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Decision on possible fixed nurse-to-patient ratios expected next year

The government is expected to conclude whether it is clinically appropriate to define specific nurse-to-patient ratios across different activities in the new year, health minister Philip Dunne has revealed.

Speaking at a Health Select Committee inquiry yesterday, the minister said there has been a “big focus” on increasing the level of nurse staffing in hospitals since the Francis Report, something which he believes the government has had “some success” with.

“We have various strands of work being done now to look at whether or not it would be clinically appropriate to specify specific ratios of nurses to patients across different activities,” he argued. “At this point, those studies are concluding and we don’t have the output for that, but we will do at some point in the new year.”

Speaking as part of an investigation into the nursing workforce, Dunne also admitted that at present, there is no defined dataset that clearly quantifies what the staff vacancy level is across the NHS, although his department is reportedly working to change that.

“[Vacancies] are something we’re looking at and have some concerns about, because there isn’t an acknowledged dataset at this point which gives clarity about the actual vacancies are opposed to the proxies that people are using,” explained the health minister.

“The proxy that is most frequently used is the number of NHS job adverts, which gives rise to a number but is not particularly useful because you may have job adverts running in perpetuity because trusts know they have a turnover of staff. It doesn’t necessarily give you an accurate figure at any point in time. The advert may be for a number of jobs, too.”

The latest information the government has, he said, suggested there were around 36,000 clinical posts left unfilled by a substantive member of staff, but of these, 33,000 nursing and midwifery spots were covered by bank and agency staff. Therefore, the widely reported vacancy figure of almost 40,000 posts “doesn’t take into account the shifts which are filled by a large number of bank and agency staff.”

While this does bring the total number of genuinely empty posts to a much lower level, it goes against the government’s publicised ambitions to bring down public spending on agency staff, something which health secretary Jeremy Hunt has been keen on tackling for years.

“I’ve commissioned some work from NHS Digital to get a metric, a dataset, so we can get a handle on what the actual vacancy level is across the NHS,” revealed Dunne.

Some organisations, however, would argue that the health minister’s more positive approach towards the nursing workforce is unrealistic, with many organisations releasing stark data and surveys indicating that thousands of posts are being left unfilled every day, leading to a reported staffing crisis running across the whole of the NHS.

In September, for example, the Royal College of Nursing released a major report, which surveyed over 30,000 of its members, that ultimately painted a picture of services stretched to their limits, with insufficient staff available to provide adequate patient care. More than half said that there had been less nurses on shift than planned, and that their ability to deliver care suffered as a result.

The Department of Health’s NHS workforce strategy is expected next year, although Dunne refused to reveal any information about it to the committee apart from the fact that it will take social care into consideration.

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