Why NICE must publish its safe staffing guidance

In the past few months the National Institute for Health and Care Excellence has coordinated work on what is likely to be the best assessment so far of how nurse numbers affect care quality in accident and emergency units.

In the past few days, however, it has decided the resulting guidance will not be published, and will instead be kept under lock and key until an unspecified later date.

‘NICE’s U-turn could tarnish its international reputation for independence’

This is a bad decision for a number of reasons.

Questions about whether NICE was pressured into its U-turn from outside risk tarnishing the organisation’s international reputation for independence.

The work is taxpayer funded and could potentially be used to plan services ahead of winter.

Need more detail

Publication would also allow a full debate about why NHS England and Department of Health are against further NICE produced guidance on nurse staffing levels. They could point out where and why it is wrong, if this is the case.

Alternatively, if the recommendations are unpalatable because of cost alone, the government should explain why, in this case, finance is being prioritised over safety.

‘Publish this guidance without delay’

The only argument given by NHS England and the government so far, pointing to the need to consider the entire clinical workforce, has been nebulous and without detail.

Jeremy Hunt said earlier this month that “there can be no compromise on the issue of safe staffing”, and the Francis inquiry illustrated why this is the case.

Without the guidance being available it is hard to see how compromise is not exactly what we have, implying the government is repeating past mistakes.

HSJ therefore calls on NICE, NHS England and the DH to publish the guidance without delay.