The document leaked to the Health Service Journal titled ‘Safe staffing for nursing in A&E departments: NICE safe staffing guideline’ – revealed that A&E Department are ‘significantly understaffed half of the time’. It is understood this documented was suppressed by the Department of Health (DoH).
The document, that has not been released is thought to have been suppressed by the government, and sets minimum safe staffing guidelines for A&E departments. It is thought that the Department of Health requested the document not to be published after instructing NICE to stop investigating safe staffing levels late last year. This follows a Freedom of Information act request revealed that Jeremy Hunt said “it could be confusing for staff and the public if NICE were to release one piece of work on safe staffing now without any context and in isolation of any final guidance on safe staffing levels“.
Part of the document, named ‘issues with current practice’, stated that the current system is ‘not adequate to meet current demands’, ‘Specifically, staffing levels may not meet demand approximately almost half of the time’.
The document also said data should be recorded on staff having to miss breaks, working extra hours and ‘red flag’ incidents such as patients who wait more than 30 minutes for pain relief.
HSJ’s patient safety correspondent Shaun Lintern argues that “NICE’s leaked accident and emergency recommendations mean providers must take action”
A spokeswoman from the National Institute for Clinical Excellence said: “NICE has not published guidance on safe staffing in accident and emergency departments and doesn’t intend to do so”.
UPDATE: The Royal College of Nurses has released the following statement: “These guidelines were put together by experts, looking at strong evidence and found a very clear relationship between the number of registered nurses and patient care”. “The evidence for the importance of having the right numbers of nurses, and the right ratio of nurses to healthcare assistants, would have led to new recommendations and guidance on the safe range of nurse staffing levels”. “These recommendations would have exposed shortages, and this would have had financial consequences. It is concerning that these consequences may have been a factor in the decision to scrap this important work”. “The evidence clearly shows the important of the registered nurse and their role in patient care. Any work on safe staffing that follows must be centered on this fact“.
UPDATE: The document has been released by the BSJ, you can download it and read it in full here: Safe nurse staffing A&E guideline FINAL.
Sources: Lintern, S. 2016. Health Service Journal Online. Available at here.
Labour calls for £500m emergency ‘winter bailout fund’ for NHS
Labour will call for the government to commit a £500m “winter bailout fund” for the NHS over the coming months.
Jonathan Ashworth, the Shadow Health Secretary, says the money is needed to increase capacity in struggling hospitals and pay for extra staff as the NHS faces the worst winter on record.
He also said it was Labour’s “ambition” to return NHS funding increases to the same level as during the 1997-2010 Labour governments.
Mr Ashworth claims that Jeremy Hunt, the Health Secretary, and Theresa May have failed to provide an adequate plan to how the NHS is preparing, for what is expected to be, the worst winter on record for the health and social care service.
Janet Davies, Chief Executive and General Secretary of the RCN, said:
“Any bailout money this winter should be used to bolster frontline staff and help ensure safe patient care. Having the right number of nurses is key to treating people effectively and safely.
“Yet too many hospitals are chronically short of nursing staff. As demand increases over the winter months, it’s patients who will pay the price unless something is done.
“Properly funding the NHS is a political choice – it should not reach the stage where a last-minute bailout is required to keep people safe.”
The Shadow Health Secretary will use a speech to the Labour party conference today to call for the extra funding.
£13 million funding to help hospital A&Es prepare for winter
The Department of Health has announced 19 hospitals in England will benefit from extra funding for emergency care over winter.
Following a plea for funding from NHS Providers, the association that represents healthcare trusts, the Department of Health (DoH) has announced it will provide additional funding to nineteen NHS hospitals in England.
The 19 hospitals across England will be given a cash injection of over £13 million for emergency care, in the latest wave of winter funding announced today by Health Minister Philip Dunne.
Around £13 million has been awarded to improve patient flow through A&E, ensuring departments are prepared for busy times during winter. The additional funding brings the total given to hospitals since April to over £90 million, part of the dedicated funding announced in the Spring Budget.
Minister of State for Health Philip Dunne said:
“Thanks to the hard work and dedication of staff, the NHS has put in place strong plans ahead of winter – ensuring patients continue to receive safe and efficient care as demand rises over the coming months.
This funding will give more hospitals the boost they need to streamline patient flow in A&E, freeing up A&Es to care for the sickest patients and helping make sure all patients get the right treatment in the right place as quickly as possible”.
The funding will be used to help hospitals finalise preparations ahead of winter, particularly to handle the large volumes of patients attending A&E. By investing in the necessary equipment or infrastructure, hospitals will be able to target improvements to patient flow and relieve pressure on A&E.
The funding supports NHS England’s wider plans to improve A&E performance in England by 2018. In particular, it will help hospitals hit the target of admitting, transferring or discharging 95% of patients within 4 hours.
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