If you don’t have enough nurses, the standard of care will suffer. That’s not hard to work out, and yet still trusts are planning on making nursing workforce cuts (page 2).
In the wake of Mid Staffs, you’d think managers would be frightened of anything that jeopardised their ability to provide safe, high-quality care, but it seems if the axe has to fall, it’s usually around the blue uniforms.
Last week, the British Medical Journal’s survey revealed death rates among patients having operations later in the week and over the weekend were higher than during the first few days of the week. The survey showed the “weekend effect” was higher for patients with three or more previous admissions or those who have co-morbidities, suggesting they need complex care. What this report implies is that if you don’t have adequate staff numbers to provide surgical and postoperative care, patients will be put at risk. There are calls for hospitals to operate 24/7 services, so that medical support is always available, but until this happens, there is a strong argument for increasing, rather than reducing, nursing staff over the weekend to counter the increased incidence of failure to rescue.
It feels like no one is thinking strategically about how to ensure care is provided at a safe level; some trusts still seem more concerned about hitting the numbers
And it’s not just in the acute sector that inadequate resource is having an impact. Earlier this month, the Royal College of Nursing raised concerns about there being too few nurses in the community to provide an effective service. It studied other countries and found that a lack of suitably qualified nurses had been a major blocker in bringing care closer to patients’ homes. Figures from the Health and Social Care Information Centre show the number of district nurses in NHS England have fallen from 12,802 in 2002 to 7,547 in 2012. If the NHS is to be reshaped to provide more community care and prevent costly hospital admissions, this is a worrying trend.
It feels like no one is thinking strategically about how to ensure care is provided at a safe level; some trusts still seem more concerned about hitting the numbers than looking after patients in an environment that puts their choices - and their safety - first.
However, that is not the case everywhere. Doncaster and Bassetlaw and South Teesside are both increasing their nurse numbers as they cope with growing service demand (page 3). They realise you can’t keep adding patients without increasing nursing resource.
We need more trusts to be brave enough to face up to the fact that nursing may be the easiest place to find savings, but cut too deeply and it will impact patients severely.
That’s why our Speak Out Safely campaign encourages staff to raise concerns about unsafe staffing levels or practice. Visit nursingtimes.net/sos
Jenni Middleton, editor
firstname.lastname@example.org. Follow me on Twitter @nursingtimesed