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'Shocking' decision to shelve safe staffing work has had ongoing policy implications, claims nurse academic

The decision in 2015 to stop a national evidence review on safe staffing was ‘shocking’ and has had ongoing policy implications, a senior nurse researcher has said.

The decision in 2015 to shelve a national evidence review on safe staffing was shocking and has had ongoing policy implications, a senior nurse researcher has said

University of Southampton faculty of health sciences principal research fellow Jane Ball said she had possibly been 'naive' to believe research informed policy.

Speaking at the RCN International Research Conference in Oxford on Thursday, Ms Ball claimed it was the first time the National Institute for Health and Care Excellence (NICE) had been asked to discontinue a piece of work.

Media coverage

Ms Ball said: This completely shocked me and [that decision] didnt get covered at all in the general media. We started after the Francis Inquiry with a message that the patient is first and foremost, as well as being about safety at all costs.

The decision in 2015 to shelve a national evidence review on safe staffing was ‘shocking’ and has had ongoing policy implications, a senior nurse researcher has said


Principal research fellow Jane Ball. Picture: Nathan Clarke

University of Southampton faculty of health sciences principal research fellow Jane Ball said she had possibly been 'naive' to believe research informed policy.

Speaking at the RCN International Research Conference in Oxford on Thursday, Ms Ball claimed it was the first time the National Institute for Health and Care Excellence (NICE) had been asked to discontinue a piece of work.

Media coverage

Ms Ball said: ‘This completely shocked me and [that decision] didn’t get covered at all in the general media. We started after the Francis Inquiry with a message that the patient is first and foremost, as well as being about safety at all costs.

‘We seem to have arrived at a place where the underlying driver for policy is where finance ultimately trumps quality.’

Ms Ball added it was ‘a shocking sign’ of what happened between policy and research when academics came up with the ‘wrong answer’ to an issue.

‘[The halt to NICE’s work on safe staffing] was shocking and heralded a series of unfortunate, other negative policy shifts. Things that seem to undermine rather than support nurse safe staffing in the NHS.’

Shift examples

Ms Ball gave some examples of what she perceived as being the policy shifts, which followed, including:

  • Trusts told to cap the amount spent on temporary staffing (2015).
  • The announcement of the nursing associate role introduced to ‘bridge the gap’ between healthcare assistants and registered nurses (2015).
  • A report by the independent Migration Advisory Committee Migration which said the nurse shortage is the NHS’ own making.
  • Care hours per patient day (CHPPD) introduced (2016).
  • NHS Improvement guidance on ‘Safe sustainable staffing’ (2016).
  • The proposed ban – which was then 'paused until further notice' – preventing nurses working for an agency if they have a substantive contract (2017).

Ms Ball said the sometimes counter influence of politics and economics on research could have the potential to discourage further work.

However, she said academics had the potential to improve care whether policy makers referred to them or not.

She said: ‘We might not always see research have an impact with a capital ‘P’ [for policy] but that doesn’t make it less valuable – a compass still points to north, whether looked at by a walker or shoved in their pocket.

‘We have to commit to sharing that and to speaking truth to power.

‘Perhaps we have to share our evidence with everybody so they can ask the right questions of those who make decisions. We need to put research into the hands of patients, nurses, taxi drivers, our next door neighbours, so people have sufficient evidence about what good care looks like.’


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