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

HSJ has reproduced the safe staffing guideline for accident and emergency departments from NICE from a leaked document

On 10th July 2015 The Guardian’s James Meikle reported: Nice to publish report on NHS staffing levels despite being told to stop work

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.”