Cuts in NHS nurse staffing levels are threatening “increased mortality and morbidity”, according to the College of Emergency Medicine (CEM).

The comment follows a report that pressure on nursing staff has led to a 30% increase over a year in the number of A&E patients waiting beyond four hours.

News that Circle may cut 46 nursing jobs at Hinchingbrooke Hospital has added to NHS concern over this issue.

According to a Nursing Times report, the number of patients waiting over four hours for a bed once admitted through A&E has increased from 51,000 in the first six months of 2011 to 67,000 in the first six months of 2012.

The trust with the highest proportion of A&E patients waiting over four hours is Surrey and Sussex Healthcare (22%).

CEM President Mike Clancy commented: “There is quite clear evidence that with overcrowding goes increased mortality and morbidity. There is a real patient safety issue.”

According to Tim Curry, Assistant Head of UK Nursing at the Royal College of Nursing (RCN), the shortage of acute nurses is not being balanced by increased provision of district nurses: these are also less numerous.

In this context, the proposal by private healthcare provider Circle to make 46 nurses and healthcare assistants redundant has provoked criticism.

It followed a review which said Hinchingbrooke was over-staffed at the busiest times relative to other NHS hospitals. However, the RCN’s Eastern Regional Director Karen Webb said the hospital’s staffing at those times was merely adequate.

A trust spokeswoman said there would be consultation on the proposals, and any job losses would be managed through ‘natural wastage’.

NICE has backed moves by the Department of Health to make NHS organisations publish which of their technology appraisals are included in local formularies from April next year.

Research has found that certain PCTs are blacklisting expensive treatments recommended by NICE creating a postcode lottery for patients across England.

That led to NICE chair Sir Michael Rawlins calling for patients to sue trusts which do not provide access to treatments recommended by the regulator.

Sir David Nicholson, NHS Chief Executive, has since written to SHAs and PCTs saying that he “wants to see” which NICE technology appraisals are included on local formularies.

“Formularies have an important role in underpinning safe and effective use of medicines,” he said in his letter. “However, they should not duplicate NICE assessments or challenge an appraisal recommendation. Once in formularies, there should be no further barriers to the use or prescription of technologies or medicines.”

Professor Gillian Leng, Deputy Chief Executive of NICE, welcomed the instructions by Sir David and said NICE is now working on creating a best practice guide to developing local formularies.

“This will help ensure consistency in the way in which local formularies are produced, and ensure there is no local evaluation of drugs that have been positively appraised by NICE.

“NICE-approved drugs should not be excluded from local formularies on the grounds of cost. We want all patients to have access to medicines that we consider to be effective.”

The Scottish Medicines Consortium (SMC) has approved the restricted use of Janssen’s prostate cancer drug Zytiga (abiraterone acetate).

The treatment has been recommended as a treatment option for men with metastatic castration resistant prostate cancer who have received only one prior chemotherapy regimen.

Zytiga – which was discovered in the UK – has been shown to prolong the life of some patients by nearly five months when compared with placebo plus low dose prednisolone in clinical trials.

Martin Price, External Affairs Director at Janssen UK, said the pharmaceutical company had gone to “significant lengths” to find a solution that allows patients to be treated with the drug.

Annually there are more than 40,000 men diagnosed with prostate cancer in the UK. More than 10,000 men die of the disease – making prostate cancer the second most common cause of cancer deaths.

Dr Rob Jones, Senior Lecturer and Hon Consultant in Medical Oncology, Beatson West of Scotland Cancer Centre, called the decision to approve the restricted use of Zytiga “very good news”.

The treatment was approved for use in the NHS in England when NICE reversed its original recommendation back in June after Janssen had agreed a Patient Access Scheme with the DH.

St George’s Healthcare Trust has launched a new dementia scheme to help raise awareness of patients with the condition in hospitals.

The Butterfly Scheme identifies patients who require additional support from healthcare professionals whilst in hospital and allows appropriate levels of care to be offered.

Jen Tulloch, clinical nurse specialist for dementia, said the scheme enables staff to “offer considerate and suitable support to patients with memory impairment”.

The Government highlighted the challenge the NHS faces in treating patients with dementia when it doubled its funding efforts to £66m earlier this year. Dementia was also chosen as one of the first four clinical networks established by the NHS Commissioning Board Authority last month.

As part of the initiative – which has been used in other hospitals around the country – patients and their notes are affixed with a sticker to identify their condition. Healthcare professionals also wear the same sticker to identify themselves to patients and their families should help be required.