The law gives those setting staffing levels a wide margin of appreciation to deploy according to skill and experience, rather, than simply being tied to professional qualifications, explains Paul Ridout
As reported by HSJ on 29 January 2019, the Care Quality Commission has warned providers not to consider the new Nursing and Midwifery Council grade “nursing associates” as permitting reductions in registered nurse numbers.
Perhaps this is intended to alarm providers when setting rotas against taking full advantage of extra trained staffing available through these long-overdue reforms.
There are not and will not be sufficient registered nurses. What are the duties exclusively reserved to registered nurses?
If the CQC wish to challenge, they will need to lead evidence on lack of competence rather than simple numbers
Some may see this as a hollow shriek to try to preserve status quo in staffing rota management.
In fact, when analysed; it is nothing more than a reminder that staff must be selected and deployed so as to be sufficient in numbers and skills to meet the demands which they will face on the floor.
The law assists in three simple ways by reference to the Fundamental Standards [The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014].
Reg 18(1) – “sufficient numbers of suitably qualified, competent, skilled and experienced persons must be deployed in order to meet the requirements of this Part….
Reg 19(1)(b) – “Persons employed for the purposes of carrying on a regulated activity must –
(b) have the qualifications, competence, skills and experience which are necessary for the work to be performed by them.
Reg 2 – Interpretation
“Nursing Care” means any service provided by a nurse and involving –
The provision of care, or
The planning, supervision or delegation of the provision of care.
Other than any services which, having regard to their nature and the circumstances in which they are provided, do not need to be provided by a nurse”.
The combined effect of these provisions is to give those setting staffing levels a wide margin of appreciation to deploy according to skill and experience, rather, than simply being tied to professional qualifications.
Of course, this does not mean that no nurses need to be deployed but it does enable available resources to be used to avoid shortages in qualified nurses and to make appropriate cost saving.
If the CQC wish to challenge, they will need to lead evidence on lack of competence rather than simple numbers.