The National Institute for Health and Care Excellence (Nice) recently warned that registered nurses’ workloads should not exceed more than eight patients at any one time, as patient safety will be at risk.
Nice spent several months examining evidence on the impact staff numbers have on the quality and safety of the care which patients receive.
This intervention will put more financial pressure on hospitals, many of which are already struggling. Campaigners believe at least 20,o00 extra nurses are needed across the country, at a cost of £700m.
Until now, government ministers have refused calls for the NHS to introduce minimum staffing levels, due to worries about costs.
In one serious case, a previous official inquiry found that understaffing at Stafford hospital due to cost-cutting by the trust, directly contributed to “appalling care”, including patients dying and suffering serious harm.
Nice’s deputy chief executive, , Professor Gillian Lengis, states that hospitals should not view Nice’s new recommended 1:8 ratio as a straitjacket, but that failure to observe it and overloading nurses risk harming patients.
Leng also suggests that hospitals must constantly be on the alert for “red flag events”, such as patients not receiving help to go to the bathroom or not receiving pain medication, which can trigger an immediate need for more nurses on the wards.
Susan Osborne, the chair of the Safe Staffing Alliance, supported the new regulations for minimum staffing levels, stating:
“A 1:8 ratio still means that the nurse only has seven and a half minutes per patient per hour, which is too little. If it’s more than eight then patients won’t get fed, care plans won’t get written, and nurses can’t sit and talk to patients and reassure them about their condition. Care just won’t be given to a proper standard, and patients can die.”
Osborne also stated that eight should be the absolute maximum number of patients, as even the proposed minimum levels are “bordering on unsafe care”, as ideally the ratio should be 1:4 or 1:6.
Many hospitals cut staffing levels in 2010 in an attempt to meet the NHS savings target of £20bn by 2015.
Although hospitals have been recruiting since, many trusts are struggling to recruit nurses locally and recruitment from overseas countries such as Spain, Portugal and Ireland is increasing.
One NHS nursing expert states that trusts unable to find permanent staff are spending hundreds of millions of pounds a year on bank and agency nurses to fill gaps in nursing rotas.
The Labour Party is likely to question the coalition on whether it will accept the minimum staffing recommendation, as the party has already highlighted the fact that thousands of nursing and other frontline jobs have been cut since the election, and one in six hopsitals in England have failed inspections due to understaffing.
This level of understaffing is dangerous, and from trusts’ cost-cutting and NHS savings targets, it is clear that economic cost is currently prioritised above human cost.
Our ageing population and lengthening lifespans are cited as one of the problems for nurses being overworked. However, increasing numbers of patients, staffing cuts and cost-cutting in other areas due to government pressure, are having detrimental effects on patient care, and even patients’ lives. It is clear that priorities must be reconsidered, with the patient placed at the heart of all new policies and decision-making.
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