Concerns NHS England safe staffing guide for mental health 'lacks rigour'

NHS England published the Mental Health Safe Staffing Framework this week. The guidance avoids setting specific staffing levels for inpatient wards, arguing: “To do so may result in less consideration for local needs, and underestimating the number of staff required to ensure care delivery maintains therapeutic benefit.”

The framework recommends the use of two workforce tools and a checklist for lead clinicians to present to their board. It also provides advice on how mental health services can review their workforce planning.

However, a number of leading experts on nursing workforce have expressed their doubts about the framework to HSJ.

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John Baker, professor of mental health nursing at the University of Leeds said he was “disappointed” with the guidance. He said: “Of most concern is that there appeared to be an absence of service user views and representation in the development of the framework, and the link between safe staffing and improved outcomes. It clearly lacks the rigour and independence of external organisations such as [the National Institute for Health and Care Excellence].”

Peter Griffiths, from the University of Southampton, said the two tools highlighted in the framework were described as evidence based but there was no review of the strength of evidence behind them.

He said: “The danger is in seeing the use of the tools as sufficient assurance in themselves. The work done in developing the tools is great but there needs to be a strong push for rigorous independent evaluation rather than simple acceptance that they are ‘evidence based’.”

The concerns follow recent criticism of NHS England after it asked NICE to stop work on developing nurse safe staffing guidelines for the NHS last month.

NHS England has taken over the programme, although the new mental health framework was commissioned before this happened.

The national body said the framework would feed into its mental health taskforce which will report later this year.

Chief nursing officer Jane Cummings said: “Developed by nurses for mental health leaders, the framework aims to ensure that mental health inpatient wards have the right staffing level for their specific needs.

“This is just one component of a significant ongoing programme of work that NHS England and its partners are undertaking to ensure the NHS is safely staffed with the right people, with the right skills.”