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New nursing strategy calls for transparency on staffing levels

Hospitals could be required to publish nurse staffing levels at least twice a year under plans set out in the chief nursing officers’ strategy.

The proposal is one of a raft of recommendations set out in Compassion in Practice which was launched by chief nursing officer for England Jane Cummings and Department of Health director of nursing Viv Bennett today.

They also call for any proposed changes to skill mix to be discussed by the boards of NHS organisations and recommend the introduction of pre-registration nurse “apprenticeships”.

The strategy reveals univeristies will be required to recruit for values as well as academic achievement and proposes junior staff should be more involved in leadership and service improvement at the beginning of their careers.  

Ms Cummings said: “The actions we are setting out – developed with nurses, midwives and care staff – can change the way we work, transform the care of our patients and ensure we deliver a culture of compassionate care.

“We must seize this opportunity to create a future where people are treated with compassion, dignity and respect by skilled staff who have the competence and time to care.”

Ms Cummings and Ms Bennett also recommend ward or community nurse and midwife leaders be made supervisory to “give them time to lead”. They call for all nurses to help make the case for supernumerary status by demonstrating the positive impact it can have on role modelling, staff supervision, clinical placements and communication with patients, families and carers.

They add: “We hope this will be accepted and built into all future workforce tools.”

The strategy also recommends a leadership programme that would result in a nationally recognised qualification covering change management and communication.

It commits the NHS Commissioning Board and the DH to developing evidence based staffing levels for nursing outside of an acute setting. The commissioning board will also develop a methodology which organisations can use to measure their culture.

Ms Bennett said: “Our aim is to maximize the contribution of all nurses, midwives and carers to improving the publics’ health by making every contact count for health and wellbeing.”

The strategy was developed to address concerns about declining quality of nursing care and follows a consultation with more than 9,000 nursing staff. It is based around the “6Cs” that Ms Cummings and Ms Bennett believe should underpin nursing: care, compassion, courage, communication, commitment and competence.

It suggests improvements in patient safety and experience can be driven by increased use of the patient safety thermometer and the friends and family test, where patients are asked if they would recommend a service.

Health secretary Jeremy Hunt said: “We want to do all we can to support those who care for patients - and this new vision will help us do that. Nurses, midwives and care staff have one of the most demanding and sensitive roles in the NHS and social care, and they command our respect and support.”

Readers' comments (8)

  • Ms Cummings and Ms Bennett also recommend ward or community nurse and midwife leaders be made supervisory to “give them time to lead”. This is already the case with critical care nursing, RCN/BACCN/ICS HAVE ALL SIGNED UP, then is again a Clinical Co-orindator role in HDU/ICU that should support staff in a supernummery role, TO ensure correct staffing levels, Maybe the strategy will enable Unions/Nurses/Midwives and even patients and public to question NHS Trust Boards where this is not the case.

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  • good, about time. staffing levels have a massive impact on patient care and standards. we also need to look at skill mix and question why totally inappropriate nurses are promoted.

    this six ''c' is in danger of becoming a bit of a joke with other words beginning with the letter 'c' becoming more appropriate amongst staff

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  • michael stone

    The publication of accurate (I have doubts about this - managers might try to manipulate the figures) staffing levels including breakdowns by type of clinician and type of ward, is hugely important !

    I'll believe it when I can see it, however.

    We are likely to end up with some sort of 'averaged figure' that is not very useful.

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  • on paper we have the right staffing level, in practice though of course we don't have enough staff. senior staff who sit in the office and do no hands-on care are counted in the numbers, as are NQs who are supposed to be supernumary for a while.
    It's not going to be an honest and transparent account of what is really going on and the numbers will not be accurate.

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  • michael stone

    Anonymous | 5-Dec-2012 12:06 pm

    There is a well-known technique for reducing the number of recorded accidents - you don't report all of the accidents that happen.

    Very common 'evasive method' !

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  • Oh dear. When will the people in charge learn? Trust bosses will manipulate figures to whatever they want: If they have cut nursing levels too much, they will just leave out sickness and such so it looks like more nurses on the wards.
    The bigger question is:

    What will be the penalty for not publishing the figures? Who will apply any such penalty? A slap on the wrist? A paltry fine?

    I see that our CNO is not working in the real world! While the "6 Cs" are all well and good, she is forgetting the 7th C which stops us from being effective: Costs!!

    As for the shift in student training (ie: apprenticeships and values), this was in place over 20 years ago until the people in charge decided that the P2K system (which was a failure in the US) was the way forward....now, they want to revert back to before? Imagine that!!

    Until we have leadership that actually does something about dangerous nursing levels, or at least attempts to, rather than just coming out with soundbites for the media, we will continue to watch the destruction of this profession. How can we focus on compassion, communication, bravery etc when we don't even have the time to get the basic care done? I have now, officially, lost all respect for the entire Nursing Leadership

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  • I am glad that the will is there but we know how these things are manipulated so easily-please lets hope the numbers really are transparent and not manipulated by the managers

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  • We use a team brief on the ward which says there are x amount of staff present for report
    So nightshift go home staff go to training days and seniors hit the office chairs to audit and manipulate figures less than half are on the ward but the brief still says there are x staff present so managers will just find ways to make the numbers look good to cover their asses and the staff on the floor will carry the can .

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