What is the true story behind NICE stopping “A&E safe staffing guidance” levels? Money and fear of civil unrest…

A&E is another area where the conflict between quality and cost is coming to the front of people’s lives. Following the (meant to be important) Mid Staffordshire enquiry, one of the recommendations was for “A&E safe staffing guidance” levels, and these were requested following the mid staffs report and NICE duly began its investigative process. The reply below prompts NHSreality to ask why the request from NHS England was the key factor. The truth is that the other regions (N Ireland, Scotland and Wales) have no control over NICE, and although use its recommendations, have no regulatory power. They cannot request an inquiry or request that guidance be generated (or dropped). So this is one area of complete muddle. We do not have a NICE for the whole UK, and as the different experimental regional health systems diverge, citizens might rightly ask for the ability within their own health system, to initiate a NICE guideline. All rural areas might need different compromises than cities.. Was this the “hidden cost” that led NHS England to call it off? Lack of staffing causes many deaths, and the choice is evident between reducing numbers of A&Es in rural areas, or continuing with less than adequate standard staffing levels. Bringing back fear, by covert post-coded rationing could lead to civil unrest and migration into locations with access to tertiary specialist

On 20th January 2015 the Health Services journal reported from a leaked document: Safe staffing for nursing in A&E departments: the full NICE safe staffing guideline

Critics say move by Department of Health to take evidence reviews in-house will lead to lower standards in staffing as watchdog plans to release its report

and on 20th January 2016: A&E units may be understaffed almost half of the time, leaked documents show

A freedom of information enquiry to NICE by NHSreality was answered “..I’m writing to confirm that as NICE was asked by NHS England to suspend the safe staffing programme, we don’t hold any evidence that was taken into account to withdraw from our commitments. The following news article was published on the NICE website at the time of the decision being made: (4th June 2015 – NHS England asks NICE to suspend safe staffing programme)

NHS England has asked NICE not to begin new activity in its safe staffing programme.”

The scandal behind a deferred A&E staffing level target?

Paying for the NHS – a letter from Dr Norman White. Safe staffing levels abandoned?  

Plan your hospital advocate…. NHSreality warned you that it was happening near you. The problems of Mid Staffs and Sussex Mental Health services are endemic, and Christmas is not a time to be ill..

Lack of staff in hospitals leads to hundreds of deaths

NHS staffing levels risk another Mid Staffordshire-style scandal – report

Plan your hospital advocate…. NHSreality warned you that it was happening near you. The problems of Mid Staffs and Sussex Mental Health services are endemic, and Christmas is not a time to be ill..

The Government and NICE. Income and expenditure. Rationing by exclusion – but covertly

When is a target/standard not a standard? When it’s changed as “unrealistic” and NICE says so? NHS patient safety fears as health watchdog scraps staffing guidelines

Some hospitals double odds of death from a heart attack. Survival is better if you live in a city with a tertiary centre..

Self Harm. Deprived areas in the UK: most are far from Tertiary care. They will have lower life expectancy.



This entry was posted in A Personal View, NHS managers, Rationing, Stories in the Media, Trust Board Directors on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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