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Nurse campaign calls for minimum 4:1 staffing ratio


A campaign has been set up to lobby government to introduce a mandatory minimum staffing ratio of four patients to each registered nurse.

Members of the 4:1 Campaign said they were “acutely aware of the pressures experienced by staff everyday through understaffing and the negative consequences this has on direct patient care and experience”.

“We believe a mandatory minimum staffing ratio of 4:1 should be introduced by the government to ensure that patients are cared for safely and effectively,” they state in a letter to Nursing Times.

“Research articulating the link between high patient-nurse ratios and poor patient health outcomes is strong and the experience of 1:4 ratios from California and the Australian state of Victoria demonstrate the immense benefits to patients and hospital staff where mandatory staffing ratios have been implemented,” they add.

The campaign has been set up by a group of nurses in London but has a growing support across the country, a spokesman told Nursing Times. Members of its founding committee include both newly-qualified and experienced nurses, and also healthcare assistants.

It follows similar calls from the Safe Staffing Alliance, which was set up last summer and wants a minimum ratio of eight patients to every nurse. The group’s members include the Royal College of Nursing, Unison and the Patients Association.

The Francis report recommended minimum staffing levels be drawn up for each specialty, but stopped short of calling for an overall mandatory staffing level. The government has consistently rejected introducing a mandatory minimum nursing ratio, arguing that local flexibility is needed.




Readers' comments (17)

  • Staying Late to Chart: Is this Legal?

    from the USA but may be of some relevance or spark debate

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  • Interesting and ambitious but it can not be funded even before the recession. Can we find a realistic solution. We have many nurses with Doctorates. How can we achieve better patient outcomes without always wanting to spend more money. As a student I observed that thirty bedded wards were staffed by one registered nurse and enrolled nurse a student and two HCA's. The staffing is much better now so we have to find better ways of working. Private companies will start arguing they can deliver care more effectively and efficiently and cheaper. The Australian and American examples are of little use as comparators as the Health Services in these countries are structured and run differently. I agree the NHS is over managed at great cost with minimal patient benefits.

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  • I suspect many people see no harm in bringing back the two tier system, and would like to get rid of the degree only course, letting people who would make good nurses actually be able to apply for nurse training. There are many excellent HCAs who should be given more opportunities to undertake nurse training but may not have the academic qualifications.

    we NEED more qualified nurses on each shift, it is DANGEROUS without them, we don't need any more proof, just get on with it.

    Stop wasting money on employing more and more managers who have no front line experience or knowledge, cut the pointless redtape and stop spending money on endless initiatives which never come to anything.

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  • I once sat on an airport runway for 2 hours (I was in a plane, obviously!) because an air steward had phoned in sick and the airline thought the cabin crew: passenger ratio was too high for a safe flight.

    The airline industry is always being held up as the model of safety that healthcare should follow. Seems like this would be a good place to start.

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  • tinkerbell

    Jodie's mate | 12-Jun-2013 12:37 pm

    totally agree. We should follow the airline model of safety, peoples lives are at stake.

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  • You would be surprised how many highly qualified nurses, have lost their jobs due to cut's and are finding it very hard to get jobs. It costs thousands of pounds to train nurses in this country, But i recently saw a artical saying that recoupment from Portugal was being considered, I do think we need to use our own resource first that tax payers in this country have payed to train.

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  • Ask for 4:1 be happy with its all games.
    Just give us enough people to care for our patients and everyone will be happy.
    The money will come from the savings of the incredible amounts we pay to complainants, and people whos care is compromised to the point that they sue.
    Its all there it just needs to be redistributed properly.
    Audit the amount of monies paid out once staffing ratio correct then see the real savings, in peoples dignity and treatment.

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