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Nursing staff cuts will mean hike in risk to patients


The director of the National Patient Safety Agency has issued a stark warning about the impact cuts in nursing posts will have on patient safety.

NPSA patient safety director Suzette Woodward told Nursing Times that nurse under staffing would cause “risk factors” such as tiredness and fatigue, and lead to burnout, inadequate education and supervision.

She said: “All are classic examples that predispose individuals to make mistakes, and make it difficult for others in the environment to identify a mistake before the consequences are serious.”

She added: “Reducing nursing numbers is not the way forward to efficiency and any changes should be risk assessed for their impact on patient care.” 

Ms Woodward was speaking to Nursing Times in the lead up to the publication of the Health Bill this week. She expects it will create a “statutory duty of quality improvement which encompasses patient safety” for providers and commissioners.

However, she said she was concerned about the lack of a national body to ensure this duty was met.

“It is not clear who will ensure that improvements are made; who will provide the national direction and support; who will help reduce variation across the system; who has the time to really look at what the key risks are for patients across the system and share lessons and good practice,” she said.

She also expressed concern about the imminent abolition of the NPSA, which she said would leave the patient safety movement leaderless.

That could lead to a lack of understanding of patient safety issues, creating a culture of fear where trusts ask “who did it?” instead of “why did it happen?” when something went wrong, she said.

Ms Woodward called on nurses to work to change the blame culture.

“Even today, nurses continue to have policies which state that when nurses are involved in a drug error they are to be ‘punished’,” she said.

“There needs to be a commitment by nurse leaders and nurse managers for a different approach.

“Without such leadership, the patient safety movement cannot succeed.”


Readers' comments (10)

  • Of course it bloody will!!!

    'Risk factors'??? Oh come on, lets say it plain and bloody simple shall we, less Nurses equal poorer care standards and higher death rates, it is as simple as that!

    It is not just these cuts that are causing this however, this has been the situation for years now! These cuts are just going to make things a LOT worse!

    Ms Woodward, you call on US to change things? What the hell do you think many of us have been trying to do for years?

    Many of us have been practically screaming from the rooftops that we do not have enough staff and it is directly affecting patient care! Yet when things go wrong, what happens? That's right, it's always the individual Nurses fault isn't it! God forbid management ever spend some money and get more staff in!

    So why aren't the NPSA doing something about it other than 'issuing warnings? Why haven't they done anything before?

    Things need to change, and they need to change now! It will take a damn site more than 'issuing warnings' to do that!

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  • Incorrect skills mix...or is it absent skills mix at ward level?
    Very wrong and very dangerous.

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  • Mike, I think you might have been mistaken here. Ms Woodward, who has a nursing background, isnt saying people should blame the frontline staff, in fact, she has always said the opposite, as she does in the article. All her work in the NPSA has been about stopping the blame culture and looking towards the systems on how to improve. She believes that a blame culture stops reporting and therefore learning.
    Ms Woodward and the NPSA arent the problem, the government destroying everything that has been improved over the last decade, are.

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  • Mike says "So why aren't the NPSA doing something about it other than 'issuing warnings? Why haven't they done anything before?"

    Firstly if you check it is not within the NPSA's powers to intervine, they were set up to collect reports and recommend actions to improve the service. They were never given the power to enforce, they are purely an advisory agency.
    As for what they are doing know, unfortunately they are one of the so-called QANGOs that the government seem to see fit to close. Maybe when patient safety worsens or when the medical staff get blamed rather than the system people may realise what they lost in the closure of this agency, which in a few short years has already received international praise

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  • Anonymous | 18-Jan-2011 10:04 pm, no I think I just didn't explain myself very well. My point was to the specific statement 'Ms Woodward called on nurses to work to change the blame culture' and I tried to get across how much more can we be expected to do? We have tried, over and over, it hasn't worked.

    I agree with you that it is the government that is the problem, but I'm sorry the last government were just as bad and I really haven't seen much improvement whilst Labour were in power.

    Anonymous | 18-Jan-2011 10:11 pm again I think you missed my point, or I didn't explain myself very well. Probably the latter reading it back. I KNOW that they do not have the power to intervene, but WHY don't they? I mean what is the point of having the CQC, the NPSA, etc, if all they can do is make 'recommendations' that those in power feel free to ignore? What is the point?

    Maybe these organisations SHOULD start doing more, regardless of wether they have the technical power or not. Perhaps they could start lobbying for trusts/government to be held to account legally for poor patient numbers when evidence clearly states this leads to poor care and a high mortality rate?

    I wish things were different, I wish these organisations had more teeth. My point was nothing will change untill they start developing a bit more of a bite, and we as a profession grow a collective backbone and start striking or doing SOMETHING!

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  • slightly off point, but the whole idea of introducting a management structure in the nhs was to engage individuals to take over all non-clinical management of the organsation without meddling in the clinical care provided by the professional staff, who are the experts, and thus alleviating them of these time-consuming non-clinical administrative and managerial duties and ensuring that they are provided with ALL of the resources they needed so that they could devote their time to caring for patients -
    what happened?
    the result is a multi-tier organisational system in which the managers work separately, have placed themselves higher in an illusionary hierarchy of their own making and command higher salaries.

    Upside down, inside out and back to front, eh what?

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  • Mike: "Maybe these organisations SHOULD start doing more, regardless of wether they have the technical power or not."

    How can they do something they have no power or authority to do?

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  • Anonymous | 20-Jan-2011 11:12 pm, by acting outside of their remit and applying pressure legally if necessary? Just a thought.

    Don't get me wrong, I have a lot of respect for what they are saying and trying to do. I'm just so bloody tired of these toothless organisations telling us that we need more staff, care standards are low and need to improve, etc (as if we didn't already know), and then doing nothing at all to help us change that.

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  • getting good care in the nhs depends on where you are, the time of day, number of staff on duty at the time and who you see. it shouldn't be like this there should be equal care for all.

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  • It is interesting, lots of individuals and groups are speaking up (and have filled in appropriate forms!) and warning about the risks of the current govt policy, and yet it depends on the will of people, either ourselves and/or govt, to change it. It can't happen if we are not prepared to enact something that clashes with our basic tenets of nursing, or humanity really.
    We don't have to do a dramatic protest or be running in the streets. We just have to gently say no, we are not prepared to do that.

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