Can we measure how changes in the nursing workforce affect patient care?

Ward staff are the largest staff group in the hospital workforce and constitute the biggest budget item for most acute trusts. The nature of the ward workforce has changed considerably in the last 30 years but it is unclear what impact the changes have had on patient care. Understanding the link between resources and staffing levels on the one hand and outputs and outcomes for patients on the other is vital, particularly if further changes to the workforce are planned. In order to explore them, this article examines: (1) some of the reasons for changes to the workforce, (2) some of the research already available, and (3) the nature of research and information required. Finally, it looks at the work that the Audit Commission carried out in 2000 and which is currently being repeated by the Healthcare Commission.