Hot numbers - nurse staffing ratios

What is it with mandatory nurse staffing ratios that makes them too hot to touch?

By now, everyone knows the evidence - high nurse staffing levels in hospitals result in lower mortality and fewer unsafe incidents, and a better quality of care. In a recent Nursing Standard survey, 90% of 1,700 nurses said they support the introduction of mandatory staffing levels. Yet, according to the latest NHS workforce figures, nurse numbers continue to fall.

In the US and Australia, where evidence-based nurse-patient ratios have been legislated in some states but not others, nurse workload, patient mortality and failure to rescue events are all lower in states with ratio legislation. There is resistance to mandated staffing ratios on the grounds of lack of flexibility and that services may be curtailed if ratios fall below the threshold, but these look suspiciously like excuses when put up against the overwhelming benefits of mandated ratios.

Meanwhile, Robert Francis said in his report on Mid Staffs that the National Institute for Health and Care Excellence should take on the task of developing the evidence for safe staffing levels. But so far, ministers have failed to act. Still too hot to handle?

About the author

Frances Pickersgill is Nursing Standard’s development editor