Hospital chief to chair nurse staffing group
Nursing academics who led research which found patients were at risk if nurse to patient ratios fell below one to eight have been commissioned to conduct a government backed review of the evidence on nurse staffing, HSJ has learned.
However, the advisory committee which will make final recommendations on nurse staffing on acute adult inpatient wards will be chaired by a hospital chief executive.
As part of the government’s response to the Francis report health secretary Jeremy Hunt asked the National Institute of Health and Care Excellence to develop guidance on safe staffing.
Following an open tender NICE has awarded the contract to conduct a literature review to the University of Southampton. The team will be led by Peter Griffiths, chair of health services research at the university’s centre for innovation and leadership in health sciences, with Jane Ball, deputy director of the National Nursing Research Unit.
They worked together on the RN4CAST study which found hospitals with an average 1:8 ratio would expect to see approximately 2 per cent more deaths per year among surgical patients and 1 per cent for medical patients when compared to the best staffed 20 per cent of hospitals
A spokeswoman for NICE said they had been commissioned to conduct “objective reviews of the literature” online with NICE methodology, “not to make recommendations on staffing levels”.
She said the recommendations for staffing on acute adult inpatient wards would come from the Staffing Levels Advisory Committee who would consider the evidence “alongside relevant economic models”.
The advisory committee is to be chaired by Miles Scott, chief executive of St George’s Healthcare Trust in London. It will also include two directors of nursing, three senior nurses, a healthcare assistant representative, a health economist and three external workforce experts as well as representatives from the medical and allied health professions. The full membership will be announced in the new year.
Mr Scott joined the NHS as a graduate trainee in 1988 and has more than 10 years’ experience as a chief executive.
A spokeswoman for NICE said he had been chosen to chair the group as an “excellent chair with the skills to lead an independent committee through the complex areas of research related to staffing”.
Speaking during an NHS England webinar to discuss nurse staffing levels, Mr Scott said major challenges to delivering safe staffing levels included patients with special needs, varying dependency and poor operational processes.
“You can have a fantastic ward manager, you can have brilliant staffing levels but if the operational processes – [such as] the way in which meals are bought into the wards, the timing of ward rounds - are poor staff and leadership have to compensate for that,” he said.
He said the group would also have to consider the “challenge of productivity” when making recommendations but feared most hospitals had already realised most of the potential from e-rostering.
Mr Scott added: “Will staffing become a no go area? Our biggest costs are our workforce we need to understand both how we deliver our productivity requirements and also our quality and safety requirements.”
Guidance on staffing levels for acute adult inpatient setting is the first of 10 topics to be produced by NICE. Subsequent areas include accident and emergency, mental health inpatient and community settings and operating theatres.
A steering group is being set up to prioritise the topics that are looked at although recent NICE board papers suggest areas where an evidence base already exists will be first to get guidance. The advisory committee will co-opt members with particular areas of expertise when it is looking at other topic areas.