NHS finances are severely strained. As often stated in the press, this is mostly due to the rising demand for the services it provides as well as to some major budget cuts. At the same time, a ‘’hidden’’ workforce crisis is also reported in the media, which call for action against workforce understaffing. Yet, there is much to learn regarding the relationship between staffing levels and outcomes, especially from specialized settings within the English NHS. Although adequate staffing levels are important, outcomes are also affected by the staff mix and the skill mix. Yet only recently these points have started making their way to the press, as alternatives to the minimum staffing levels practices.
New study suggests that skills deployment rather than staffing levels have greatest impact on mother and baby outcomes
New study published in the Health Service and Delivery Research Journal and co-authored by our own Professor Cookson concludes that though staffing levels have positive and negative effects on some outcomes, the deployment of doctors and midwives where they have most beneficial impact is important. It also highlights that the there appears to be limited opportunity for role substitution and managers may wish to exercise caution in increasing the number of support workers who care for higher-risk women.
The findings have informed the NICE guidelines on maternity staffing.
A full abstract is attached below and the full report can be found at the HS&DR Journal
First, it is unlikely that a single measure can capture the multi-dimensional nature of health care quality and this limits the extension of any results to the whole health care system. For example, the mortality rate would not be the best indicator of the quality of cataract surgery, or maternity services.
Improving the quality of health care is important to service users and taxpayers, and therefore to Government and the media. Stories, usually focusing on poor quality of care, abound. And NHS quality initiatives are seemingly endless. Since the early nineties, policy makers have focused on increasing competition forces between providers to drive up the quality and to drive down the cost of health services. The positive effect of competition on productivity is well established in the literature on the private sector. Health care markets, however, differ from other markets in ways that do not allow direct translation of those results (Gaynor and Vogt, 2000). A key difference is that 'quality' is either very difficult or impossible to observe directly.
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