Parliamentary sketch – When management babble is not enough

Posted on: 16th January 2014

There just aren’t enough registered nurses on hospital wards.  That’s what I’ve telling Health Ministers for years and I will repeat again in the Commons this week.

While much of the health debate is becomes obsessed with changing and tweaking management tools for Commissioners, incentivising health systems with “payment by results” and more sophisticated “tariffs”, creating new “pathways of care” and spending (and mostly wasting) £billions on fancy IT systems, frontline nurses are run ragged.

Many people have noticed this in recent years when visiting hospital wards.  Some have put this down to a maliciously uncaring attitude (clearly individual cases of callous or unprofessional behaviour should be dealt with), but in many settings we’ve found that there simply aren’t enough registered nurses serving on hospital wards.

Also many confuse registered nurses with committed and hard working (but clinically untrained) healthcare assistants; and that doesn’t help when explaining the nature of the problem.

My Health Select Committee has recommended that hospitals should display at ward level the numbers of registered nurses that are needed to ensure patient safety and also the numbers on duty at any time.

Using material provided to me by the Safe Staffing Alliance (whose members include the Florence Nightingale Foundation, the Patients Association, Nursing Standard and the Royal College of Nursing, amongst others) I have warned that there are at least 4,000 “excess deaths” in hospitals in the country as a result of there being inadequate numbers of registered nurses at ward level.  The Safe Staffing Alliance has recommended that the Government should introduce a “fundamental standard” where a limit of eight patients to each registered nurse – excluding the nurse in charge – should never be breached.

If this were introduced it would give nurses the justification to “blow the whistle” when that level is both reached and breached.  The most recent official estimates suggest that as many as 43% of hospital wards have registered nurse to patient ratios worse than the recommended “fundamental standard”.

Whenever I have raised this issue before senior officials and Ministers have retreated behind management babble, claiming that it is more a question of “culture” or “leadership” than basic numbers of registered nurses.

Well, I say enough of the babble and the management gizmos.  Just getting the numbers right will improve patient care.

14th January 2014

You can contact Andrew George by email:  His constituency office can be contacted at Trewella, 18 Mennaye Road, Penzance, Cornwall, TR18 4NG.  Telephone: 01736 360020.