Safe staffing guidance still elusive - three years on from Mid Staffs

摘要

Evidence reviews into safe nurse staffing that reveal gaps in available information have led to calls for urgent progress to be made on the issue. The National Institute for Health and Care Excellence published four evidence reviews last month. It looked at safe nurse staffing in inpatient mental health services, adult services in the community and in accident and emergency. NICE also reviewed management and organisational approaches that support safe nurse and midwife staffing. These reports had been intended to inform subsequent guidelines on safe nurse staffing, but NICE was told last summer by NHS England to suspend the work it had been doing on safe staffing. Patient outcomes A theme that runs through the reviews is the lack of reliable evidence about how staffing levels affect patient outcomes and the need for further research (see box). The community nursing review stated 'it was not possible to draw firm conclusions about what approaches for assessing and determining nursing staffing and/or skill mix are effective'. The paucity of information for the reviews begs the question 'what happens now?'. It is three years since the care scandal at Mid Staffordshire NHS Foundation Trust made safe nurse staffing a politically as well as clinically sensitive issue.