SATURDAY 10 MAY 2014 An NHS watchdog recommends a ratio of no more than eight patients for eer! hospita" n#rse$ %#t the target wi"" not &e mandator!$ The National Institute for Health and Care Excellence (Nice) has drafted new guidelines on staffing levels for adult inpatient wards in acute hospitals in England after the Francis Inquiry into failings at id !taffordshire NH! Trust" The watchdog said there is #ore ris$ of har# with a lower ratio of nurses to patients% &ut stopped short of saying one to eight was an a&solute #ini#u#% saying hospitals need flexi&ility over day'to'day staffing" ( Nice spo$es#an said) *The draft guideline recognises that if each registered nurse is caring for #ore than eight patients during the dayti#e on a regular &asis% there is an increased ris$ of har#" *It stresses the i#portance of chec$ing if patient needs are adequately &eing #et in these situations" *The lead nurse should consider any +red flag events+ as indicators of the ward &eco#ing in danger of &eing under'staffed and therefore tailor the nu#&er of availa&le nursing staff as needed"* ,ed flag situations include patients not &eing provided with help to go to the &athroo#% not &eing as$ed a&out their pain levels or delays in providing #edicines" -rofessor .illian /eng% deputy chief executive and director of health and social care at Nice% said) *There is no floor or ceiling nu#&er on the required nu#&er of nursing staff that can &e applied across the whole of the NH!" *0hat the safe staffing advisory co##ittee concluded was that assessing patient needs was para#ount when #a$ing decisions a&out the nu#&er of nursing staff and planning should allow for flexi&ility on a day'to'day or shift'&y'shift &asis" *This guideline is an i#portant step forward in addressing the issues of having adequate nu#&ers of nursing staff within the NH!"* -eter 0alsh% chief executive of patient safety charity (ction against edical (ccidents% said) *ore than eight patients per nurse on acute wards is definitely unsafe ' so why shouldn+t it &e #andatory not to exceed that ratio1 *The Care 2uality Co##ission should now use this guidance and include clear require#ents on staffing in its standards and enforce the#"* 3r -eter Carter% chief executive of the ,oyal College of Nursing (,CN)% said) *0e are encouraged that these guidelines have &een created ' following considera&le and consistent evidence fro# the ,CN of the danger to patients where there are too few staff" *They underline what we already $now ' that a registered nurse caring for #ore than eight patients under these circu#stances is a cause for concern ' in #any cases% considera&ly #ore nurses will &e needed" *Hospitals si#ply can+t deliver what today+s patients need if they are staffed for care fro# another century" Too often% staffing levels are allowed to yo'yo &ecause of finances% and this puts staff under strain and patients at ris$" *For any patient to receive su&standard care is unaccepta&le" Nurses will &e hoping that once the full set of guidelines is co#pleted% the NH! will never again &e so vulnera&le to short ter# financially driven decisions a&out patient care"* ( 3epart#ent of Health spo$eswo#an said) *There are over 4%566 #ore nurses on our wards since 7656 and in response to the Francis Inquiry we have &een tough on insisting on co#passionate care in our hospitals" *0e have increased the NH! &udget in real ter#s and are clear that hospitals #ust &alance their &oo$s whilst ensuring co#passionate% quality care for all" 0e $now this can and is &eing done ' safe staffing levels lead to &etter care and can save the NH! #oney"*