Intended for healthcare professionals


Mid Staffordshire should lead to a fundamental rethink of government policy

BMJ 2013; 346 doi: (Published 08 April 2013) Cite this as: BMJ 2013;346:f2190
  1. Allyson M Pollock, professor,
  2. David Price, senior research fellow
  1. 1Centre for Primary Care and Public Health, Queen Mary, University of London, London E1 2AB, UK
  1. a.pollock{at}

The QIPP initiative threatens safe levels of staffing

NHS staffing levels emerged as a key concern of the Francis inquiry into substandard care at Mid Staffordshire NHS Foundation Trust. Inappropriate and low levels of staffing have previously come to light in the corporate nursing home and residential care sector through scandals such as the one at Winterbourne View. Francis notes that as part of the trust’s financial recovery plan, “Savings in staff costs were being made in an organisation which was already identified as having serious problems in delivering a service of adequate quality, and complying with minimum standards. Yet no thought seems to have been given in any part of the system aware of the proposals to the potential impact on patient safety and quality.”1

According to Francis, the solution is training and regulation of staffing levels, including “evidence based tools for establishing the staffing needs of each service,” proper risk assessment “when changes to the numbers or skills of staff are under consideration,” and advice during commissioning when major changes to staffing or facilities are proposed.1

The Department of Health in its initial response published last month focuses on inspection and training and says …

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