Patient safety

17.04.19

Lessons from Mid-Staffordshire scandal being lost as NHS staffing levels are ‘putting patients’ lives at risk’

One in four NHS wards routinely operate with staffing levels so low they threaten patient safety, researchers have warned.

Hospital wards are still understaffed to the extent that patients’ lives are being put at risk, researchers at the University of Southampton have found, as a national shortage of nurses has not been addressed.

The report states that policy changes made in 2013 in response to the Mid-Staffordshire care scandal have not worked, with a strong initial response to the Francis Inquiry becoming more muted.

One in four NHS trusts surveyed said that for over 65% of their shifts last year, their ratio between patients and registered nurses exceeded 8:1 – which is the ration considered by NICE to be a threat to patient safety.

Whilst the number of nursing staff in acute care across the NHS since 2013 has increased, the researchers said that there had been no net improvement on staffing levels due to a rise in patient admissions, and there had also been a dilution of skill levels.

Professor Jane Ball, research fellow at the University of Southampton and lead author of the report, said: “One of the biggest challenges has been the national shortage of RNs. The ongoing national shortage of RNs, and failure to increase supply sufficiently, has not been addressed.

“This failure has prevented safe staffing levels from being achieved.

“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 RNs to meet the demand.

“The continued failure to train enough RNs to meet patient needs is a fundamental flaw and misalignment of policy.”

Ball said a “complete lack of alignment” between initial policy responses and the subsequent workforce investment from the NHS has left trusts “with a clear vision of safe-staffing but without sufficient means to deliver on it.”

According the report, the average nursing vacancy rate is 10% across the country, and the researchers warned that with hospitals still running with staffing levels that put patients’ lives at risk, the lessons from the Mid-Staffordshire inquiry were being lost.

Patricia Marquis, the Roya College of Nursing’s director for England, commented: “Now that there are 40,000 unfilled nurse jobs in England, it is time for ministers and the NHS to get a firm grip on the situation before it deteriorates further.

“The legacy of the Francis Report was a once-in-a-generation opportunity to increase nurse staffing levels, but any short-term progress in hospitals has fallen away.”

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