The National Institute for Health and Care Excellence spent nearly £1m on its work to develop nurse safe staffing guidelines for the NHS, HSJ has learned.

  • NICE confirms it has spent £1m on safe staffing work since autumn 2013
  • NHS England says it is “too soon” to say what resources it will use on safe staffing programme
  • National commissioning body’s timetable to be set out in next few weeks

NICE was told to suspend its work by NHS England chief executive Simon Stevens last week.

A spokesman for NICE said yesterday it had carried out the work on safe staffing under a contract with NHS England and the Department of Health funded through its “grant aid” from the government.

He said the work’s costs included salaries and costs of committees and other overheads. “We’ve spent approximately £1m since autumn 2013,” he added. This included £130,000 in 2013-14, £743,000 in 2014-15 and £123,000 in 2015-16 through to May.

Nurses pushing hospital bed

The safe staffing work by NICE included salaries, costs of committees and other overheads

A spokeswoman for NHS England said it was “too soon” to say what resources it would have in place to take the programme forward.

She told HSJ a timetable setting out the work programme NHS England would undertake on safe staffing would be outlined in “the next few weeks”.

There has been widespread concern over the decision to suspend work by NICE, which was a key recommendation of Sir Robert Francis following his public inquiry into poor care at Mid Staffordshire Foundation Trust.

An interim report on NHS efficiency by Lord Carter, published yesterday, also said NICE should be used to improve guidance on appropriate staffing levels and skill mix.

In a letter to nursing directors yesterday, chief nursing officer Jane Cummings said NHS England would continue to use NICE “where appropriate”.

Asked what that meant in practice, an NHS England spokeswoman said there was a lack of evidence for non-acute healthcare settings. This meant there was a “need to find a new approach to testing what is right, which includes looking at what evidence exists, commissioning new research and national and international best practice”.

She added: “We will continue to use NICE for commissioning evidence reviews in discussion with them and other advisers. We’ll give more information on this when it is available.”

Asked about how much investment NHS England would make in the safe staffing work, she said: “It is too soon to say, but some of the work will be incorporated into programmes of work already being undertaken by the mental health taskforce, the urgent and emergency care vanguards and national quality board.”

A source close to the NICE safe staffing programme told HSJ there was a lack of evidence in some areas but “NICE’s job and commission was to base guidance on best available evidence and, where it is lacking, to use expert judgement”. They said: “I am far from convinced NHS England has real capability to find and properly assess evidence, especially given that it is limited.”

In relation to the focus on other staff roles alongside nurses, the source added: “They could certainly have given a brief to look at safe staffing including not just nursing.

“Even in a multidisciplinary world the question of safe nurse staffing remains and the NICE guidance and brief did consider inputs from other staff groups as a factor.”

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