Three-quarters of staff nurses in acute trusts say they do not spend enough time on direct patient care, according to research by HSJ and Nursing Times. And nine in 10 of those believe this has an adverse impact on patients.

The surveys of more than 2,100 nurses, therapists and managers were carried out as part of supplements to be published next week to mark the launch of the NHS Institute for Innovation and Improvement's 'Releasing Time to Care: Productive Ward' programme.

Seventy-three per cent of staff nurses and 76 per cent of therapists said they did not spend enough time caring directly for patients. A total of 89 per cent of nurses and 83 per cent of therapists said this was bad for patients.

Staffing levels were given as the top reason for factors working against efficient practice by nursing staff (81 per cent) and managers (65 per cent).

But eight out of 10 managers said discharge planning is the ward process with most room for improvement. And about half of the therapists surveyed said they were regularly told to discharge patients early without the support in place for care outside of hospital. But as many said they were often or always unable to discharge patients because of a lack of community rehabilitation beds.

The surveys also found managers had a more negative view of ward teams than frontline staff.

Of the staff nurses surveyed, 30 per cent said they thought they spent up to 40 per cent of their time on direct patient care. In contrast, about half of managers thought nurses spent that amount of time on patient care.

Royal College of Nursing head of policy Howard Catton said: 'This absolutely chimes with what nurses have been reporting to the RCN. Some of the key factors taking time away from patient care are number of admissions, bed occupancy rates and organising discharges because of reduced length of stay.'

'The Releasing Time to Care programme aims to help nurses deliver the care that they went into nursing for,' said NHS Institute head of service transformation Kate Jones. 'We have worked with ward-based staff to help them improve the core processes of care and have already reduced the time that these take.'

The Productive Ward programme, supported by HSJ and NT, is running over the next 12 months. It will launch at the RCN Congress on Monday with supplements published with next week's HSJ and NT. For more information go to