NHS chief executive Sir David Nicholson has told managers they must do more to ensure nursing levels on wards are safe.
Speaking at the NHS Employers conference in Liverpool this week, he told human resources managers: “You’d be amazed how many people simply don’t know how many nurses they have, never mind how many nurses they have on an individual ward or an individual shift.”
He told managers to check which tools they were using to “satisfy” themselves that staffing levels on wards were appropriate.
Nursing levels were found to be particularly low at Mid Staffordshire Foundation Trust during a high profile period of poor care standards which has sparked two inquiries.
Sir David said some “very simple practices” could be implemented to prevent the problems being repeated in other trusts. For example, some trusts are bringing in systems to ensure nurses check on patients every hour – a practice known as “hourly rounding”.
As reported by Nursing Times in March, this has already been implemented by trusts in the East Midlands.
Sir David also highlighted its use at Nuffield Orthopaedic Centre, part of Oxford University Hospitals Trust. He said nurses there had found “it reduced the amount of work they did”, despite initially raising concerns they would be too busy to do it.
He also told managers to ask themselves about the quality of leadership support offered by the trusts, including the training for ward sisters.
Mid Staffordshire had demonstrated how “the quality of first line leadership is the thing that sets the tone for that individual ward”, he said.
He added: “It’s worth asking these questions because I think you will be surprised in your organisation.”
Health secretary Andrew Lansley also discussed nursing standards when he addressed the conference.
He said: “There are an immense number of excellent nurses, and healthcare assistants, across the NHS, proving their patients with exemplary care on a daily basis. [And] often providing that service in difficult and trying circumstances. But we have to admit that’s not the whole story.”
However, he said the compulsory registration of HCAs was not the solution. He officially announced plans to set minimum training standards for HCAs, as reported in Nursing Times last week.
He said: “Some see the compulsory registration of HCAs…as part of the solution. I don’t believe the case is strong enough to extend statutory regulation to a further 1.2m relatively low paid workers, requiring them by law to pay registration fees in order to pursue their livelihoods.”