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Stretched Nurses 'Struggling To Give Safe Care'
Patients in some NHS hospitals are receiving "unsafe and unsatisfactory" care because of staff shortages, a nursing chief has told Sky News.
Elderly patients are particularly at risk of being left in discomfort and distress, according to Dr Peter Carter, the chief executive of the Royal College of Nursing.
His warning comes as the National Institute For Health and Care Excellence (NICE) prepares to issue draft guidelines to hospitals, stating nurses should ideally be responsible for no more than eight patients at once.
Failing to meet this ratio puts patients at "increased risk of harm", it said.
One estimate is that 20,000 additional nurses could be needed to meet NICE's recommendations.
"There is a lot of very good care, but there are undoubtedly many clinical situations each day where nurses are really struggling to provide the level of safe and satisfactory care they would wish to do," Dr Carter told Sky News.
"Nurses tell us they often come off shifts knowing they've not provided the level of care they'd wish to.
"Patients are left in discomfort - sometimes they're incontinent and nurses are unable to change them for considerable periods of time, which adds to distress.
"That's the reality. It's not that the nurses don't care - just that there are insufficient numbers of them.
"We have copious examples, particularly on wards for older people, where you have one nurse for 12, 14 and sometimes 15 people."
Dr Carter welcomed NICE's guidelines but said sometimes even "one to eight" was not nearly enough.
"Research demonstrates that once you go over the one to eight (ratio), serious problems begin," he said.
"There are plenty of settings, (such as in) neo-natal and intensive care, where you need one to one."
NHS staffing levels have been criticised following the Mid Staffordshire scandal, which uncovered evidence of increased mortality rates and serious neglect.
NICE will issue final guidelines for adult inpatient wards in acute hospitals in England in July following a consultation.
Its deputy chief executive, Professor Gillian Leng, said: "We'll be issuing draft guidelines on Monday, providing advice on how hospitals should ensure nurse numbers on wards are appropriately tailored to the needs of patients.
"The advice is for hospital managers, the board, and nurses working on wards.
"We want to make sure patients receive effective, safe care.
"We've also set out some information about what needs to be monitored in terms of outcomes for patients who have falls or pressure ulcers, and what nurses need to keep track of on a day-by-day, hour-by-hour basis to make sure patients are being cared for effectively."
The Department of Health said administrative staff and managers had been cut since 2010 but there were 5,100 more nurses working on wards.
Health Secretary Jeremy Hunt added: "NICE's work on staffing is a major step forward.
"For the first time in its history, the NHS will have the evidence it needs to make sure that nurses are able to spend enough time with their patients."