Tag Archives: nursing levels

NHS nursing levels: Nine in 10 hospitals missing targets

The vast majority of hospitals in England are struggling to recruit enough nurses, figures show.

Some 92% of the 225 acute hospital trusts in England did not manage to run wards with their planned number of nurses during the day in August.

The figures, published by the NHS, show that hospitals in England are falling short of their own targets for levels of safe staffing.

The Department of Health said staffing was a priority.

A spokesman added that 50,000 nurses were currently in training.

Analysis by the Health Service Journal shows average staffing levels across the 225 acute hospital sites in August was worse compared with data for January, when 85% of hospitals missed their staffing targets for nurses working during the day.

The figures also showed 81% of hospitals failed to have enough registered nurses working at night.

Some 79% of hospitals missed their target for registered nurse staffing across both day and night.

‘Long way to go’

Royal College of Nursing chief executive Janet Davies said hospitals were trying to catch up on their staffing levels.

She told BBC Radio 4’s Today programme: “We went through a period of time where we were trying to save money. We cut posts, we didn’t train enough nurses and we’re still feeling the effect of that.

“We’ve a long way to go. We’ve got to catch up on this for some time. But equally, we have to keep the nurses we’ve already got. It’s great to train people, it’s great to bring people in, but our experienced nurses are leaving.

“They’re leaving because they’re overtired – it’s a bit of a vicious circle.”

She said nurses were “exhausted” at the end of their shifts and often having to stay late to provide extra care.

“They do get very concerned because they know what they should be doing for patients and if they can’t, it’s really upsetting,” she added.

Hospitals have been required to publish monthly data on whether they have enough nurses on wards since April 2014.

It followed a report into the Mid Staffordshire NHS Trust, which was heavily criticised for failings of care that may have contributed to unnecessary deaths.

Many hospitals have had to boost their nurse numbers by recruiting overseas, and spending on agency staff has contributed to NHS deficits.

A Department of Health spokesman said: “Staffing is a priority – we’ve put more than 7,600 additional nurses on our wards since May 2010 and there are 50,000 nurses currently in training.

“We know that there are big challenges for hospitals, so we are helping the NHS to employ the staff it needs at a fair price by clamping down on rip-off staffing agencies and identifying billions of pounds of back-office savings so that as much money as possible goes to the front line.”

It comes after a study published in the British Journal of Anaesthesia suggested that fewer patients die after emergency surgery in hospitals that have more doctors and nurses.

The research, looking at data involving nearly 295,000 patients, also found death was more likely following a weekend admission, saying this showed staffing was a factor in the so-called weekend effect.

And a separate Nursing Times survey last week suggested nurses are under so much pressure that they cannot guarantee safe care for their patients.

The survey of nearly 1,000 nurses found eight out of 10 are under more stress at work than they were a year ago, with more than half saying they “rarely” or “never” had either sufficient time or staff to ensure safe care for patients. A third said their ward or team was “always” short-staffed.

Source BBC News

Safe nursing levels recommended

Hospitals in England should be wary about having nurses care for more than eight patients each on wards during the day, draft NHS guidance suggests.

The National Institute for Health and Care Excellence (NICE) says there is more risk of harm if there is a lower ratio of nurses to patients.

But it stopped short of stipulating one to eight was an absolute minimum, saying flexibility might be required.

The Department of Health said the number of front-line staff had risen.

NICE said while flexibility was needed, hospitals should be able to justify a situation where the recommended ratio of nurses to patients was breached.

It said this was because there could be cases where patients’ illnesses and needs were less serious than normal, and, therefore, it would be wrong to set strict thresholds.

But the guidance recommends nurses raise the alarm – or a “red flag” – when care is being compromised, no matter what the ratio.

That could include situations where there are not enough staff to help patients use the toilet, monitor their vital signs or administer medication.

Safety check

NICE deputy chief executive Prof Gillian Leng said: “There is no floor or ceiling number on the required number of nursing staff that can be applied across the whole of the NHS.”

She added decisions about the number of nursing staff should “allow flexibility on a day-to-day or shift-by-shift basis”.

The guidance, which is now being consulted on before the final recommendations are made in the summer, applies to general acute wards.

Specialist areas such as maternity, paediatrics, and accident and emergency will get their own guidance at a later stage.

NICE was asked to look at the issue by ministers who promised to explore safe staffing levels following the public inquiry into the Stafford Hospital scandal.

Many hospitals have already started paying close attention to nurse numbers; for example, a number publicly display actual staffing levels on wards along with what they should be.

NHS England wants this to become routine across the health service, while later this year hospitals will have to submit their staffing levels each month so they can be displayed on the NHS Choices website.

‘Sensible’ guidance

Royal College of Nursing general secretary Peter Carter said: “For any patient to receive substandard care is unacceptable.

“Nurses will be hoping that once the full set of guidelines is completed, the NHS will never again be so vulnerable to short-term financially-driven decisions about patient care.”

A spokesman for the Foundation Trust Network, which represents hospitals, said the guidance was “sensible” and supported what many trusts were already doing.

“Local nursing and clinical teams are best placed to make the judgement on what is best for their patients,” he added.

The guidance also applies to Wales, although it will now be up to ministers there whether it will be applied.

In Scotland, hospitals are already routinely monitoring and publishing staffing levels – although there are no recommended minimums.

Health Secretary Jeremy Hunt said: “NICE’s work on staffing is a major step forward – for the first time in its history, the NHS will have the evidence it needs to make sure that nurses are able to spend enough time with their patients.”

A Department of Health spokesman said the number of admin staff and managers in hospitals had been cut since 2010 but there were 5,100 more nurses working on wards.

“We have increased the NHS budget in real terms and are clear that hospitals must balance their books whilst ensuring compassionate, quality care for all. We know this can and is being done,” he said.

What is your reaction to these guidelines?

Source BBC News