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 […]

20 January 2016

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 It is thought that the Department of Health requested the document not to be published after instructing NICE to stop investigating safe staffing levels late last year.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