to other trusts is money. It can’t afford it. Why can’t the politicians be honest about that instead of dressing it up? They want falls prevention, pressure ulcer prevention and A&E targets met, but won’t give nursing directors enough staff to do it. But what they will do is burden them with paperwork that doesn’t keep patients safer.
We’re notching this one up as yet another opportunity missed.
Jenni Middleton, editor firstname.lastname@example.org. Follow me on Twitter @nursingtimesed