Staff shortages ‘raise risk of dying in hospital’

The Royal College of Physicians report criticised the effect of low staffing levels in NHS hospitals. Picture: Greg Macvean

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POLITICAL parties should make an urgent commitment to developing minimum NHS staffing levels to reduce death rates and improve patient care, an eminent medical body has said.

The Royal College of Physicians of Edinburgh (RCPE) has warned that there is an increased risk of death and poorer outcomes when patients are treated at times when staff capacity is reduced.

The call for minimum staffing levels was made in an article written by RCPE president Professor Derek Bell and Anne Jarvie, chair of the RCPE lay advisory group and a former chief nursing officer for Scotland.

Published today, the article reaches its conclusion after examining ten investigations into serious failings in care in the UK since 2000.

Among those considered were the public inquiries into children’s heart surgery at Bristol Royal Infirmary and the deaths and poor care at Mid-Staffordshire NHS Trust.

In Scotland, the authors looked at the inquiry into the 2007-8 Clostridium difficile outbreak at Vale of Leven hospital, which resulted in 34 deaths, the review of above-average mortality rates at NHS Lanarkshire and the recent investigation at Aberdeen Royal Infirmary, which identified problems with the quality of care.

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In their article, Professor Bell and Ms Jarvie argued that a culture change was needed to concentrate more on patient and staff well-being. Writing in the RCPE Journal, the authors said: “There is emerging evidence to suggest that the increased industrialisation of the NHS, through which NHS services are becoming increasingly viewed as commercial products and with a relentless focus on ‘efficiency’ rather than quality, is leading to a decrease in morale and an erosion of professionalism. Combine this with perpetual structural change within the NHS and the increased politicisation of health, and we have the making of a perfect storm.”

They said the NHS had to move beyond the “cycle of blame” that emerged from investigations into failings.

“This approach negatively impacts on staff morale, stifles innovation and contributes to the four common themes which have been identified and must be addressed – poor leadership, insufficient staffing, poor communication and poor professional engagement,” they said.

According to the authors, the introduction of minimum levels would help tackle staff shortages: “We need to develop minimum staffing levels for doctors in the medical specialities and other professions in hospitals and this is urgently required for medical staff for out of hours including weekends and hospital at night rotas. There is strong evidence to show the increased risk of death and poorer outcomes in patients when treated out of hours when staff capacity is reduced, and a solid case for developing seven-day working.”

As well as securing political support for minimum staff levels, the RCPE said patients should become more involved in improving their care. Doctors should report concerns about poor care and managers should support staff.

A Scottish Government spokeswoman said: “We are clear that we must learn lessons where healthcare does not meet the standards we demand.”