NICE publish draft staffing guidelines for acute hospitals

Topics covered: Ridouts professional advice

NICE is currently consulting on draft staffing guidelines for nursing in adult inpatient wards in acute hospitals.  They are the first in a series of guidelines on safe staffing in different healthcare settings that NICE was asked to produce, by the health secretary, as part of the government’s response to the Francis report.

The draft guidance indicates that there is an increased risk of harm when registered nurses are caring for more than 8 patients during the day on a regular basis.  However, the guidance highlights that there is no single nursing staff to patient ratio that can be applied across the wide range of wards safely or adequately to meet the needs of patients.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE said “there is no floor or ceiling number on the required number of nursing staff that can be applied across the whole of the NHS.  What the safe staffing advisory committee concluded was that assessing patient needs was paramount when making decisions about the number of nursing staff and planning should allow for flexibility on a day-to-day or shift-by-shift basis.”

The draft guidance highlights the need for awareness and consideration of patient needs and ‘red flag events’.  These are signals that require an immediate response and should be considered as indicators of the ward becoming in danger of understaffing.   Red flag events include patients not being provided with the basic care requirements such as delays in medication provision, help with visits to the bathroom, asking patients about their pain levels and making sure the patient is comfortable and the risk of pressure sores is assessed and minimised.

The draft guidance also calls for senior level management to take greater responsibility and includes step-by-step information on how to determine the number of nursing staff required to be funded.  To assist with the use of this guidance NICE will be assessing a range of practical toolkits developed to determine staffing requirements.  NICE will endorse toolkits considered to comply with the guidelines and meet specific criteria.

Professor Leng added “this guideline is an important step forward in addressing the issues of having adequate numbers of nursing staff within the NHS.  It is vital that we have the views of relevant stakeholders and we now encourage registered stakeholders to submit their comments via the NICE website.”

The public consultation on the draft guidance closes on Tuesday 10 June 2014 – The consultation document can be found at the following link:

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