Hospital Dr News

Recommended staffing ratios “should not be unthinkingly adhered to”, NHS bosses now say

The NHS is backtracking on its commitments to improve staffing ratios in a bid to save money, a new communication suggests.

In the wake of the Mid Staffs scandal, hospitals were urged to increase the number of nurses and lower the ratio between staff and patients.

However, senior NHS figures have sent a directive saying hospitals no longer have to adhere to centrally determined ratios.

The letter states that it is “important to look at staffing in a flexible way which is focused on the quality of care, patient safety and efficiency rather than just numbers and ratios of staff.

“We would stress that a 1:8 ratio is a guide not a requirement. It should not be unthinkingly adhered to. Achieving the right number and balance of clinical and support staff to deliver quality care based on patient needs in an efficient way that makes the best possible use of available resources is the key issue for provider [hospital] boards.”

Hospitals may be tempted to cut their nurse staffing levels as a result of the new advice, the Royal College of Nursing warned.

Last year NICE advised that the ratio of 1:8 nurses to patients should be viewed as a minimum.

The move, set out in a letter to all hospital CEOs, has sparked fears that patient safety will be sacrificed in the name of cost saving.

The letter has been signed by NHS England, the Care Quality Commission, the National Institute for Health and Care Excellence (NICE), and the new regulator NHS Improvement.

The letter adds: “Trusts are responsible for ensuring that they get the balance right by neither under-staffing nor over-spending, and are able to secure the right complement of clinical staff to meet local patient need and circumstance.”

It recommends that ‘allied health professionals’ are included in ward-based teams to improve outcomes.

The NHS spends over £2.6bn on locum agency staff each year to fill workforce gaps and this figure is set to rise.

The NICE staffing ratio was widely hailed as a way of avoiding a repeat of the Mid Staffs scandal, which suffered from a lacking of nursing care, and the letter appears to be significant downgrading of the priority on staff numbers.

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