The National Institute for Health and Care Excellence is yet to be asked to draw up evidence-based tools for establishing minimum safe staffing levels, six months after it was recommended by the Francis report.
Robert Francis QC’s public inquiry report on Mid Staffordshire Foundation Trust called for NICE to develop evidence-based tools to ensure safe staffing levels on a specialty by specialty basis, as an alternative to a national mandatory ratio.
In its initial response to the report in March, the government agreed to work with NICE on the recommendation.
A separate report for the government, published this month by US patient safety expert Professor Don Berwick, also backed the idea and stated that NICE should “undertake as soon as possible” work to develop the guidance.
But a spokeswoman for NICE said last week that, while it was aware of the issue, the work was yet to be “referred” to it by the Department of Health.
“The topic has not been referred to NICE, as yet. However, it is something that NHS England is looking at as part of its [national nursing] strategy Compassion in Practice,” she told Nursing Times.
A DH spokeswoman confirmed that it still intended to request NICE to carry it out. She said: “NICE will be asked to look at evidence-based staffing levels guidance and tools, but discussions are at an early stage.”
However, Jim Buchan, professor of health sciences at Edinburgh’s Queen Margaret University, said the lack of progress was “surprising”.
“They are not even at the starting block yet,” he said. “This is a significant job which would require a lot of resources if they wish to do this over a short timescale.”
He added: “We need tools that are relevant to the care environment; we need leadership locally that has the resources and responsibility to meet the levels the tools are demanding and we need some degree of professional responsibility and decision making at ward level.”
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