LONDON (Reuters Health) – The staffing levels on hospital wards vary significantly across England and Wales without any clear evidence that more staff leads to better clinical outcomes, a government watchdog said on Wednesday.
The Audit Commission said hospital trusts should look closely at whether they could improve efficiency and effectiveness of their ward staffing without putting patients at risk. Ward staffing is the single biggest item in trusts' budgets.
"I guess many would expect NHS trusts to have similar staffing levels on their wards but there is actually a good deal of variation," said Andrew Foster, Controller of the Audit Commission. "It's widely recognised that nurses work hard, but it's only with good management and planning that patients will get the most from their efforts," he said in a statement.
The Audit Commission study of ward staffing in 2000 found that trusts in the South West of the country spend more than hospitals in other parts of the country. Although differences in local labor markets could account for some differences, they did not represent the whole picture, the watchdog agency said.
Rather, trusts that spent more on ward staffing did so because they employed more nurses per bed. The commission suggested that this could in some cases be the result of poor management.
"Hospitals that do have higher levels of staffing are urged to satisfy themselves that there are benefits for patients," it said in a statement.
The commission pointed out that there were no good measures for assessing the impact of nursing staff on quality of care. It added that the impact of specialist nursing staff on quality of care also needed "close inspection."
Geraldine Cunningham, co-director of the Nursing Leadership Programme at the Royal College of Nursing said the report raised more questions than it answered.
"We would welcome better evaluation of patient outcomes and skill mix in the interests of quality patient care," she said in a statement.
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