Mandatory staffing levels in hospitals 'could leave community short'

NICE leader claims minimum nurse-to-patient ratios are too inflexible

The adoption of minimum staffing ratios in hospitals could drain nurses away from the community, according to the National Institute for Health and Care Excellence.

NICE deputy chief executive Gillian Leng told Welsh Assembly members considering the implementation of mandatory nurse-patient ratios in the country that a loss of staff outside acute settings was a concern.

She said that NICE guidance on safe staffing in community settings was being given greater priority, at the request of England’s chief nursing officer Jane Cummings.

Professor Leng was giving evidence to the health and social care committee of the Welsh assembly on the draft Safe Nurse Staffing Levels (Wales) Bill. This could pave the way for Wales to become the first part of the UK to set legal ratios.

Labour assembly member Lynne Neagle asked if the bill could lead to resources being pulled from other areas that are not covered by guidance, such as community nursing.

Professor Leng said this was a ‘reasonable concern’. The date for community staffing guidance has yet to be confirmed, although the deputy chief executive said it could be published late in 2016.

Professor Leng warned against the introduction of mandatory nurse-patient ratios. She said issues such as patient acuity, changes in technology, skill mix and length of stay make it difficult to set such ratios.

‘The risk is the minimum becomes the target,’ she said. ‘We know that the nurse requirements vary with time. The type of staff we have in hospital is going to continue to change. The key risk of setting something in legislation is that it is fixed.’

The draft bill does not prescribe minimum staffing ratios, but says Welsh ministers would provide guidance to health boards.

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