The Department of Health has admitted Lord Carter’s proposed new nursing care metric is not used anywhere else in the world in the form that it will be in the NHS – contrary to what was originally claimed.
The countries previously referenced by the DH as using the new metric – the US, New Zealand and Western Australia – use a similar nursing hours per patient day tool to plan safe staffing but do not include healthcare assistants in their calculations, unlike the NHS version.
“We are future-proofing our metric as we want to include similar processes for other staff groups at a later date”
Lord Carter’s review, published in February, recommended the care hours per patient day metric become the “principal measure of nursing and care support deployment” in the NHS from April this year.
It is calculated by adding the number of hours of registered nurses to hours of healthcare support workers and dividing the total by every 24 hours of inpatient admissions.
The DH also accepted the Carter Review figures for 411,000 nurses being employed in the NHS was based on six-year-old data and included nurses employed by GPs and bank staff, meaning a risk of staff being counted twice.
Latest data from the Health and Social Care Information Centre says there are 322,000 full time equivalent nurses employed in hospital and community health services.
A spokesman for the DH said the “principles” of the care hours metric were based on tools used in other countries, saying: “We stand by the validity of [the care hours per patient day metric].”
He added: “While each country uses this metric slightly differently, it is not wrong that we reported this metric is being used. The difference is that we are future-proofing our metric as we want to include similar processes for other staff groups at a later date.
“We are very clear that we do not want to lose the important role of a registered nurse, which is why we have broken it down by registered nurses and healthcare support workers,” said the DH spokesman.
“It is crucial to remember this is one metric to be used alongside other pieces of guidance to help ward sisters and hospital managers make professional decisions on staffing levels,” he told Nursing Times’ sister title Health Service Journal.