Intended for healthcare professionals


Commentary: Reaction to the RCP’s recommendations on safe staffing

BMJ 2018; 362 doi: (Published 23 July 2018) Cite this as: BMJ 2018;362:k3196
  1. Jennifer Richardson, features editor, The BMJ
  1. jrichardson{at}

Robert Francis, the CQC, and others respond to the Royal College of Physicians’ report

“A laudable attempt to justify numbers”—Robert Francis, chair, Mid Staffordshire NHS Foundation Trust Public Inquiry

The Royal College of Physicians’ approach to quantifying safe staffing is “encouraging,” says Francis. “Work like this is extremely welcome because since Mid Staffs I’ve been keen to see some staffing standards which might assure patients and the public that wards are safely staffed.”

What has been done to date has lacked hard figures, he says. “The challenge has always been to find an evidence base to justify any numbers for staff-patient ratios and so on,” he adds. “This does seem to me to be a laudable attempt to do that, at least for the medical team.”

He says the test is for a non-executive director of a trust to be able to judge how its staffing needs have been calculated. “It’s something that’s been conspicuously absent in the nursing field.”

Francis is disappointed not to see patient involvement in the RCP’s report. “I would have thought that it would have been useful to look at or hear some experience of what patients think is necessary in order for them to feel safe.” This could be included in the audits that the RCP has urged trusts to carry out on its recommendations, he suggests.

The RCP’s recommendations now need to …

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