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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?'


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

    Back to reality!

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  • Aaron

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

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