Leaked NICE document shows safe nurse staffing ratios in A&E

A leaked document shows that the National Institute for Health and Care Excellence (NICE) had intended to recommend minimum nurse ratios for hospital emergency wards.

In June, NICE published guidance on safe staffing for adult acute wards and maternity units, but NHS England asked it to suspend its programme before its guidance on emergency care was ready.

NHS England has created a new body, NHS Improvement, which has taken over the safe staffing project with input from the chief nursing officer Jane Cummings. They are expected to emphasise a multidisciplinary approach to the project rather than set safe staffing levels specifically for nurses.

However, an unpublished NICE guideline on safe nurse staffing in emergency departments has been leaked to the Health Service Journal.

The guideline calls for all major departments to ensure there is at least one registered nurse for each triage cubicle and each priority ambulance patient, and for every four major cubicles and two resuscitation cubicles.

It also recommends two registered nurses for each major trauma patient and for each cardiac arrest patient, as well as one trained children’s nurse or a nurse trained in caring for children on every A&E shift.

Labour’s shadow health minister Justin Madders said: ‘The government’s decision to block these guidelines from being published is deeply concerning and raises a lot of questions about the ability of experts to give independent advice to the NHS.

‘Ministers need to urgently set out how they intend to tackle the workforce crisis in the NHS and ensure hospital wards are not left dangerously understaffed.’

An NHS Improvement spokesperson said: ‘We have been asked by the National Quality Board to update the official safe staffing guidance, which includes emergency care, and we plan to publish our work later this year.’

NICE said: ‘NICE has not published guidance on safe staffing in accident and emergency departments, and does not intend to do so.’