Mandatory safe staffing levels urgently needed, says RCN

Published: 22 April 2013

The number of staff on hospital wards and in the community is falling to unsafe levels regularly, in some cases on a daily basis, according to new evidence from the Royal College of Nursing.

Almost 90 per cent of nursing staff surveyed by the RCN said staffing levels were not always adequate to provide safe patient care, with almost a third saying they were rarely or never safe. More than 8,000 RCN members responded to the survey.

“Understaffing is the single biggest challenge facing the NHS today,” said RCN Chief Executive & General Secretary Dr Peter Carter. “The introduction of mandatory safe staffing levels, enshrined in law, is now a matter of extreme urgency.”

Ensuring safe staffing levels across the health service was a key recommendation of the Francis report into failures at Mid Staffordshire NHS Foundation Trust. The vast majority of nursing staff (91 per cent) questioned in the RCN survey said they support the introduction of mandatory safe staffing levels but most (71 per cent) fear the Government will not to deliver on the inquiry’s recommendations. The RCN believes a failure to act could potentially be disastrous with two-thirds of respondents saying they felt problems of poor care could happen where they work.

In another survey of 2,086 ward sisters and community team leaders, three out of four said staffing levels dropped to unsafe levels at least once a month. More than a third reported staffing levels were unsafe on a weekly basis, while almost one in ten said staff numbers fell to an unsafe level on every single shift.  Despite these concerns, nearly half said they were unable to authorise additional staffing when necessary, and of those who were able to initially authorise extra staff, many reported that even then, their requests were ultimately turned down.

“Robert Francis rightly highlighted that ward sisters will be crucial in driving improvements in care, and this means the Government must listen to them,” Dr Peter Carter added. “The concerns of ward sisters are very clear: they do not have enough staff to always provide the high level of care they know all patients deserve.”

The RCN expressed disappointment last month about another missed opportunity when the Government chose not to act on the inquiry’s recommendation for mandatory regulation of health care assistants. The survey results reveal 88 per cent of the nursing workforce also support this recommendation.

Dr Peter Carter said: “What happened at Mid Staffordshire was a tragedy. We have always been emphatic that where individual members of staff, including nurses, are wilfully negligent they should face the consequences. However, we know that some of the most important recommendations from the Francis inquiry are being ignored, potentially leaving in place the systemic failures which allowed such a tragedy to happen in the first place.”