The NHS has little idea whether nurse staffing levels are safe in England, members of a high profile safety review panel have admitted, after they found hospital data on staffing did not tally with what they found during inspections.
The report by NHS England medical director Sir Bruce Keogh said data for eight of the 14 hospital trusts examined by the review suggested there was no problem with nursing levels on wards.
But when the review teams carried out their inspections they found “frequent examples of inadequate numbers of nursing staff in some ward areas”.
In his report Sir Bruce said: “The reported data did not provide a true picture of the numbers of staff actually working on the wards.”
The review suggests high level data on workforce levels may present an unrealistic impression of staff available on hospital wards on any given shift.
This could lead to NHS trusts drawing false assurances from workforce data while their wards go understaffed.
At several of the trusts examined the review team found staff feeling unable to voice their concerns to senior managers.
Ruth May, NHS England’s regional director of nursing for the Midlands who led some of the review teams, told Nursing Times: “I don’t think we do know that staffing is adequate across the NHS.”
Sir Bruce Keogh, who as sat beside her, agreed with her comments.
Ms May said the “big lesson” for NHS boards nationwide was that they needed to “consistently look at [the] staffing” they had available.
She said: “There are lessons on staffing for the NHS outside these 14 trusts. We need to look at this on a shift by shift basis so that boards and some wards are looking at their staff [number] as a whole.”
The review found that at some of the 14 trusts there was a disconnect between the funded nursing levels and the actual numbers available on each shift. This was exacerbated by an “over-reliance on unregistered and temporary staff”.
The review also found “particular issues with poor staffing levels on night shifts and weekends” and problems linked to extensive use of locum doctors.
All 14 trusts have been given actions to improve workforce issues with all undertaking urgent reviews of safe staffing levels.
Paula Clark, chief executive of the Dudley Group Foundation Trust, said she agreed with Ms May about the reliability of data on staffing levels. She added: “If you take the data from something like the [electronic staff record] you will just get your establishment figures.
“There needs to be a lot more collaboration between those putting the data together and the actual trusts.”