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Safe nursing levels recommended Safe nursing levels recommended
(about 1 hour later)
Hospitals in England should be wary about having nurses care for more than eight patients each on wards during the day, draft NHS guidance suggests.Hospitals in England should be wary about having nurses care for more than eight patients each on wards during the day, draft NHS guidance suggests.
The National Institute for Health and Care Excellence (NICE) says there is more risk of harm if there is a lower ratio of nurses to patients.The National Institute for Health and Care Excellence (NICE) says there is more risk of harm if there is a lower ratio of nurses to patients.
But it stopped short of saying one to eight was an absolute minimum.But it stopped short of saying one to eight was an absolute minimum.
Instead NICE said flexibility was needed - but hospitals should be able to justify if that ratio was breached.Instead NICE said flexibility was needed - but hospitals should be able to justify if that ratio was breached.
It said this was because there could be cases where patients' illnesses and needs were less serious than normal, and, therefore, it would be wrong to set strict thresholds.It said this was because there could be cases where patients' illnesses and needs were less serious than normal, and, therefore, it would be wrong to set strict thresholds.
But the guidance recommends nurses raise the alarm - or a "red flag" - when care is being compromised, no matter what the ratio.But the guidance recommends nurses raise the alarm - or a "red flag" - when care is being compromised, no matter what the ratio.
That could include situations where there are not enough staff to help patients use the toilet, monitor their vital signs or administer medication.That could include situations where there are not enough staff to help patients use the toilet, monitor their vital signs or administer medication.
Safety checkSafety check
NICE deputy chief executive Prof Gillian Leng said: "There is no floor or ceiling number on the required number of nursing staff that can be applied across the whole of the NHS."NICE deputy chief executive Prof Gillian Leng said: "There is no floor or ceiling number on the required number of nursing staff that can be applied across the whole of the NHS."
She added decisions about the number of nursing staff should "allow flexibility on a day-to-day or shift-by-shift basis".She added decisions about the number of nursing staff should "allow flexibility on a day-to-day or shift-by-shift basis".
The guidance, which is now being consulted on before the final recommendations are made in the summer, applies to general acute wards.The guidance, which is now being consulted on before the final recommendations are made in the summer, applies to general acute wards.
Specialist areas such as maternity, paediatrics, and accident and emergency will get their own guidance at a later stage.Specialist areas such as maternity, paediatrics, and accident and emergency will get their own guidance at a later stage.
NICE was asked to look at the issue by ministers who promised to explore safe staffing levels following the public inquiry into the Stafford Hospital scandal.NICE was asked to look at the issue by ministers who promised to explore safe staffing levels following the public inquiry into the Stafford Hospital scandal.
Many hospitals have already started paying close attention to nurse numbers; for example, a number publicly display actual staffing levels on wards along with what they should be.Many hospitals have already started paying close attention to nurse numbers; for example, a number publicly display actual staffing levels on wards along with what they should be.
NHS England wants this to become routine across the health service, while later this year hospitals will have to submit their staffing levels each month so they can be displayed on the NHS Choices website.NHS England wants this to become routine across the health service, while later this year hospitals will have to submit their staffing levels each month so they can be displayed on the NHS Choices website.
'Sensible' guidance'Sensible' guidance
Royal College of Nursing general secretary Peter Carter said: "For any patient to receive substandard care is unacceptable.Royal College of Nursing general secretary Peter Carter said: "For any patient to receive substandard care is unacceptable.
"Nurses will be hoping that once the full set of guidelines is completed, the NHS will never again be so vulnerable to short-term financially-driven decisions about patient care.""Nurses will be hoping that once the full set of guidelines is completed, the NHS will never again be so vulnerable to short-term financially-driven decisions about patient care."
A spokesman for the Foundation Trust Network, which represents hospitals, said the guidance was "sensible" and supported what many trusts were already doing.A spokesman for the Foundation Trust Network, which represents hospitals, said the guidance was "sensible" and supported what many trusts were already doing.
"Local nursing and clinical teams are best placed to make the judgement on what is best for their patients," he added."Local nursing and clinical teams are best placed to make the judgement on what is best for their patients," he added.
The guidance also applies to Wales, although it will now be up to ministers there whether it will be applied.The guidance also applies to Wales, although it will now be up to ministers there whether it will be applied.
In Scotland, hospitals are already routinely monitoring and publishing staffing levels - although there are no recommended minimums.In Scotland, hospitals are already routinely monitoring and publishing staffing levels - although there are no recommended minimums.
Health Secretary Jeremy Hunt said: "NICE's work on staffing is a major step forward - for the first time in its history, the NHS will have the evidence it needs to make sure that nurses are able to spend enough time with their patients."Health Secretary Jeremy Hunt said: "NICE's work on staffing is a major step forward - for the first time in its history, the NHS will have the evidence it needs to make sure that nurses are able to spend enough time with their patients."
What is your reaction to these guidelines? Do you work in the NHS? Send an email to haveyoursay@bbc.co.uk with 'nursing' in the subject line.