Lowest death rates founds where nurses have six or fewer patients at one time

On the same day junior doctors staged their second walk-out over proposed contract changes, research by the University of Southampton and King’s College London has revealed a striking link between nurse staffing levels and death rates in NHS trusts.

The study found deaths were at their lowest among trusts where nurses who had six or fewer patients to look after at any one time. As soon as nurses juggled 10 patients at once, death rates were 20 per cent higher than the hospitals who had nurses looking after six or fewer.

The findings were revealed after researchers analysed mortality rates in 137 acute hospital trusts covering 46 hospitals and 401 wards. The two year study also undertook more detailed analysis of 31 of these.
 
At a time when hospitals report an average staffing ratio of one nurse for every eight patients (rising to 15 in the evenings), the findings make stark reading according to Janet Davies, CEO of the Royal College of Nursing. She said: “The evidence is a clear warning about the impact on patient care outcomes if we are to have too few registered nurses.”
 
Rising numbers of NHS trusts are struggling to recruit enough nurses, with Mid-Yorkshire NHS Trust found to have one nurse for 22 patients before it was later branded as being ‘unsafe’.
 
Anne Marie Rafferty, professor of nursing policy at King’s College, said this was the first study to shed light on the impact of the policy to shift the safe staffing policy decision from nursing to that of the clinical team.
 
Research author, Jane Ball, from the University of Southampton, said: “When determining the safety of nurse staffing on hospital wards, the level of registered nurse staffing is crucial.”
 
The research also found death rates were 7 per cent higher in trusts where there were higher levels of support workers. Ball said: “At best, healthcare support workers make no difference, but at worst, a higher level of support workers is linked to an increased risk of death during a hospital stay."
 
Rafferty said these secondary findings highlighted the “dangers of simply substituting healthcare support staff for qualified nursing staff”.
 
The report concluded: “Current policies geared towards substituting [nursing aid] workers for registered nurses should be reviewed in the light of this evidence.”
 
In the past, researchers have linked hospital mortality rates to either the amount, quality, or happiness of nurses on staff. A 2015 study from the University of Pennsylvania found mortality risks were lower if nurses were happier at their jobs.