Concern has again been raised over nurse / patient ratios in NHS hospital wards. Increasing nurse workloads could mean potential risk to quality of care, according to a draft report recently released by The National Institute for Health and Care Excellence (NICE).
In the report, NICE suggests that “patients are at risk of harm if a nurse has to care for more than eight people on a ward during the day.”
Once more we see confidence in NHS care being put to the test as nurses and hospital staff attempt to maintain standards despite increased patient numbers and over-stretched resources. However, patients can, and still do, commonly fall victim to tragic mistakes in hospital wards where government cuts mean nurses are often expected to take care of many more patients than ever before. At the start of 2014, NHS England admitted that twenty-five patients a month were being “harmed by NHS staff blunders.”
Earlier, in September 2013, Health Secretary Jeremy Hunt said that “The NHS treats a million people every 36 hours, and we know that the vast majority of these patients have excellent care.” In response, Shadow Health Secretary, Andy Burnham pointed out that “Ministers have been repeatedly warned that too many hospitals in England do not have enough staff to provide care. Their failure to act has left wards under-staffed and nurses over-stretched.”
Eight months on and the NICE report indicates that the staffing situation may not have improved. With individual hospitals allowed to set their own nurse staffing levels, NICE warn that “hospitals in England should be wary” about exceeding safe workloads.
Furthermore, they now advise that a hospital should be able to provide an explanation when the recommended ratio of at least one nurse to eight patients had not been met.
Few would disagree with the suggestion that imposing set patient / nurse threshold ratios may be too inflexible as there may be circumstances where a patient’s illness or injury and care requirements were less serious. But the NICE report clearly signals the risks of patient care being compromised whatever the prevailing ratio. An obvious example given might be “when there are not enough staff to help patients use the toilet, monitor vital levels or administer medication.”
According to the Department of Health spokesman there are now 5,100 more nurses working on wards. At the same time it is reported that a number of hospitals have begun paying close attention to staff levels by publicly displaying in wards the actual number of nurses on duty alongside recommended minimum levels.
NHS England say that they intend to make staffing information “a standard routine” across the health service, and later this year hospitals will be required to submit their staffing levels each month for public access on the NHS website.
Underlining the unacceptability for any patient to receive substandard care, the Royal College of Nursing says "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."
There can be no doubt that the latest step by NHS England towards greater transparency is to be welcomed. As a result, the issue of staffing resources will, hopefully, be fully addressed, the likelihood of preventable medical blunders reduced and patient confidence in the quality of care provided, strengthened.