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Blog: RCN's Peter Carter on staffing

Exclusive The chief executive of the Royal College of Nursing says Berwick's review into patient safety should be acted on now

This week, the publication of Professor Don Berwick's review into patient safety has shown yet another leading expert calling for the NHS to ensure there are the right numbers of nursing staff to care for patients.

Of the numerous factors that lead to poor care, few are as important as unsafe staffing levels. This has been recognised by Francis, Keogh and Berwick, all of whom have called for trusts to guarantee appropriate and adequate staffing levels, using evidence-based tools.

Berwick recommends that nurse staffing levels and skills mix should be consistent with the scientific evidence on safe staffing, adjusted to local context. We know that the only way to achieve patient safety and high quality care is through mandatory safe staffing levels, complemented by flexible tools that allow workforce leaders to respond to local demands.

Through our Frontline First campaign, we are monitoring cuts to nursing posts not just in acute settings, but in the community as well, using evidence from our members on the ground. We know that the number of district nurses has fallen by 40% between 2002 and 2012. Furthermore, just five district nurses were trained in London in 2012.

For those nurses who remain, the situation is becoming increasingly difficult. A 2012 RCN survey revealed that 59% of community nurses spend less time with their patients than they did a year ago, while just 6% said they always had time to meet the needs of their patients. Just last week a British Medical Journal study showed that most ward nurses are forced to ration care because they simply don't have enough time. 

Put simply, the fewer nurses on the ward and in the community, the more patients will have their lives put at risk. Mandatory safe staffing levels are now a matter of extreme urgency.

The recent plethora of expert, evidence-based reports on patient safety present us with a once in a generation opportunity to deliver safe staffing. The government must act now on this crucial issue that for too long has put patient lives at risk.