Shelved A&E safe staffing guidance would have showed some trusts are 'inadequately staffed'

Emergency department matron James Bird, who helped draft NICE safe staffing guidance for A&Es, has said the guidance would have led some trusts to realise they are understaffed

Guidance on safe staffing for A&Es, which has now been abandoned, would have shown some trusts are ‘inadequately staffed’, an emergency department matron has said.

James Bird, who works for Imperial College NHS Trust, was a member of the advisory committee working on developing guidance on safe staffing levels in A&E departments for the National Institute for Health and Care Excellence (NICE). NICE suspended its safer staffing guidance programme last week.

It followed the announcement by NHS England chief executive Simon Stevens that staffing should be looked at as part of his organisation’s reviews of urgent and emergency care, maternity and mental health services.

NICE published its draft A&E guidance in January and the final guidance was due to be published in May.

Speaking at a Healthcare Conferences UK event on safe staffing in London yesterday, Mr Bird said the guidance is ‘completely written’ and ready for publication.

He said: ‘It was not going to be a cheap guideline to meet.

‘There would be a number of trusts that would have realised that they were inadequately staffed. Abandoning the guidance does not mean they are not inadequately staffed.’

The draft guidance included recommendations for two registered nurses to one patient in major trauma or cardiac arrest cases.

It also said that because demand in A&E can change rapidly, when planning the number of nurses for the establishment, it is important to allow for enough nurses to care for a higher than average number of patients attending on a daily basis.

Mr Bird said the final version of the guidance was 'not dissimilar' to the draft.

When asked by Nursing Standard if he was disappointed by last week’s announcement, he said: ‘Of course. It is a year’s worth of work.’

A NICE spokesperson has said the guidance was 'largely complete although publication was being delayed while work was finalised on a costing report'.

The spokesperson added that the guidance was not published in May as scheduled to allow for this costing report and confirmed it will not now be published.

He said: 'We will make the work we have done available to NHS England if they would find it helpful to have it as part of the work they are now going to take forward.'

NICE confirmed last week that its work on securing safe staffing levels in A&E departments, mental health and community settings is now ‘likely to be taken forward as part of NHS England’s wider programme of work’.


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