One in four acute trusts fail to meet NICE safe-staffing guidelines as they don’t have enough nursing staff, a study by the University of Southampton has found.
Published yesterday, the study concluded that acute hospitals are still not adequately staffed to prevent patient harm, despite the introduction of national policies as a result of the 2013 Mid-Staffordshire Inquiry.
The NICE guidelines suggested that ‘a greater risk of harm’ might occur when one nurse is caring for eight or more patients and this ration should trigger a review of staffing.
However the guidance hasn’t resulted in improvements on hospital wards as one in four directors of nursing told the researchers their wards couldn’t meet the guidance.
Recruitment and retention problems
The study analysed the responses of 91 directors of nurses through a survey undertaken between March and April 2017 and found that 60% blame their trusts’ unsafe staffing levels to difficulties in recruiting staff.
The researchers revealed that trusts reported an average 10% vacancy rate in number of registered nurses but in some trusts, it is around 20%.
The team of researchers – whose work was funded by the National Institute for Health Research Policy Research Programme – analysed national workforce data and learned that the number of nurses has increased since Sir Robert Francis’ Inquiry, but it hasn’t matched the number of growing hospital admissions.
On the other hand, the increase in number of nursing support staff was three times greater than that of nurses, ‘causing a dilution of skill levels in NHS acute care’, the report said.
Lead author of the study – Implementation, Impact and Costs of Policies for Safe Staffing in Acute NHS Trusts – Professor Jane Ball said that the ‘ongoing national shortage of registered nurses has not been addressed’.
Professor Ball said: ‘Over and over again, different bodies and think tanks including the King’s Fund, the Nuffield Trust, the Health Foundation, the Health Select Committee on Nursing Workforce, and the Migration Advisory Committee have pointed to the fact that we have not been training enough nurses to meet the demand.
‘The continued failure to train enough registered nurses to meet patient needs is a fundamental flaw and misalignment of policy.’
As of June 2018, NHS Improvement data revealed that the health service was missing over 41,000 nurses, which later reduced to 39,148 at the end of December.
The Cavendish Coalition, which comprises 36 health and social care bodies including NHS Employers, warned in November last year that this number might be higher than 50,000 post-Brexit.
An NHS Improvement spokesperson said: ‘Nursing vacancies have reduced by 3,000 in the last year, and as part of the NHS long-term plan we have launched the largest ever national recruitment campaign to encourage people to consider a career in the health service, which reversed the decline in nursing degree applications as thousands more applied for these posts, while upcoming proposals will set out how we can grow the NHS workforce.’
Commenting on the study, RCN director for England Patricia Marquis said minister and the NHS should act now to prevent further deterioration of this situation.
She said: ‘The Government should commit to a new law for England to provide accountability for staffing levels for safe and effective care, and provide an additional investment of at least £1bn in nurse education to retain the existing workforce and train the next generation of nurses.’