Senior national and regional nursing leaders were taken by surprise by Simon Stevens’ announcement that the National Institute for Health and Care Excellence’s work on safe staffing guidance was to be stopped, it has emerged.

·        Senior nurses in national bodies unaware of decision to suspend staffing work before announcement

·        Safe Staffing Alliance chair describes decision as “bolt out of the blue”

·        RCN calls for review of decision

·        Cure the NHS campaign group to march

Those unaware of the move included Ruth May, NHS England chief nurse for the Midlands and East region and national lead for the safe staffing work. She has been appointed as Monitor’s chief nurse. It also includes other members of the NICE steering committee, from across the Department of Health, Monitor and NHS England, several senior sources told HSJ.

HSJ understands these figures only learned of the decision after the speech at the NHS Confederation by Mr Stevens, NHS England chief executive, on Thursday, which referred to his move to stop NICE’s work. He said staffing guidance would now be considered by his organisation.

Speaking at a safe staffing conference in London this morning, Dr May said “a lot of really good work” had been done with NICE and that its evidence based approached to the issue was a strength.

She told delegates: “We had a very close relationship [with NICE] and I am very grateful for the work we have done with them.”

Dr May said that “one of the attractions of working with NICE” was the “support” it offered NHS England because it was “using a great, evidence based” approach.

Ruth May

Ruth May said the NICE guidelines already published were ‘not perfect’

She said it was possible the nurses and experts involved in NICE’s work on the guidance could be brought in to NHS England’s work on it, but that she had not seen any NHS England plans for this.

Although she did not comment on who knew about the decision in advance, Dr May said the two guidelines so far published by NICE – on acute inpatient and maternity services - were “not perfect” and improvements “could always be made”. She said it was “too early” to judge what NHS England would do to replace NICE’s programme.

Chief nursing officer Jane Cummings told HSJ’s sister title Nursing Times last week that NHS England would look at “value for money” and re-emphasised her long held view that imposing rigid nurse to patient ratios were not the answer to safe staffing. She accepted her office did not, as yet, have any plans to increase resources to manage this work, and that it was yet to work out the detail of how to implement the plans.

NICE was commissioned by the Department of Health and NHS England to draw up staffing guidelines for nine areas of healthcare following recommendations by Sir Robert Francis in his report into poor care at Mid Staffordshire Foundation Trust.

The Safe Staffing Alliance of nurse leaders and the Royal College of Nursing have called for Mr Stevens’ decision to be reviewed.

Safe Staffing Alliance chair Susan Osborne told the conference this morning that the decision had been a “bolt out of the blue”.

The former director of nursing told HSJ: “I am concerned that senior nurses like Ruth May and those working at NHS England and with NICE didn’t know that this was going to happen.

“We want NICE to be re-instated. It is the independent body with the right mechanisms to consider these issues. This could be an opportunity to improve the work they were doing.”

Royal College of Nursing policy director Howard Catton said: “Given that this work from NICE is being stopped, I am surprised there wasn’t broader consultation before the decision was taken.”

He said the RCN was calling for a review of Mr Stevens’ decision, and for that review to include the Care Quality Commission, Monitor, trade unions and others.

Mr Catton told delegates: “This journey [on safe staffing] needs to continue… There are risks from stopping NICE. If we take those risks and we suffer the consequences of compromising patient care we should not blame the nursing profession.”

NHS England has been approached for comment.

It was also announced today that the patients and families who campaigned for a public inquiry into the scandal of poor care at the Mid Staffordshire Foundation Trust plan to hold a “safe staffing march” in Whitehall in protest at the decision to suspend work on nurse staffing guidelines by the National Institute for Health and Care Excellence. Members of Cure the NHS will march from Downing Street to Richmond House on 18 June at 2pm. The group has also appealed for nurses who support the safe staffing programme by NICE, which was recommended by the Francis Inquiry, to join them.

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