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Current policy context of safe staffing in A&E Departments

Howard Catton Head of Policy The Royal College of Nursing opened today’s Nursing Staffing and Skillmix in A&E Departments conference with:

• an update from the urgent and emergency care review
• understanding the evidence base from the urgent and emergency care review
• safe staffing in the context of current developments

In his presentation Howard discussed why safe staffing is so important for patient safety and nurse safety, and gave examples of the evidence to support it.  He then focussed on what staffing data shows for A&E and the shortfall in staffing bands 4-8.  

NICE are due to release their guidance for staff staffing in A&E very soon which will recommend:

  • 2 RNs to 1 patient in major trauma or cardiac arrest 
  • 1 RN to 4 cubicles in either ‘majors’ or ‘minors’
  • Specialist input for children, older people or those with mental health needs
  • Plan above average number of patients to deal with peaks in demand and allow flexibility


For further information on the NICE guideline visit http://www.nice.org.uk/guidance/indevelopment/gid-sgwave0762 

Howard made reference to the recent RCN Frontline report here http://frontlinefirst.rcn.org.uk/sites/frontlinefirst/index.php/blog/entry/the-fragile-frontline/

Howard made the following comments;

"Happy staff = happy patients"

"If we're getting it right with patient experience it means we're getting it right for staff experience; lower burnout, lower stress and better morale. So its a win win all round if we get it right."

"Nurse education is associated with  lower rates of mortality"

"The "Francis effect" on nurse staffing has increased numbers. There are over 6000 more nurses now than in may 2010."

Howard’s full presentation is available for download at the end of this page.

Howard Catton qualified as a registered nurse in 1988 and held a variety of nursing posts in England and the United States.  He studied social policy in Cardiff (BSc Econ) and Industrial Relations at Warwick (MA) and has worked as a Personnel and Organisational Change Manager in the NHS.

Howard has held a variety of posts at the RCN, including Regional Officer and as a national policy adviser for workforce research and health policy.  He has worked for the New Zealand Nursing Organisation and the International Council of Nurses in Geneva.

Howard also served as a local Government Councillor for 7 years, for five of which he was Cabinet member with lead responsibility for corporate and customer services.

In 2005, he was appointed Head of Policy at the RCN and Head of Policy & International in 2010.  His department work with a wide range of stakeholders, including government and think tanks, on the development and implementation of policy at home and overseas to ensure nursing influence and voice.  The department also leads on supporting the RCN’s sister nursing associations and alliances internationally.  

Future events of interest:

Masterclass: Nursing Revalidation
Tuesday 2 June 2015 
Hallam Conference Centre, London

Nurse Prescribing
Tuesday 2 June 2015 
ICO Conference Centre, London

Safe Staffing: Nursing Staffing Levels and Skillmix
Monday 8 June 2015 
Hallam Conference Centre, London

Nursing Revalidation for Specialist Practice and Advanced Roles
Tuesday 9 June 2015 
ICO Conference Centre, London

Nursing Appraisal and Revalidation: Implementing the New NMC Code of Practice
Thursday 2 July 2015 
Manchester Conference Centre, Manchester

Advancing IV Therapy
Thursday 2 July 2015 
Manchester Conference Centre, Manchester

Nurse Prescribing for Pain
Tuesday 22 September 2015 
Hallam Conference Centre, London

Nursing Appraisal & Revalidation & Implementing the New NMC Code of Practice
Monday 19 October 2015 
Hallam Conference Centre, London


Download: Howard Catton full presentation

18 May 2015

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