Shortage of nurses ‘kills hundreds of patients’

HUNDREDS of patients die every year after emergency surgery because there are not enough nurses to care for them, research suggests.

A five-year investigation into death rates in English NHS hospitals found those with the highest staffing levels had the lowest death rates.

Experts who analysed the chance of dying within 30 days of being admitted for an emergency operation discovered a five-fold variation in death rates across 156 NHS hospital trusts – from 1.6 per cent at the best trust to 8 per cent at the worst.

Crucially, the hospitals with the worst survival records had far fewer nurses, doctors and surgeons.

When the hospital trusts were divided into the best, middle and worst groups in terms of the number of nurses and doctors per patient – researchers linked a 7 per cent difference in death rates to staffing alone.

This was despite the fact that patients at the best hospitals – many of which have specialist or trauma units – were often more seriously ill before surgery and more likely to suffer complications following operations.

The authors said the figures were ground-breaking, and having sufficient staff to spot and manage complications was a key factor in determining whether patients lived or died.

The study, published in the British Journal of Anaesthesia, looked at patients admitted to hospitals in England for emergency surgery for bowel problems, peptic ulcers, appendicitis, hernia repair and pancreatitis.

Using records from nearly 300,000 patients, collected between 2005 and 2010, the researchers found that 14 NHS trusts had significantly higherthan- expected death rates, while at nine they were significantly lower.

Comparing these two groups, hospitals with the best survival rates had 24 per cent more nurses than the worst – 2.33 per bed compared to just 1.88.

They also had 44 per cent more doc- tors per patient, 40 per cent more consultant surgeons and 38 per cent more junior surgeons.

The difference in 30-day death rates between these two groups of hospitals was 60 per cent.

Across all the hospitals, 12,500 patients died within 30 days of surgery over the five-year study period – a 4.2 per cent overall mortality rate.

Study author Professor Mike Grocott, critical care specialist at the University of Southampton, said: ‘Our study has identified a striking association between staffing levels, clinical experience and patient outcomes.’

He said he had no reason to suspect a significant change in the five years since the data was collected.

Co-author Dr Peter Holt, a vascular surgeon at St George’s Hospital in Tooting, South London, said: ‘Although we have not demonstrated causation, we believe the findings should form an important part of the debate over disparities in staffing levels and resource provision between NHS trusts.’

The Government yesterday said it was giving an extra £1.8billion to hospitals with financial deficits to help them provide a safe level of care.

But medical groups said more investment was needed across the board.

The NHS is desperately short of nurses and many trusts have to recruit from Spain, Portugal, India and the Philippines to fill gaps on rotas.

Unions are also furious at plans to scrap bursaries worth up to £20,000 for future nurses and midwives, which they warn will deter thousands from entering the profession.

Janet Davies, of the Royal College of Nursing, said: ‘Poor staffing levels have a serious impact on patient care.’

Clare Marx, of the Royal College of Surgeons, added: ‘It is wholly unacceptable that death rates vary so significantly for the sickest patients across the country. This has to become one of the top priorities for the NHS.’

A Department of Health spokesman said: ‘There are already more than 7,100 additional nurses on our wards since 2010, almost 10,000 more doctors and we have invested £10billion to fund the NHS’s own plan for the future.’

‘It is wholly unacceptable’