The government’s new guidance on staffing levels should be seen as a “giant step forward” to “normalise” what is already “business as usual” in some of the best NHS organisations.
The guidance, announced last week as part of the government’s full response to the Francis report, expects all hospitals to public staffing levels on a ward-by-ward basis together with the percentage of shifts meeting safe staffing guidelines from next April
Ruth May NHS England’s director of nursing for Midland and the East led the development of the new guidance for boards on staffing.
Speaking at the CNO’s Summit, she said that whilst there was evidence that poor staffing could lead to overly restrictive or abusive practice it was not up to the government to set minimum staffing levels.
“It is a board’s responsibility to ensure safe staffing on a shift by shift basis…This is about us as leaders using our expertise to decide what is best locally.”
Dr May also warned that boards would need to watch closely for any “unintended consequences” to changes they made in staffing levels.
“We need to be extremely careful in fixing the problems of today that we are not creating another for the leaders of tomorrow,” she said.
She reiterated that the National Institute for Health and Care Excellence would be publishing guidance on acute adult in-patient staffing levels in July 2014 and this would then be rolled out to other areas of the service from August.
Professor Gillian Leng, NICE deputy chief executive, told delegates that the guidance the organisation would produce should be “overlaid” at a local level.
During a question and answer session that followed, Professor Jill Maben from the National Nursing Research Unit suggested that falling below a ratio of one nurse for every eight patients should be considered a “never event”.
But Dean Royles, chief executive of NHS Employers, said that making it a never event would be the same as setting a mandatory level – a move so far rejected by his organisation and the government.
“It is really important that boards make their own judgement,” he added.
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