Editorial

Calm heads are needed in safe staffing debate

Of the 290 recommendations in the Francis report, published 26 months ago, one has become the focus of fevered debate over the past couple of weeks. The eminent QC, who spent an entire year running his rule over the NHS, suggested that the National Institute for Health and Care Excellence should determine the minimum number of staff and the appropriate skill mix across a range of settings and specialties in England.

Of the 290 recommendations in the Francis report, published 26 months ago, one has become the focus of fevered debate over the past couple of weeks. The eminent QC, who spent an entire year running his rule over the NHS, suggested that the National Institute for Health and Care Excellence should determine the minimum number of staff and the appropriate skill mix across a range of settings and specialties in England.

The government responded by accepting Sir Robert’s advice, and set NICE to work. Guidance on adult inpatient settings and some maternity services has already been issued, and work was well advanced for emergency services, mental health and a host of other areas. Then, without notice, that work was halted and responsibility for taking it forward passed to the chief nursing officer, Jane Cummings.

In the end all that matters is there being enough staff to deliver high-quality care

The fallout over the past week or so has been extraordinary. Such was the outcry that Ms Cummings felt moved to call for calm at one point, as senior nurses took to Twitter and the letters pages of Nursing Standard and the Times to vent their feelings. There were the makings of a full-scale professional row.

Ms Cummings’ intervention appears to have worked, for now at least. The noise has abated and a calmer debate will now ensue, which has to be healthier than a dispute played out in public.

Nonetheless, the Safe Staffing Alliance remains concerned and is justified in continuing its successful campaign. As the alliance’s chair Susan Osborne writes in this issue, NICE had the benefit of unrivalled expertise coupled with independence from government, so should have been allowed to continue in its work.

Whoever leads this work and whatever guidance ensues, in the end all that will matter to nurses, patients and the public is whether our hospital wards, care homes and communities have enough staff with the right qualities to deliver high-quality services. For Ms Cummings to succeed, she needs – and deserves – everyone’s support.

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