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Government refuses to budge on mandatory staffing levels

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The government has maintained its view that nurse staffing levels should be determined at local level in its initial response to the Francis report.

The Mid Staffordshire Foundation Report Public Inquiry report, published last month, called for the National Institute for Health and Clinical Excellence to produce evidence-based tools for establishing the staffing needs of each service.

This recommendation was welcomed by many nursing organisations – though others had initially hoped for a stronger recommendation backing the introduction of a national overarching minimum ratio for nurses per patient and also for nurses per healthcare assistants.

However, in its response to the Francis report today the government sought a softer position that combined part of the Francis recommendation with its existing policy – it has always rejected national minimum staffing levels in favour of local flexibility.

The DH said today that he supported the production of the tools by NICE, but emphasised that they would be used to inform decisions “by local professional leaders”, rather than be mandatory.

The response acknowledges that staffing levels in terms of numbers and skill mix are “vital for good care”, but resisted setting minimum staffing numbers and ratios.

It restated the government’s long-standing claim that minimum standards could lead to a lack of flexibility in workforce planning or lead to some organisations only aiming for the minimum number and no more – the so-called “race to the bottom”.

In addition, the response states that the newly-created post of chief inspector of hospitals will be charged with inspecting staffing levels and reporting if they are inappropriate.

The national nursing strategy, Compassion in Practice, which was launched at the end of last year recommends that information on staffing is published twice a year.


Sign our Speak Out Safely petition to support a transparent and open NHS. We are calling on the government to implement recommendations from the Francis report that will increase protection for staff who raise concerns about patient care.


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