Towards safe nurse staffing in England’s National Health Service: progress and pitfalls of policy evolution

Journal article


Lawless, J., Couch, R., Griffiths, P., Burton, C. and Ball, J. 2019. Towards safe nurse staffing in England’s National Health Service: progress and pitfalls of policy evolution. Health Policy. 123 (6), pp. 590-594. https://doi.org/10.1016/j.healthpol.2019.03.011
AuthorsLawless, J., Couch, R., Griffiths, P., Burton, C. and Ball, J.
Abstract

In 2013, a national inquiry into care failings at a large public hospital in England resulted in major healthcare reforms that included targeting policy aimed at ensuring the adequacy of nurse staffing levels on hospital wards within NHS England. This paper uses a review of publicly available documents to provide a contextual account of the evolution of nurse staffing policy development prior to and following the inquiry. We found that securing safe staffing policy has been impacted by caveats and competing policy, evidence gaps, lack of coordination, and the absence of readily implementable solutions. Consequently, five years on, safe staffing policy for NHS England is described in aspirational terms that ascribes accountability to providers, but fails to adequately address barriers to delivery. Kingdon's 'policy windows' model is used to explain why policy, even when driven by strong public concern and with high inter-sector support, may struggle to gain traction when the conditions necessary for success are not present, and in the face of practical or political constraints. The progress and pitfalls encountered are not unique and the experience of safe staffing policy in England may have lessons for other countries grappling with policy development or implementation in this area.

KeywordsHospitals; Nursing workforce; Patient safety; Policy
Year2019
JournalHealth Policy
Journal citation123 (6), pp. 590-594
PublisherElsevier
ISSN0168-8510
Digital Object Identifier (DOI)https://doi.org/10.1016/j.healthpol.2019.03.011
Official URLhttps://doi.org/10.1016/j.healthpol.2019.03.011
Publication dates
PrintJun 2019
Publication process dates
Accepted12 Mar 2019
Deposited26 May 2020
Output statusPublished
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