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Francis response: NICE confirms safe staffing guidance programme


The National Institute for Health and Care Excellence has confirmed it has been asked to provide guidance on safe staffing levels for adult inpatient wards and eight other settings.

As reported by Nursing Times last week, NICE recently issued a tender document in advance of expecting to be commissioned to do the work.

Yesterday, the institute issued a statement setting out more details on the guidance, which will form part of the government’s response to the Francis report into care failings at Mid Staffordshire Foundation Trust.

In its statement, NICE said it would carry out a “comprehensive review of the evidence relating to staffing levels in the NHS and will evaluate available, relevant data on nursing activities at ward level”.

NICE said it would produce guidance initially focusing on adult wards in acute inpatient settings and the endorsement of associated workforce tools.  The focus of the work will be nurse and healthcare assistant staffing levels, the institute said.

The guidance on safer staffing on adult inpatient wards is due to be published in July 2014. After that, NICE said it would work on guidance on safer staffing levels for:

  • Accident and emergency units
  • Maternity units
  • Acute inpatient paediatric and neonatal wards
  • Mental health in-patient settings
  • Learning disability in-patient units
  • Mental health community units
  • Learning disabilities in the community
  • Community nursing care teams

Both the Francis report, in February, and the Berwick report on patient safety in August, recommended that NICE should be the lead organisation in the development of advice on NHS staffing levels.

Professor Gillian Leng, the deputy chief executive of NICE, said: “At first, we will focus on nurses in hospital wards where patients need urgent short-term care.

“There is already a lot of information available to help us develop the guidance which will allow NHS organisations and organisations providing care to NHS patients set safe and efficient staffing levels,” she added.

The government has consistently rejected the idea of setting a single minimum staffing level. This is despite increasing support for the ratio of one nurse for every eight patients called for by the Safe Staffing Alliance and based on findings from the National Nursing Research Unit.

As reported by Nursing Times earlier this week, the Prime Minister’s Nursing and Care Quality Forums called for the ratio of 1:8 to be introduced as a temporary safety measure until the NICE guidance is ready.

This call was repeated yesterday by Jane Ball, deputy director of the NNRU at King’s College London. She said: “Our research shows that where the number of registered nurses falls below a level of one nurse to eight patients, care becomes unsafe and can lead to patients dying unnecessarily. 

“This can be a useful fundamental standard, which could be used whilst we wait for the guidance on safe staffing levels from NICE.”

The government’s full response to the Francis report into care failings at Mid Staffordshire Foundation Trust was published yesterday.

In its response report – Hard Truths: the journey to putting patients first – the government has accepted 281 of the 290 recommendations made by the Francis report in February.

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Readers' comments (4)

  • Why did we wait ten months for this?

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  • Yes Roger, who needs an expensive study to tell us ? "listen to the voices".
    note longterm care wards and old people missing from list. Private sector and care homes are irrelevant- we know.
    note also they speak of nurses levels- not care assistants who do bulk of hands on care.
    some overseas efforts in here

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  • Not that old chestnut again why is it that some H.C.A. always think that they are the only ones that do patient personal care, when with many nurses myself included this is the reason we went into the nursing profession. To give holistic care. SO please give us a Break.

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  • It is time staffing levels are investigated. Nurses are struggling with the increse in documentation and providing effective care for patients.

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