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Mid Staffs had too few nurses to do ward rounds


A doctor at Mid Staffordshire NHS Foundation Trust has admitted that medical staff there should have done more to address serious nursing shortages.

Consultants at Stafford Hospital had warned managers there were not enough nurses to accompany them on ward rounds and, as a result, were not receiving up-to-date feedback on their patients’ conditions, MPs heard last week.

As part of an inquiry into patient safety, the Commons health select committee held a special session on the lessons that could be learnt from the failings at Mid Staffordshire NHS Foundation Trust. Health minister Ben Bradshaw gave evidence as well as representatives from the trust and the RCN.

Peter Daggett, consultant physician and endocrinologist at the trust, told the committee that nurse staffing levels had become so low before the arrival of Healthcare Commission investigators in March 2008 that consultants were doing ward rounds without nurses.

Dr Daggett said: ‘I could not do ward rounds without having a nurse – but it had become the norm not to have a nurse. [Consultants] conducted ward rounds without a nurse being present.’

He added that with hindsight, doctors should not have accepted excuses from management that there was no funding for more nursing posts. ‘We should not have accepted their mantra that there [was] no money,’ he said.

MPs also heard evidence from RCN head of policy Howard Catton, who said that nurses’ reports of serious untoward incidents were ignored by middle management and did not come to the attention of the hospital board. ‘They went into a black hole or into a waste-paper basket,’ he said.

Mr Catton admitted that the poor quality of care experienced by many patients at the hospital was ‘unacceptable’. ‘Nurses have said with no hesitation that there is unacceptable care here, I don’t think we are trying to deny that,’ he said.

But he added that the hospital’s board should have done more to allow staff to make their concerns known. ‘Boards must give clear support,’ he added.

Mr Bradshaw hinted that the government was considering introducing powers to reverse foundation status, following the revelations about Mid Staffordshire.

Asked by MPs whether the government should be able to remove foundation status, Mr Bradshaw said: ‘That is something that certainly I think will be part of the deliberations – that are currently under way at the department at the highest level – to decide what legislation may be necessary to address some of the concerns that have arisen out of this case.’


Readers' comments (7)

  • The same old story that has been repeating and keeps on repeating. When are we going to learn? Having less nurses and so with less experienced nurses on the floor directly attending the patients care been the problem since Tony Blair. Have we not learn enough ignoring the situations? How much more accidents to look into and consider your present measures are inefffective? How much more this present health care system endangering lives?

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  • We don't have minimum staffing levels. And therein lies the problem. If hospitals are not obliged by legislation to employ adequate numbers of staff then you can be sure that they won't where they can get away with it.

    So why is there no legislation on staffing? Quite simply because that would mean more money needed for staffing budgets. Money the govt doesn't want to give.

    Everything always points back to a failure of central govt policy....always.

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  • A few years ago there were many articles discussing wether Britain should have staff to patient ratios like canada and australia. I thought for a brief moment that at last perhaps it would be considered seriously here. Unfortunatley the articles dissapeared as quickly as they appeared and any comments made about the subject was that it would take away the autonomy of nursing practice ect ect. Well its time it was legalised as personally i feel that it would improve patient care and stop managers cutting their costs by not covering staff shortfalls and endangering patients lives. As nurses we deserve to be supported and so do our patients unforunately it seems meeting targets is the only thing important to trusts and nothing else matters.

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  • Doesn't seem to be too much change. I have been working at stafford for 5 months now, and the pressure the nurses are under is enormous. At night, there is ONE staff nurse and an auxiliary looking after 18 acute patients. Have you tries writing a proper report / handover for 18 patients?? Meanwhile we all get bollocked for not completing audit forms.
    Stafford has been criticised for not attracting enough staff to work here, yet we have been told that all of our 2010/2011 holidays are now "booked" for us (I.E ALL of our alloted annual-leave has been GIVEN to us, and has been written on the Matron's year-planner in stone), and if we want to change anything we'll have to swap with other nurses. One nurse started here just before christmas, and was told that "they couldn't have their booked holiday, and would have to re-arrange it". Swapping holidays from matron always comes with a sneering look and a torrent of why it's such a big problem to change and organise.
    I'm honestly looking for somewhere else to work now.

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  • you know what it is the same up and down the country that wards dont have enough nurses sometimes on our ward of 42 patients we can have 5 to 6 staff this includes HCA and RGNs on a morning shift the busy times on the ward. how can 5 to 6 members of staff meet the needs of their patients. IR1 done by RGNs but nothing heard from these IR1s. government wants to stop putting of and give the NHS staff ratios policies. oh by the way audits are now coming before patient care. staff nurses are been grilled for not filling in audits forms. nursing has become the art of filling in chart after charts. i came into nursing to administer high quality care like a lot of other nurses but we cant meet our patients needs because their is not enough staff. how can audit forms meet patient care needs. what happened staffordshire can happen to any other hospital up and down the country. RGNs should start strike actions because its the RGNs who get the blame if their are failings on the wards even though nurses are highlighting there is a problem and not enough staff per shift by IR1 and going to their matrons and managers. and you no wat there is some good nurses about and it is not fair. the goverment putting money before patient care and govenment knows it is easy to blame the nurses. nurses we should stand our ground and strike get in the media that we are not happy and we cant do our jobs.

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  • More paperwork/audits have now been introduced at Stafford.
    We now have "Comfort rounds", to be completed and signed EVERY HOUR, asking patients questions such as "are you in pain, would you like a drink" etc. It says that this is a pilot scheme, but the nurses, as usual, are at the brunt of this scheme, trying to care for their patients and complete these stupid audits. It also takes away all responisbility from the patient to decide for themselves if they want to call the nurse (they DO have buzzers to call the nurse you know!).
    Are things improving? Not at this rate, I don't need a chart to tell me if my patients are being looked after, I'm trying to actually do it!
    Who actually invents this stuff?? More managers trying to justify their positions and cover their ar*es to keep themselves in their highly paid jobs?

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  • don't knock it comfort rounds sounds great...if you can't do them because your not staffed enough/aren't superhuman then incident form, emails, chain of command.
    The fact they recognise it is great. Still struggling are hospitals to accept, COMFORT care is actually bloody important. I just wish relatives would complain more

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