The latest guidance from NICE (National Institute for Health and Care Excellence) offers instruction to A&E departments on how to ensure safe levels of nursing staff. This follows recent news that more people than ever are waiting longer to be seen at A&E – a problem likely to be exacerbated by the worsening weather predicted in the coming weeks.

The guidance continues to stress the need for adequate numbers of staff to meet rising demand and pressures from an ageing population and more people with long-term conditions, while still ensuring a good standard of care.

The news, published in The Telegraph, that A&Es will be forced to declare nurse shortages is an interesting addition to the guidance that has the potential to give patients and their families greater scrutiny over care. Due to concerns about severely short-staffed units, NICE guidance calls for a maximum of four patients per nurse and believes that hospitals without the correct staffing levels should have to inform the public. This comes following widespread evidence of staff shortages and overcrowding across the NHS, as well as failings in the length of time people are required to wait and the standard of care that patients eventually receive.

Similarly, an article in The Guardian highlights the NICE suggestion that patients should be moved in instances of extreme overcrowding or additional staff brought in from other wards to address the shortages. While the benefits of such guidelines are clear to see, they fail to address exactly how this would be achieved in a time of funding cuts, staff shortages and greater demand on services across the entire health and social care sector – not just in A&E.

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Legitimate concerns remain that many hospitals will simply be unable to meet the requirements set out by NICE. For example, it is not clear where the spare staff would come from. What is clear, however, is the need for all parties in the run-up to the election to come up with a cohesive and comprehensive plan to invest in the NHS and increase recruitment efforts. Greater emphasis on budgets and staffing levels must be taken into account as funding remains the key factor in solving the NHS crisis.