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DoH Suppressed NICE Document on Safe Staffing



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 It is thought that the Department of Health requested the document not to be published after instructing NICE to stop investigating safe staffing levels late last year.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.


Nursing vacancies hit record high leaving patient care at risk

It can be “dangerous” when there aren’t enough nurses to provide care.



Patient Falls Risk with IV

There are now a record 43,671 empty nursing posts in the NHS in England alone.

NHS figures show that there are now a record 43,671 empty nursing posts in the NHS in England alone, according to the Royal College of Nursing (RCN).

The College says a global shortage of nurses alongside the removal of the nursing bursary has compounded this figure which now sees 12% of posts through the NHS in England without a full-time Registered Nurse.


Figures from the University and College Admissions Service (UCAS) show a 29% overall decline in applications to undergraduate courses since 2015, when the bursary was cut by the Government.

In a report released today titled ‘Standing up for patient and public safety’, the Royal College of Nursing outlines the evidence of the need for a new law that allocates specific legal responsibilities for workforce planning and supply.

A new law is needed.

The report states that in order to address the record number of vacancies, and the gap between the numbers of health and care staff needed to deliver patient care vs. how many are in the system.

Figures included in the report reveal that the number of nursing staff has consistently failed to keep up with the dramatic rise in demand for services and the number of emergency admissions.

The report finally makes a further call for legal clarity on the roles, responsibilities, as well as accountabilities, for workforce planning and supply.

In September, after pressure from RCN members, NHS England and NHS Improvement asked the Government for clarity over who is accountable for the nursing workforce.

‘Nurses are working harder than ever’.

Dame Donna Kinnair, Chief Executive and General Secretary of the Royal College of Nursing said: “Nurses are working harder than ever to deliver safe patient care but are being held back by a system that is legally lacking teeth. Despite the public, patients and nurses all agreeing that clarity is needed on responsibilities for delivering enough nurses, we have yet to see any government pledge anything of the like, and as a result are staring down the barrel at a record 43k empty nursing posts.

“We know how dangerous it can be when there aren’t enough nurses to provide care, but at present, almost all accountability rests with the frontline nurse working on the understaffed ward, rather than those responsible for the system they work in.

“We believe the time has come for change and that patient care was future-proofed by law, and that from the government down, decision makers are held to account.

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NHS calls for clarity on who is accountable for the nursing workforce

Figures suggest there are around 40,000 unfilled nursing vacancies throughout the NHS in England.



Working nurses in the CCU

Healthcare leaders are calling for legislation to be included in the forthcoming Queen’s Speech.

NHS England and NHS Improvement have called on the Government to clarify who is accountable for the nursing workforce and the chronic problems it’s currently facing.

Following ongoing pressure from nursing unions, the two organisations met today and recommend that the government should “revisit with partners whether national responsibilities and duties in relation to workforce functions are sufficiently clear.”


With around 40,000 unfilled nursing vacancies in the NHS in England and thousands more throughout social care, the Royal College of Nursing (RCN) believes the Secretary of State for Health and Social Care should be legally accountable for the workforce.

Along with other health care leaders, Dame Donna Kinnair, Chief Executive & General Secretary of the RCN, written to the Government calling for the legislation proposed by NHS England and NHS Improvement to be included in the forthcoming Queen’s Speech.

Staff shortages have reached ‘alarming levels’.

Responding to the news, Dame Donna Kinnair said: “We are pleased that NHS England and NHS Improvement has recognised the concerns of RCN members and the public and has stated that the issue of accountability for workforce planning and supply remains an area that needs be resolved.”

“In the week after we have launched a major public facing campaign calling for investment in the nursing workforce as well as for accountability to be clarified in the law, yet again, the case is made for this to be taken seriously.

“We are clear that government is well placed to determine how accountability can be clarified in law.

Adding; “Staff shortages have reached alarming levels with at least 40,000 vacant registered nurse posts in the NHS in England alone with thousands more vacancies in public health and social care.

“We now hope government will listen to this message, as well as the voices of the thousands of members that responded to the NHS England engagement process, and bring forward this legislation, taking the opportunity to include accountability in government and throughout the health and care system, for workforce planning and supply.”

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