Minimum nurse staffing levels 'not the answer', says minister

Addressing a conference on the Report of the Mid Staffordshire Foundation Trust Public Inquiry, Dr Poulter also said the Government’s response, due at the end next month, would not address in detail each of the inquiry’s 290 recommendations.

Asked about Robert Francis QC’s proposal that the National Institute for Health and Clinical Excellence develop nationally recognised minimum nurse staffing levels for a range of healthcare settings, Dr Poulter said he had “not seen the evidence that supports that”.

“Sometimes when you put in mandatory standards you can have a drive to the bottom,” he told the conference, organised by think tank the King’s Fund. “I don’t think staffing ratios [are] the answer.”

HSJ understands the government favours the approach set out by the Chief Nursing Officer’s strategy Compassion in Practice last year. This calls for existing tools for calculating appropriate staffing levels to be refined to support local determination by nursing directors.

On the government’s response, he said: “Our response will focus on common themes rather than be line by line on every one of the recommendations. It will reflect the impact of culture, a greater focus on quality, greater clinical input into policy making and a greater attention to the needs of patients.

“The role of the trust board should not and cannot be underestimated. Board members need to provide good leadership and model compassionate care so it can be felt throughout the organisation.”

Dr Poulter also appeared to suggest that the report was a vindication of the government’s reform of the NHS.

“It’s clear from this report that patient care and safety has suffered… It’s also clear that the system needed to be restructured to put patient safety at the heart [of the NHS],” he said.

During a question and answer session the junior minister was asked by Oxford University Hospitals Trust chief executive Sir Jonathan Michael how trusts should handle the sometimes competing pressures to provide quality care, meet performance targets and balance the books.

Dr Poulter, who has continued to work as a doctor since being elected as an MP in 2010, said improved integration with better partnerships between primary and secondary care could help reduce some of these pressures but insisted there was never an excuse for the failures of care described in the Francis report.

“There should be no one trying to make excuses for that,” he said.