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Guidance on safe medical staffing issued

Royal College of Physicians guidance includes recommendations on advanced nurse practitioners
ANP_in_A&E

Royal College of Physicians guidance makes recommendations on advanced nurse practitioners

Guidance on safe medical staffing, which includes recommended numbers for advanced nurse practitioners in various settings, has been published.

The staffing levels guidance, devised by the Royal College of Physicians (RCP), draws on advice from the National Institute for Health and Care Excellence, Academy of Royal Medical Colleges, NHS Improvement (NHSI) and others.

It aims to help organisations map their current staffing against the recommendations and to then ensure safe care is being provided.

Staff tiers

The guidance divides staff into three tiers according to their level of expertise and specialty.

Advanced nurse practitioners (ANPs) are included in tier 1, as competent clinical decision-makers who can make initial patient assessments.

The guidance covers a range of wards and states how many hours of work

Royal College of Physicians guidance makes recommendations on advanced nurse practitioners

ANP_in_A&E
Picture: Tim George

Guidance on safe medical staffing, which includes recommended numbers for advanced nurse practitioners in various settings, has been published.

The staffing levels guidance, devised by the Royal College of Physicians (RCP), draws on advice from the National Institute for Health and Care Excellence, Academy of Royal Medical Colleges, NHS Improvement (NHSI) and others.

It aims to help organisations map their current staffing against the recommendations and to then ensure safe care is being provided.

Staff tiers

The guidance divides staff into three tiers according to their level of expertise and specialty.

Advanced nurse practitioners (ANPs) are included in tier 1, as competent clinical decision-makers who can make initial patient assessments.

The guidance covers a range of wards and states how many hours of work is required as a minimum for each tier of clinician. For example, between for weekdays on a 30-bed medical ward, an equivalent of 2.2 tier 1 clinicians working at least a combined 71 hours a week would be needed, the guidance states.

‘Despite demands for action, five years after the Francis report, we are no closer to staffing for safe and effective care in England’

Janet Davies, RCN

At least one tier 2 clinician would also be required and a tier 3 clinician would be needed for 24.5 hours per week.

Safe patient care

The guidance states: ‘The Francis Report into incidents at the Mid Staffordshire NHS Foundation Trust highlighted the importance of adequate numbers of staff in assuring safe patient care.

‘There is evidence that higher levels of medical staffing are associated with reduced mortality for medical patients.

‘There were, however, no benchmarks against which to judge safe medical staffing levels, particularly with regard to out-of-hours work.’

RCN general secretary Janet Davies said: ‘This report puts patient safety firmly on the new health secretary’s radar.

‘Despite demands for action, five years after the Francis Report, we are no closer to staffing for safe and effective care in England.

Nurses’ contribution

‘ANPs are included in the RCP’s guidance for calculating safe medical staffing levels in acute settings, recognising the contribution made by nurses of all levels.

‘The document recognises the importance of continuing professional development in enabling ANPs to deliver effective multi-professional working for the best outcomes for patients.’

Wales is the first UK country to enact a safe staffing law. It requires acute hospitals to display figures for how many staff should be – and how many are – on duty on public boards in all adult medical and surgical wards.

A safe staffing bill is before the Scottish parliament, but it does not mandate minimum nurse-to-patient ratios. England and Northern Ireland have no formal frameworks or legislation on safe staffing.


Related material

RCP report


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