Consensus Development Project (CDP): An overview of staffing for safe and effective nursing care

Abstract

This paper was prompted by an invitation by the Royal College of Nursing Strategic Research Alliance to produce an overview of the research evidence on nurse staffing levels, the strengths and weaknesses, and how evidence has been applied to policy and practice. It was undertaken to contribute to a Consensus Development Project, which sought to give members of the public access to expert overviews of research related to nursing. The goal was to outline the essential elements required for safe and effective nursing care provision for adults, to enable discussion and consensus on next steps. | BACKG ROU N DThe basic principle that healthcare providers must have sufficient nursing staff on duty to provide care safely and effectively is enshrined in various guidance and regulations influencing the National Health Service (NHS) in the UK. The NHS Constitution (first published in 2009, and updated several times since) makes explicit that patients have the "right to be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality" (DHSC, 2019). NHS organizations are expected to ensure that staffing is sufficient to fulfil this patient right, and staff are expected to raise concerns if conditions for safe care are not in place. This expectation is underpinned by a legal duty for NHS organizations to "encourage and support all staff in raising concerns at the earliest reasonable opportunity about safety, malpractice or wrongdoing at work, responding to and, where necessary, investigating the concerns raised and acting consistently with the Employment Rights Act 1996."Similarly, the Nursing & Midwifery Council (the body that regulates nurses and midwives in the UK) is explicit about registrants' professional obligations to raise concerns if staffing levels

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