The below Parliamentary question was asked by Lord Willis of Knaresborough on 2016-01-19.
To ask Her Majesty’s Government what research has been commissioned or published showing the correlation between nursing numbers and (1) patient outcomes, and (2) patient mortality, in England.
Lord Prior of Brampton
The Government is committed to supporting National Health Service trusts to put in place sustained safe staffing by using their resources as effectively as possible for patients.
Hospitals should be able to demonstrate that they are able to ensure safe, quality care for patients and that they are making the best use of resources. This should take account of patient acuity and dependency, time of day and local factors. It is therefore important for providers to take a rounded view, looking at staffing in a flexible way which is focused on the quality of care, patient safety and efficiency rather than just numbers and ratios of staff.
The responsibility for both safe staffing and efficiency rests, as it has always done, with provider Boards.
Comprehensive lists of research commissioned and published, of criteria in all European Union countries, Australia and the United States, each of which have a variety of systems in operation, and of discussions held by United Kingdom officials to compare patient outcomes in those countries with outcomes in England, could only be obtained at disproportionate cost.
However, the 2013 National Quality Board (NQB) guidance on safe staffing issued in 2013 How to ensure the right people, with the right skills, are in the right place at the right time: A guide to nursing, midwifery and care staffing capacity and capability, referred to a number of sources of evidence on this issue. The National Institute of Health and Care Excellence (NICE) safe staffing guideline Safe staffing for nursing in adult inpatient wards in acute hospitals, July 2014 set out the evidence and expert papers, including international evidence, that was considered in preparing the guideline. A copy of the NQB guidance and the NICE guideline are attached.
In addition, The Department’s National Institute for Health Research (NIHR) commissions research evidence to improve the quality, accessibility and organisation of health services through the NIHR Health Services and Delivery Research programme. Current research of particular relevance to the relationship between nurse staffing levels and patient outcomes and mortality includes:
– a study on nurse staffing levels, missed vital signs observations and mortality in hospital wards; and
– a study on the future of 24/7 care: investigating the links between staffing levels, patient access and inequalities in health outcomes.
As announced by the Secretary of State on 16 July 2015, Dr Mike Durkin, National Director for Patient Safety, is working with the Chief Nursing Officer to complete the work started by NICE on safe staffing levels. Their work will draw on evidence and expert advice from England and internationally, and will be reviewed independently by NICE, the Chief Inspector of hospitals, and Sir Robert Francis to ensure it meets the high standards of care the NHS aspires to.
The programme includes revision of the NQB 2013 guidance to take account of further developments in the evidence base, the need to look beyond acute settings, new models of care leading from the Five Year Forward View and the need for providers to secure both safe staffing and greater efficiency.