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Increasing nurse numbers ‘is not’ the answer

Employers say more nurses does not mean better care

Jo Carlowe

Monday, 04 February 2013

A better skills mix rather than more nurses will improve safety and care in the NHS – according to health managers.

The NHS Confederation and NHS Employers has issued a response following an online survey by Nursing Times in which three-quarters of nurse respondents described witnessing ‘poor’ care over the past 12 months and more than 57% reporting that their ward or unit was sometimes or always ‘dangerously understaffed’.

Furthermore, some 85% of nurses on general wards said the patient to nurse ratio was eight or more to one, while 44% said the ratio was 10 or more to one.

The online poll results came out in anticipation of the publication of the Francis Report into the failings at Mid Staffordshire Foundation Trust, due out on Wednesday. Inquiry chairman Robert Francis QC will present the final report to Health Secretary Jeremy Hunt before the minister makes a Commons statement.

Commenting on the online poll findings, NHS Confederation chief executive Mike Farrar said it was ‘too simple’ to ‘suggest that throwing more nurses at the problem would solve matters.

"If we are to resolve the problems highlighted by the report into Mid Staffordshire NHS Trust, we need to take a broad and deep view that looks honestly and openly at all aspects of the NHS, not just one group of staff.

"Whilst it is absolutely the case that good nursing is vital if high quality care is to be delivered everywhere, it is too simple to say this can resolved by throwing more resources at the problem.

"Staffing levels may well be an issue in some parts of some hospitals, but it is not the case that we need more nurses everywhere,” he said.

He added: “A better response would be to ensure we get four things right - the right staffing pattern and skill mix for each service, recruitment of NHS staff based more on their values, better training for nurses at the ward leader level, and ensure nurses operate in organisations that value compassion and care.

"It is critical that at a local level, we empower senior clinicians and managers to take greater responsibility for setting high standards of care, including determining the right staffing pattern for delivering these standards for their patients."

Dean Royles, director of the NHS Employers organisation, which is part of the NHS Confederation, was also critical of the emphasis on nursing levels.

“Mandatory staffing levels cannot guarantee safe care. We do not believe that imposing a crude system of staffing ratios is the right way to tackle poor care. Each NHS hospital and service has different demands on its services. Arbitrary ratios could limit organisations' ability to plan care in a way that is best for the patient and limits the way we use the skills of other staff like physiotherapists occupational therapists that provide essential care.

"The last thing we want is a minimum standard becoming a ceiling rather than a floor," he said.

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