Sir Robert Francis has expressed serious concerns over the decision to suspend the programme of work that he recommended to determine safe nurse staffing levels.
The chair of the public inquiry into care failings at the former Mid Staffordshire NHS Foundation Trust spoke out after it was revealed yesterday that the National Institute for Health and Care Excellence had ceased its work on safe staffing guidance.
The programme by NICE was a specific recommendation made by Sir Robert in his high profile 2013 report, which was immediately accepted by health secretary Jeremy Hunt.
“I specifically recommended the work which NICE has been undertaking for a reason”
In a leaked email revealed on Wednesday, NICE chief executive Sir Andrew Dillon said the programme’s work would be suspended with immediate effect.
It followed Mr Stevens announcing yesterday that chief nursing officer for England Jane Cummings would include safe staffing in a series wider service reviews. He suggested the takeover by NHS England would avoid “a more mechanistic approach” of nurse ratios.
- Shock as NICE halts work on nurse staffing levels guidance
- Unions ‘concerned’ at suspension of safe staffing guidance
Nursing Times’ sister title Health Service Journal NHS England chief executive Simon Stevens has reported that the decision to halt the programme followed a conversation between Sir Andrew and NHS England chief executive Simon Stevens.
In a subsequent interview with HSJ, Sir Robert said he was “surprised and concerned” by the latest development and pointed to the fact NICE was set up to be independent of the NHS and the wider policy structures.
Sir Robert, who is also a board member of the Care Quality Commission, said: “While there is nothing wrong and indeed everything to be said for NHS England reviewing staff levels, I specifically recommended the work which NICE has been undertaking for a reason.
“They have an evidenced based and analytical approach, which I believed would be very helpful in filling what appeared to be a gap in the discussions on this topic,” he said.
“NICE also has an advantage not enjoyed by NHS England of being independent,” he said.
“It is important to establish practical guidance, based on the needs of patients, which will enable providers, commissioners and service users alike to understand whether a particular service is safely staffed,” said Sir Robert.
“I will hold their feet to the fire to make sure we continue the excellent progress we’ve made towards safe staffing”
He added: “I would not be surprised if this news generates a significant level of concern, and it seems a shame that the work of NICE has been stopped.”
Responding to concerns about the change, health secretary Jeremy Hunt said that he would personally ensure progress continued on safe staffing.
“I am the secretary of state who is responsible for implementing the Francis report, and there will be no higher commitment. Whoever is responsible for that work, I will hold their feet to the fire to make sure we continue the excellent progress we’ve made towards safe staffing,” he said.
However, Mr Hunt said he supported NHS England’s decision to ensure “a better way of measuring safe staffing, which is more subtle than simply numbers of bodies per shift”.
But Royal College of Nursing chief executive and general secretary Peter Carter said: “If staffing levels are not based on evidence there is a danger they will be based on cost. We must not repeat the mistakes of the past.”
NHS England declined to respond to a request for comment.