Planning nurse staffing: are we willing and able?

Academic research and public enquiries demonstrate the link between adequate staffing levels and patients’ experiences and outcomes. Health care providers have a legal duty to ensure (and demonstrate to care regulators) that staffing levels are safe. Yet evidence of effective workforce planning, locally or nationally, is scarce. A plethora of tools exist to help employers to determine nurse staffing required. Although not perfect, the technical resource is none the less available to support planning, but are we willing to use it? In England the different systems have not been reviewed or tested and there is no consensus about the best approach to use. This paper asserts that decisions about current and future configurations of the nursing workforce are currently taken in a data vacuum. Fundamental aspects of nurse deployment – the proportion of registered nurses, the ratio of patients to nurse – are not systematically captured or recorded, either nationally or locally. We argue that a first step in planning is to establish this baseline. We need data on nursing inputs to relate to the growing body of data on patient outcomes, to enable managers and policy makers to understand the efficacy of current workforce configurations and inform future plans.