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Nurse staffing levels will ‘determine NHS winter capacity’

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Nurse staffing levels will be a “determining factor” for health service providers that need to open extra capacity to cope with winter pressures, NHS leaders in England have warned.

They said nursing vacancies could hamper the ability of the NHS to safely manage demands for more beds in the event of high numbers of patients attending accident and emergency departments.

“Nursing levels will be a determining factor around the number of beds we can safely provide”

Pauline Philip

The warnings were revealed at NHS Improvement’s latest board meeting on 30 November, reported Health Service Journal.

Dame Pauline Philip, the national urgent and emergency care director at NHS England, told the meeting that the health service was already seeing a deterioration in performance against the four hour waiting time standard.

She that said performance for October and the year to date was around 90% of accident and emergency patients being seen and treated within four hours.

She added that November was starting to look “more difficult”, highlighting that an increase in respiratory issues in children meant “we are starting to see a deterioration” in A&E performance.

Dame Pauline told the board meeting that staffing levels for doctors and other staff were important but “nursing levels will be a determining factor around the number of beds we can safely provide”.

NHS Improvement executive nursing director Ruth May, who is also deputy chief nursing officer for England, reiterated the concern over nursing levels, telling the board it was a “very real risk”.

She said: “There are nursing vacancies. Trusts and boards are making decisions day by day to make sure they can staff their wards. But it is not just about hospitals, but staff in community teams as well.”

NHS leaders have already warned that the health service could be set to face a tougher winter than usual due to bed occupancy problems and the experiences of countries in the southern hemisphere.

Simon Stevens, NHS England’s chief executive, said in September that the signs from Australia and New Zealand were a “heavy flu season”, which saw hospitals in those countries “struggling to cope”.

According to Health Service Journal, Dame Pauline also told the board that some trusts had achieved a 100% vaccination rate against flu but that there was variation with some community organisations only achieving vaccination rates in the low thirties.

She said planning for winter was “more detailed and intensive” than previous years and focused on targeted support to organisations under the most pressure, alongside continuous monitoring and live data. There are also contingency plans being put in place to tackle peaks in demand.

Board papers published ahead of the meeting cited a number of changes that had already been made as part of “winter resilience preparations”.

These included 85% of type one emergency departments having a primary care streaming service in place, and access to urgent treatment centres being standardised and booked via NHS 111.

In addition, more than a third of 111 calls were being answered by nurses, paramedics and doctors, compared with 22% last year, said the papers.

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