Hospital trust accused of risking lives after raising patient-to-nurse ratio to dangerously high levels

The new policy, which is applicable to Bristol Royal Infirmary (BRI) and Weston General Hospital, also extends to all specialist high-care wards, which treat patients with life-threatening conditions such as epilepsy and anaphylaxis.

A hospital trust in Bristol has been accused of risking lives after raising its patient-to-nurse ward ratio to dangerously high levels, having allegedly dismissed staff concerns and national guidance on safe staffing.

University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) has introduced a blanket policy across its hospitals that assigns one nurse to 10 patients (1:10) for all general adult wards. This ratio, which previously stood at 1:6 or 1:8 depending on the ward, rises to 1:12 for nights shifts.

Nurses at the trust have expressed their anger over the decision, saying they were never fully consulted by senior officials. Many are fearful that patient safety will be compromised as the second coronavirus wave intensifies, culminating in the unnecessary loss of life.

“Patients who would have extra nursing staff because they are very acutely unwell and need close observation I think are going to unnecessarily die,” one nurse at BRI told The Independent.

“Or if they survive, they’ll suffer long-term conditions because things were missed as they don’t have the staff at their bed side to watch the deterioration.”

Some nurses claims that they have been forced to look after up to 16 patients during their shifts due to severe staff shortages.

The trust’s new ratio exceeds guidance set out by National Institute for Health and Care Excellence (NICE), which warns that people are at risk of harm in wards where there is one nurse for eight or more patients.

The link between patient safety and nurse staffing levels has been repeatedly evidenced in research and was made clear during the public inquiry into the Stafford Hospital care disaster, in which hundreds of patients suffered neglect and abuse after hospital managers slashed nurse staffing levels to save money and meet targets.

Multiple peer-reviewed studies have shown a ratio of nurses to patients that is 1:8 or higher can also result in patient deaths on medical wards.

“Each area should be individually assessed,” another nurse said. “They’ve put in place a blanket policy which goes against NICE and doesn’t give any consideration to the needs of the different wards and their patients.”

Exemptions for the new nurse-patient ratio have been made for critical care and High Dependency Units (HDU), according to a leaked email circulated among managerial figures at Bristol Royal Infirmary.

In the email, sent out on 12 November, UHBW explained that the “difficult” decision had been made as a result of the “unprecedented times”, adding that the trust was in a “designated critical incident”.

“The Trust demand for agency nurses is outstripping supply – so we need to work on the basis that shifts will not all be covered,” the email reads.

“Nursing and midwifery leaders need to change their ‘mind set’ and risk tolerance of what is safe under business as usual and what is safe in an exceptional critical incident.

“Covering staffing gaps may need to include the use of non-nursing staff into support roles.”

Nurses who have spoken with The Independent say they were informed about the new ratio via posters that were put up throughout Bristol Royal Infirmary. Others says they found out after a colleague obtained a copy of the email before circulating it among their peers.

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