The clear conclusions of a study published today (26 February 2014) in The Lancet are that nursing cutbacks are directly linked to higher patient death rates in hospitals and that every extra patient added to a nurse's workload increases the risk of death within a month of surgery by 7%.

The study was conducted by the University of Pennsylvania School of Nursing which surveyed 300 hospitals in nine European countries (including 30 in England). Researchers compared nurse workload and education and patient outcomes, taking into account a number of factors that could influence the result.

Other findings of note were that the better qualified the nurses providing care, the better the outcomes for patients and that England has more patients per nurse and fewer degree qualified nurses than a number of other countries. For example, every nurse in Spain had a degree while only 28% of UK hospital nurses had the equivalent qualification for the period considered. The findings therefore support the recent requirement introduced that every newly qualified nurse in the UK must have a university degree.

On the issue of minimum staffing levels, the study found that English hospitals had an average ratio of nine patients to one member of nursing staff whereas this was ratio was as low as 5.2 in other countries. Since the Mid Staffs enquiry there have been repeated calls for minimum staff-patient ratios but the position of the Government to date is that it would not introduce a legal minimum because staff requirements differ between wards and hospitals.

This study follows a poll of 526 nurses for Nursing Times magazine in February 2014 which found that 39% of nurses said staffing levels had worsened at their place of work over the last 12 months. More than a third (37%) said they have stayed the same while only 22% reported an improvement.

Philippa Luscombe, partner in the clinical negligence team at Penningtons Manches LLP, said: “Nursing levels remain a real issue of concern in current hospital care. Sadly, the findings of this study reflect the trends we are seeing in our clinical negligence cases. Over the last three years the number of cases which involve failures to carry out basic compulsory risk assessments such as for falls or pressure sore, document observations as required, and identify signs of sepsis and other life threatening conditions have increased significantly. The vast majority of these cases involve failures from nurses who are over-stretched and simply don’t have time to provide basic care. This latest study, as with the Nursing Times survey, highlights that there are serious problems in this area and a direct correlation between understaffing and death rates. The new requirements regarding graduate entry are a good move but staffing numbers need serious consideration to prevent further deaths.”