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Wide variation in night nursing levels on geriatric wards

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Nurse staffing levels at night on some acute wards for older patients have been branded “risky and irresponsible” by the Royal College of Nursing. 

Wide variations in staffing levels at night were revealed in the annual Dr Foster Hospital Guide, which was published last week.

It involved data from 137 trusts, including 142 hospitals with a designated geriatric unit. The data analysts looked at how many nurses and healthcare assistants were on duty on at 10pm on two Thursdays in March and April, and at 11am on two Sundays in March and April.

South Tyneside District Hospital had the lowest number of nurses per bed, with 59 older people’s care beds looked after by two nurses and four HCAs – equivalent to 10 beds per staff member and 30 beds per nurse.

The guide showed the average across all hospitals at night was six older people’s care beds per member of nursing staff, or 12 per nurse. Hammersmith Hospital had the highest staffing level, with three nurses to every 10 beds.

The analysts also looked at weekend staffing, finding that it was usually higher than during the week. The average was four elderly care beds per member of nursing staff and eight beds per nurse. 

The guide noted previous Dr Foster research, exclusively revealed in Nursing Times, showing the number of nurses per bed was directly linked to mortality rates (news, page 1, 31 March 2009).

Writing in the guide, Peter Griffiths, chair of health services research at Southampton University, said:  “The staffing levels reported by some trusts seem low.

“It seems reasonable to ask whether they have clearly assessed the needs of patients and if they are sure that these needs can be safely met with such staffing levels.”

RCN chief executive and general secretary Peter Carter said the workforce variation was too wide to be explained purely by clinical need and that trusts must look at their staffing levels “as a matter of urgency”.

“Due to the complex needs of many older people, having staff with the right mixture of skills and experience on the ward is vital. Equally, it is both risky and irresponsible to expect two nurses and four healthcare assistants to safely look after 59 elderly patients as the report found at one hospital,” he said.

David Shilton, executive director for nursing at South Tyneside Foundation Trust, which runs South Tyneside District Hospital, said its board was “satisfied that staffing numbers currently provide safe levels of care” and kept staffing levels under constant review.

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Readers' comments (1)

  • michael stone

    There you go, mike - Peter Carter saying some wards are under-staffed, in 'the RCN's opinion'. Told you - Carter isn't 'always attacking nurses', and he does quite often agree with your points.

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