Workforce experts have reiterated the importance of nurse to patient ratios, with nursing directors currently between a “rock and a hard place”, as they struggle to reach recommended staffing levels.
One leading researcher described the recent decision to transfer safe nurse staffing guideline work from the National Institute for Health and Care Excellence to NHS England as a “devastating blow”.
“We all had hope that post Francis, something was changing, they were putting patient safety first”
The ratio was recommended by the NICE in its safe nurse staffing guidance last year for adult hospital wards.
Speaking at Nursing Times’ Directors’ Congress last week, Southampton University research fellow Jane Ball said recent announcements urging trusts to work within budgets “did not help [nursing directors] make sure staffing meets patient need as outlined in the NICE guideline”.
She said the transfer of safe staffing guidance from NICE to NHS England was a “devastating blow” for the principle of safe staffing.
“We all had hope that post Francis, something was changing, they were putting patient safety first, we were going to have some strong guidance about nurse staffing levels,” she said.
“I feel that is no longer what we are talking about when we are talking about staffing in general and not looking at the outcomes,” she added.
NHS England has also indicated that future staffing guidance will be multidisciplinary rather than only focusing on nursing.
But Ms Ball said: “The little evidence that we do have which looks beyond just nursing doesn’t suggest that you can offset other members of the team for a nurse.”
“We’ve got to make sure we eradicate waste and don’t overestimate what we need – we manage quite a conflicting financial position”
Nursing directors themselves admitted it was currently a “conflicting” time, as they were required to deal with increasing pressure to help increase the efficiency of their organisation while ensuring patient safety.
Also speaking at the Directors’ Congress last week, University College London Hospitals Foundation Trust chief nurse Flo Panel-Coates said there was clear evidence that better ratios of registered nurses produced improved outcomes.
However, she added: “We also know, as chief nurses, we are a member of the board of directors and we’ve got to make sure we eradicate waste and don’t overestimate what we need – we manage quite a conflicting financial position.”
She said some solutions to achieve safe staffing were within the nursing director’s power – such as workforce planning, good roster management and using robust staffing tools – but that “pressure” also needed to be applied to the healthcare system too.
Salford Royal NHS Foundation Trust’s deputy director of nursing Peter Murphy said there were “huge amount of challenges” to overcome for safe staffing.
He agreed with Ms Panel-Coates that nursing directors were between a “rock and a hard place”.
But he said his organisation was committed to maintaining the minimum 1:8 nurse to patient ratio that it currently enforced.