10.02.16
Support workers must complement nurses, not replace them – RCN
Healthcare support workers must complement the registered nursing workforce, not replace it, according to the head of the Royal College of Nursing (RCN).
Responding to a BMJ Open paper suggesting that a higher nurse-to-patient ratio is linked to reduced risk of inpatient death, Janet Davies said the study adds weight to the “growing evidence” of a direct link between the number of available registered nurses and patient experience.
The observational study looked at two datasets covering 2009-11. Where nurses had six or fewer patients to care for, the death rate was 20% lower than where they had more than 10.
The study, led by Professor Peter Griffiths from the University of Southampton, concluded that ward-based nurse staffing is significantly associated with reduced mortality for medical patients. However, there is little evidence for beneficial associations with healthcare support worker staffing.
“This [study] does not, in itself, provide a robust basis to identify safe staffing thresholds,” said the researchers. “However, given the overall strength of evidence for an association, it does seem feasible to identify staffing levels where risk to patients is likely to be increased,” they suggest.
“When determining the safety of nurse staffing on hospital wards, the level of registered nurse staffing is crucial, and there is no evidence to suggest that higher levels of healthcare support worker staffing have a role in reducing mortality rates. Current policies geared towards substituting [these] workers for registered nurses should be reviewed in the light of this evidence.”
RCN’s Davies added the evidence is a “clear warning” about the impact on patient care and outcomes if “we are to have too few registered nurses or are substituting them for health care support workers”.
“Healthcare support workers are highly valuable staff, but they need to complement the registered nursing workforce – not replace it,” she said. “Health services need to work towards achieving the best overall mix of skills – it could make the ultimate difference for patients.”
A spokeswoman for Health Education England (HEE) told NHE: “HEE increased adult nurse commissions significantly in its first year and increased them again the following two years. Since our establishment, we have grown adult nurse training places by over 15%.
“In addition, although our remit is primarily for the future workforce, we have taken decisive short term action to help the service with a return to practice programme in nursing - the Come Back campaign.”
She added that so far more than 700 nurses have completed their re-training and are now back on the frontline providing care and support for patients.
NHE contacted the Department of Health and NHS England for a comment on the report’s findings, but at the time of publication had received no reply.