Underrated Questions on Pte Writing Essay Topics

Underrated Questions on Pte Writing Essay Topics The Do's and Don'ts of Pte Writing Essay Topics So academic achievement is crucial to create responsible and active men and women in society. How much you could earn while your paper work is being done by somebody, who knows the way to do it correctly! In the long run, it's about how much hard work and effort which you put into any of the tests so as to clear them with excellent marks. You acknowledge the opposite view at the start of another part. You should spend time brainstorming seriously. Some students utilize the very first idea which arrives in their head and work on it, but the outcome isn't profitable. What About Pte Writing Essay Topics? Based on the duration of the essay, numerous body paragraphs will be different. Remember your final grade significantly is based on the topic. Anyway, there's no 100% guarantee your essay would be well worth a high grade. Narrative essays are told from a defined point of view, frequently the author's, thus there's feeling in addition to specific and frequently sensory details supplied to find the reader involved with the elements and sequence of the story. Don't forget to attentively read the previous portion of the topic to debate the way that you are asked to. Especially if you're giving out an instruction or suggestion, it's a terrible method of description. Learning a new language for an early age is helpful for kids. Lies You've Been Told About Pte Writing Essay Topics In the PTE writing module, you've got to summarize a lengthy text into only a single sentence, you've got to summarize a text that's spoken to you into 70 words and then you've got to compose an essay, that is three sections. Again, for more info about essay structure strategies, our PTE write essay' webinar is an excellent place to begin! You're able to continue being near our schema. Generally the toughest part of developing a descriptive essay is picking the topic. The option of compare and contrast essay topics isn't a simple task because you must demonstrate your analytical skills. In other sorts of essays, the content can fluctuate. Just be certain you're following your instructor's guidelines and understand how to construct a narrative essay from starting to end. Communication has charged significantly in the last ten decades. Writing an excellent college paper assignment is an intimidating approach. Moreover, you may also improve in different tasks with the assistance of Practice Materials. Writing practice shouldn't be boring! The Tried and True Method for Pte Writing Essay Topics in Step by Step Detail Education is occasionally regarded as something for the youth. Parent, ought to be held legally accountable for their sons' and daughters' acts. Parents ought to be held legally accountable for their sons' and daughters' acts. Pte Writing Essay Topics Secrets To put it differently, the essay should say how you intend to get ready for class. The essay questions are split into common PTE Essay writing. When you've chosen a narrative subject, you're prepared to get started writing your essay! No matter the essay category you've been assigned with, you have to be passionate enough to write on that special topic. The more you write essays, the simpler it gets but there are a couple vital elements to writing an excellent essay that you should know in the beginning. If you get essays online, it's really important to understand whether the work is still in process or has been finished. Therefore, below are some basic strategies that will help you in writing of good descriptive essay. If you're tasked with writing a descriptive essay there are lots of things which you can write about. Whispered Pte Writing Essay Topics Secrets Folks will often say they don't write out an essay plan since they're frightened of wasting valuable moment. Becoming creative and descriptive can occasionally be a challenge. Individuals often believe the very best tactic is to simply begin writing and receive the ball rolling, and that the ideas will follow. There are various kinds of music on earth today.

Free Community Colleges And Free Tuition - 1751 Words

Right now 7.8 million people are enrolled in a community college, but there are 318.9 million people in the United States. We should have more people enrolled at community colleges and free tuition would help this. Globalization makes it difficult to make a decent living without a proper education because in the 21st century jobs require more education then a High School diploma. Thomas L. Friedman talks about globalization and how it has been around for centuries, but recently has gone to a whole new level in the book The World Is Flat. Globalization is the process by which businesses or other organizations develop international influence. This is a problem because adults are losing jobs and businesses are outsourcing jobs due to not†¦show more content†¦They will have to work hard to get decent grades to get free tuition. In addition, the article The Push For Free Higher Education points out, â€Å"As one of the most developed countries in the world, America has the reso urces and need for its citizens to be taught to a certain standard in order to foster generations of young intellects.† This means that having our younger citizens educated will only help us in the long run. It will positively impact future generations, instead of having a plethora of uneducated individuals. Even though having tax payers pay for the tuition would be a highly debated issue, it would impact the society in a positive way. We would be able to stop outsourcing work because we would have more educated adults with the right requirements to get jobs they qualify for, and have a variety of different skills due to liberal arts. With free community college tuition adults will have sufficient liberal art skills, which will be beneficial to our society. In the book, The World Is Flat Friedman acknowledges, But we also need to be vigilant in upholding the teaching of art and music and literature, because they too are essential for innovation. (316). What Friedman means by this is that we just don’t need kids to be excellent at math, science, and history they also need other skills. The more skills they have will onlyShow MoreRelatedShould Community College Tuition Be Free?875 Words   |  4 PagesMy immediate response is yes, of course I want community college tuition to be free but then I realized I am already in my second year this will not apply to me. As I further ponder over it I can not help but to think on what terms would this be under. Will you have to have a certain GPA? Will it only be available to us citizens? Will there be a age stipulation? There is a number of factors that can be put on this â€Å"Free Tuition†. It sounds like an amazing offer be is it really? After hearing theRead MoreCommunity College Education Should Not Be Tuition Free998 Words   |  4 PagesCommunity College Education Should Not Be Tuition Free Every year, millions of students graduate from high school and consider studying in community college. The main reason for them to choose community colleges over four-year universities is the affordable tuition, or they have undecided majors for their careers. Unfortunately, an academic article published in 2014 â€Å"How to Help College Students Graduate,† Kirp demonstrated, â€Å"American students are enrolling college in record numbers, but they areRead MoreThe Importance Of Community College Education1207 Words   |  5 Pageseconomy and politics. For the United States of American, community college becomes one of the main factors to determine how the country moves forward. Using table 101.20 from Digest of Education Statistics of the National center for Education Statistics, from 2000 to 2014, the increase in college enrollment has been contributed by increases in the traditional college-age population and rising enrollment rates. But increasing costs of tuition and di fferent expenses each year have become huge obstaclesRead MoreA Poor Solution For America s Shortcoming1625 Words   |  7 PagesWelfare. A major issue in today’s society is the debate over free community college tuition. Even though some say free community college tuition would be one step closer to saving Americas crumbling lower class, community college tuition should not be completely free. An education from a community college is already very affordable even for those who are from low-income families. On top of being affordable, free community college tuition as it stands today is easily exploitable by those who don’tRead MoreShould Colleges Be Free? Essay1186 Words   |  5 PagesShould colleges be free in America? It is a question that is more relevant today than ever before. As education is one key factor that determines the nation’s fate going forward, this question is worth debating. Making free college education may sound good theoretically but requ ires herculean efforts to make it practically possible. The main question is whether such program be effective in the long run or not? If, yes how long will the government able to support these costs and from where? Are tuitionRead MoreThe Community College Model Works Just Fine1361 Words   |  6 Pageson Barack Obama’s recent proposal to make the first two years of community college free of charge. Dr. Michael A. MacDowell, retired president of Misericordia University and a writer for Citizen’s Voice, disagrees with Obama’s plan and makes this clear in his article s title, â€Å"The Community College Model Works Just Fine.† MacDowell’s biggest arguments is that the community college group is not the most effective group to offer free education. MacDowell successfully uses statistical facts and evidenceRead MoreCollege Should Offer Free Tuition867 Words   |  4 PagesHaving a college degree is considered to a vital part of being successful in today’s day and age. College degrees are really expensive, but in a long run they really pay off. College can be a big financial burden so with that being said, in my opinion, I think community college should offer free tuition with some sort of standards to be eligible for free tuition. President Barack Obama conveyed a speech at Macomb Community College in Warren, Michigan this past September. President Obama proposedRead MoreThe Rise And Fall Of College Tuition1575 Words   |  7 PagesHodges Professor Robert Howell English 102 21 October 2015 The Rise and Fall of College Tuition in the United States In the recent debate regarding the implementation of free college tuition across the United States, Jon Wiener, a Los Angeles journalist for The Nation, and Kelly Field, chief Washington reporter for The Chronicle of Higher Education who covers different federal education policies, discuss why college tuition should be abolished in the United States of America and the role of both DemocraticRead MoreThe Cost Of Education : Tuition Cost Is On Every Student s Mind Essay1201 Words   |  5 PagesThe Cost of Education Tuition cost is on every student s mind. The cost of college tuition is an unnecessary burden that causes students to do the following: work multiple jobs, worry about financial aid, and take time from studying and being better students. Every day I m reminded of the cost of tuition. It is on my mind when I am at the grocery store trying to decide between buying food or gas so I can go to work. Or, for example, when I have to make time to study in between my three jobs IRead MoreCommunity College Tuition Plan Raises Doubts789 Words   |  4 Pageswere people who stated their insight such as president Stanley from Westmoreland County Community College, David Patti president and CEO of the Pennsylvania Business Council and Laura Fisher, senior vice president with Allegheny Conference who agreed that if students are given the opportunity to progress in school it could mean a better economy in the future. By giving students paid tuition in community colleges it could mean they would go to a university to finish a bachelors in a major that interests

Globalization Its Effect of Wealth Essay - 2561 Words

The word globalization gets tossed around our tongues with out even slipping our minds what it is. But what is it? Globalization is the idea of companies to send jobs overseas to those who will work for less. Globalization is the ability to go to McDonald’s in China and eat a Big Mac that tastes as if you ate it on your homeland. Globalization allows you go on Facebook to communicate with your exchange partner in Germany in a matter of seconds. However, globalization can be defined even broader that includes all aspects it influences. The most suitable definition for would be that globalization is the collapse of barriers between countries allowing labor, goods, and services to be freely exchanged. One aspect that seems to be†¦show more content†¦188) By this he is explaining that they might make 54 dollars a month but comparing that to their relatives wage that is a substantial growth. He then interviews a young female Vietnamese, Tsi-Chi, who works in this sweatsho p. She compares her work setting to working on a farm. Farm work means working under the hot sun with bugs constantly pestering you for a straight 10 to 14 hours. But factory work is definitely more pleasant when a typical day is a 8 to 9 hour shift in air conditioning. On top of that many workers receive training and education, can have reduced or free meals, and are offered medical attention. This comparison makes, â€Å"Nike sound more like Santa Claus than Scrooge†(Norberg, 2003, p. 189). Nike’s appreciation for their customers has brought many workers increased wages but Norberg argues that their increased production, â€Å"will also be possible to invest in education and health for Vietnam† (Norberg, 2003, p. 189) In other words, Vietnam’s economy will begin to flourish by having the access to be on the same playing field as the United States. Therefore, they can worry more about their education and health rather than their financial strains. Lastly , Norberg insists, â€Å"It would be extremely interesting to hear an antiglobalist explain to Tsi-Chi why it is important for Westerners to boycott Nike, so that she loses her job, and has to go back into farming, and has to send her son to work† (Norberg, 2003, p. 190). This proglobalistShow MoreRelatedEconomic Exchange within a Globalized World1195 Words   |  5 Pagesessence the product of this globalization. Globalization is the international integration or interaction of resources which comes from the exchange of products and ideas between nations (Globalization n.d.). The process of globalization is mainly caused by economic exchange. This exchange can range from the trade of materials, to investment of money in foreign banks, and to the technology which has given rise to a more interconnected world. Consequently globalization can be seen have a great influenceRead MorePositive Impact Of Globalization762 Words   |  4 Pages Globalization is when companies and people begin to expand and integrate on an international scale, creating international free trade. While globalization has positive effects, it also is important to understand the impact it has across the world. â€Å"This process has effects on the environment, on culture, on political systems, on economic development and prosperity, and on human physical well-being in societies around the world† (What Is Globalization?). Globalization allows the free trade of productsRead MoreGlobalization and Citizenship Essays768 Words   |  4 Pagesactivity, investments and trade. Imagine economic integration and the rapid development of cities. This is globalization. Globalization is used to describe the increased integration and internationalization of economic affairs and relations which are facilitated and transitioned by rapid development in technology in the fields of information gathering, communication and processing. Globalization has a very big influence and impact on the economies of the world. We see many countries developing at rapidRead MoreGlobalization Is An Undeniable Reality Of The Modern World Essay1630 Words   |  7 PagesGlobalization is an undeniable reality of the modern world. That said globalization means different things to different people. The debate about globalization is particularly complex because of the wide variety of ways that globalization affects people. Everyone has a stake in globalization, but some have more power to affect the system than others, Rebecca Todd Peters, in her book In Search of the Good Life, attempts to clarify the debate about globalization by identifying the 4 main viewpointsRead MoreThe Positive Side Of Globalization1155 Words   |  5 PagesThe Positive Side of Globalization Globalization is what unites this world. As time passes, it has become easier to communicate with people worldwide. With dedication, education and will, you can have a full conversation in a foreign language anytime. If looked at in depth, globalization contributed to the spread of your native language because it was transferred by many people. As you can see, globalization is something that can help us communicate across long distances and much more. There areRead MorePeace Brought from the Modern Economic Structure1445 Words   |  6 Pageswhen economies become dependent upon trade from foreign nations, and Globalization, the act in which nations begin to integrate their ideas and concepts with one another, war and conflict can be mitigated. War is mitigated through the two phenomena due to the growing trade between nations that demands for nations to agree and play nicely with one another in order to continue this trade. This is additionally seen through the effects that a lack of trade causes on the nations. But conflicts do not seemRead MoreImpact Of Globalization On The World1262 Words   |  6 PagesThe impact that globalization provided to the world was a positive effect that expanded the influences from one country to another. Globalization is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture. Similarities on how national markets established themselves in other countries which increases not only international trade but also cultural exchange. This increases cultural trade because it gives countries the abilityRead MoreCharacteristics Of Economic Globalization893 Words   |  4 Pages Economic Globalization: An Analysis of Main Features and Effects Economic globalization refers to the â€Å"increasing interdependence of world economies† (Shangquan, 2000), as a result of free movement of goods, services, technology, capital, and information between countries and across borders. It is one of the three main areas of globalization; economic globalization moves at an increasingly fast pace as movement across borders progresses. While economic globalization has had many benefits and positiveRead MoreGlobalization And Its Effect On Society1240 Words   |  5 PagesGlobalization and the use of new technologies and how it strengthens or weakens global inequalities Globalization is a very important force in the new world and it continues to impact the lives of individuals as well as groups world over. The role and affect of globalization has broadened over time. It has resulted in the lessening of trade barriers, integration of the economy of the world, increase in opportunities for groups and individuals alike and an increase in the economic well being andRead MoreEconomic Gaps : Globalization A Real World View986 Words   |  4 PagesEconomic Gaps: Globalization-A Real World View The main sociological issue depicted in the video is globalization. Globalization deals with social changes that affect the world on an international scale. This is regarded as the most important social change of the 21st century because the entire world is connected and can communicate in a matter of seconds. This eases the flow of ideas, people, and material objects and allows a small change somewhere to spread and have far reaching effects. This video

Patient Safety - Satisfaction and Hospital Care Quality - Sample

Question: Discuss and Critical Analysis of Safe Staffing Levels Of Nurses How It Has Impact In Patient Care In Relation To Health Policies? Answer: The nursing workforce is an integral part of the health care settings as nurses have a major role in achieving better patient outcomes, and they can be considered as an important care provider among the whole health care setting (Potter et al. 2013). Staffing levels of nurses is an ongoing concern and influences the safety levels of both the nurses and the patients. Nurse staffing refers to the mix of registered nurse expertise with the appropriate needs of the people receiving nursing care in the context of situation and practice settings (Mashimo et al. 2013). The provisions of suitable nurse staffing are required for reaching safe and quality outcomes. This is achieved by multifaceted and dynamic decision making processes that consider a wide range of variables (Yang, Hung and Chen 2015). Staffing shortage refers to an insufficient mix, number and experience level of registered nurses and ancillary staffs to proper care of the patients. Hospitals that have low nursing staffing hav e a tendency to have higher rates of poor patient outcomes. There lies a strong relation between adequate nurse-to-patient ratio and safe patient outcomes (Fram and Morgan 2012). Nurse staffing policies increase nurse staffing (Shin, Park and Huh 2014). However, authorised nurse staffing ratios without suitable mechanisms to provide help achieve targeted ratios have a tendency to force the health care settings, especially those settings which are concerned about safety, to develop tradeoffs in other investments or services that can have unintended negative results for their patients (Shin 2013). The present writing is a critical analysis of safe staffing levels and its impact on patient care and the health policies on this concern. Health care systems across the globe, including the United Kingdom, are facing many struggles to improve the quality of care and control the costs of care. In some countries, greater investment in hiring qualified nurses is an integral part of the strategy used by health care settings for improving the quality of care. However, in some, policymakers of health care sector seek substitute qualified nursing workforce with less expensive assistive staff. Many researches are present that throws light on this debate and tries to draw the conclusion on the relation between nursing staff and quality of life in hospital settings (Van den Heede and Aiken 2013). Higher registered nurse staffing has a vital relation with low rates of hospital-related mortality, cardiac arrest, failure to rescue and hospital-acquired infections. The influence of inadequate registered nurse staffing on the safety of the patients is strong and consistent in almost all care units in a hospital setting (Aiken et al. 2012). No studies directly do the task of examining the aspects that significantly influence policies for nursing staffing. Very few studies address the role of agency staff (Paek et al. 2015). In the context of nurse staffing issues, it is desirable to throw light on incidences that have taken place in the past and throw light on the impact of inadequate nursing staffing on patient care quality and overall functioning of the health care setting. One such incidence in the history of public health issues is the Stafford hospital scandal. The Stafford hospital scandal was a major concern in the history of public health as it highlighted poor care and the high rate among patients at a city hospital in England. The scandal took place in the late 2000s. Around thousand patients were found to be dying due to poor care over the time span of four years (Mohammed et al. 2013). In 2010, a complete public enquiry took place chaired by Robert Francis. The inquiry considered of strong evidence based on which actions were taken against the nurses. One of the reasons that contributed to such drastic decline in patient care was inadequate staffing. As a result of poor nursing staffing, dev astating results were witnessed. Issues of unsafe nursing staffing were thus highlighted (Francis 2014). The Nursing and Midwifery Board (NMC) of the United Kingdom held hearings for the nurses who were adjudged to be unfit for nursing practices (dailymail.co.uk 2014). The different health organisations of the country put forward guidelines for maintaining an appropriate nursing staffing levels at the hospital settings. Staffing levels have always been an issue. Patients have the ultimate right to receive care by appropriately experienced and qualified nurses. This right of the patients is enshrined within the National Health Service (NHS) Constitution (Nice.org.uk 2014). The NHS ACT 1999 makes overt the corporate accountability of the board for delivered nursing quality. The responsibility of the nurses regarding safe staffing is stipulated by the Nursing and Midwifery Council (NMC). This covers the overall registered nursing force in the country (legislation.gov.uk 2016). The report of the Health Select Committee 2009 states that insufficient staffing levels have been a major factor in undermining patient safety in many cases. In one year, more than 30,000 patient safety issues were recorded by the National Patient Safety Agency (NPSA) that has r elation with staffing issues. Short staffing can compromise on the care of the patients in a direct and indirect manner. Recurrent short staffing causes increased stress among the staffing and reduced staff well-being. This leads to high sickness absence and more leaving of the staff. No proper evidence suggest that NHS ward level staffing has witnessed improvement. NHS recommends that staffing planning must be taking place at all levels-regionally, locally and nationally. The results would ideally use regional and local plans. Having a strong base for planning staffing is critical, and it must be an integrated form (Safestaffing.org.uk, 2016). Ensuring staffing levels solely rely on the right establishment. To adjudge the number of staffs required for appropriate care requires the deep look into competencies and roles of all staff groups. Staffing levels will be affected to a great extent by how certain things are carried out, in terms of effectiveness and efficiency of processes. Changes that need to take place by the help of initiatives may bring alteration in the staffing level required for maintaining same care quality (England.nhs.uk 2016). Policy making for patient safety in relation to nursing staffing has some issues in it. One such key issue is that more work needs to be undertaken for determining optimal nurse staffing skill mixes and how needs have the tendency to vary across different health care settings. The limited evidence are not in the support of introducing a nurse in the direct role of care-giving below the highest level of registered nurse. The cost effectiveness of nursing staff decisions depends on short term and long term considerations. Evidence on relationships between patient outcomes, skill mix and costs is limited. Most researches are from the other countries, mainly the United States. More research in the United Kingdom is required to confirm whether relationships and assumptions of present studies hold for other health economies and nurse education systems (kcl.ac.uk 2016). Nurses must have a greater role in making up policies for health care. The reason is attributed to the fact that nurses ha ve a strong influence on the reduction of medical errors, improvement of patient safety, promotion of wellness, improvement of care quality and coordination of care by the healthcare system (Kitson et al. 2013). The NHS puts forward a policy to standardise staff groups of the procedures and processes for addressing staffing shortfall. It also addresses the expectation of National Quality Boards recommendations for policies for addressing staffing shortfalls. The policy has been implemented from March 2015, and the next date for review is February 2018. The aim of the policy is to promote safe staffing levels and adequate skill mix. This is in order to deliver high quality care. Patients have a right to be cared for by appropriately qualified and experienced staff in safe environments, and this is enshrined in the NHS Constitution. Trusts must ensure that they have the right staff, with the right skills, in the right place. This is a duty of the Trust Board and the Trust must demonstrate safe staffing in order to comply with Care Quality Commissions (CQC) regulatory framework and standards. Furthermore, the Nursing and Midwifery Council (NMC) (2008) makes it clear that all Registered Nurses a nd Midwives are professionally accountable for safe practice in their sphere of responsibility, ensuring that risk is managed appropriately. The roles and responsibilities of the health care settings are outlined in the policy. Each health care setting must have an agreed position in relation to safe nurse staffing and skill mix. Another responsibility is the final sign-off of safe nurse staffing and skill mix establishment, and to conduct regular establishment reviews to ensure that safe staffing and skill mix are being delivered operationally. All health care settings must comply with the national requirements (NQB) for monthly submission of Nurse staffing fill rates. Evidence based staffing levels must be taken to the Board for sign-off at least every six months. Any proposed changes to the nurse staffing and skill mix establishment, required to deliver service redesign projects, must be discussed at Board level. Heads of nursing teams must be accountable for staffing and skill mix in the clinical areas they are responsible for. They also hold responsibility for escalating the concerns present to the executive teams. L ead Nurses to have responsibility for managing day-to-day and potential risk in relation to nurse staffing and skill mix establishment in accordance with Trust policy, escalating to the Head of Nursing as required. Moreover, they are responsible for investigating any adverse effect related to skill mix and nurse staffing. Senior nurses are professionally accountable for safe nurse staffing and skill mix. They have responsibility for managing day-to-day actual and potential risk in their ward or department relating to nurse staffing and skill mix establishment. All staffs must ensure that insufficient staffing is addressed and taken into account on a daily basis. If inadequate staffing and skill mix is not resolved, it is identified via incident reporting and red flag events are recorded. They are also accountable for working with fellow staff to position staff effectively in line with their job description and code of conduct (Nursing Staffing Shortfall Escalation Policy 2016). The National Quality board (NQB) guidance 2013 outlines the expectations of NHS organisations regarding need of strong escalation processes of nurse staffing. The NQB guidance states that staff should be aware of the escalation policies in place, flag where they think staffing capacity and capability falls short of what is required and be able and prepared to use the escalation policies. All lead nurses must maintain a record of escalation, the reasons why and mitigations taken to address nurse deficiencies. All other nurses must undertake evaluation and risk assessment of the staffing levels by shift basis. All wards must have a record of decision making around nurse staffing where escalation has been required. Nurses may have a strong influence on health policy and this would protect the quality of care by access to required recourses and opportunities. Nurses have individual views on health care issues and influence health care policies in different ways. With a common understanding of nurses policy influence as a concept, nurses will recognize the importance of policy making in the health sector and their influence on this process and also on patients outcomes. Nurses have their own views on maintaining staffing levels and skill mix in health care settings. Therefore they must be taken into account and their views and opinion must be put focus while making policies in relation to nursing. NHS Trust Development Authority and Monitor recognise that agencies play an important role in the health care sector. National organisations including Monitor, National Institute for Health and Care Excellence (NICE), NHS, Department of Health (DH), Cabinet Office and the Treasury, are leading other workstreams to help trusts manage their temporary workforce spend. This includes increasing supply of permanent staff and clarifying guidelines on safe staffing. The proposed agency spending rules outlined in this paper are therefore part of a national programme of work to help trusts meet the complex workforce challenges facing the healthcare sector. In June 2015, the Secretary of State announced rules to help organisations reduce their spending on agencies. The proposal put up was that maximum hourly rates are to be paid by the trust. Use of approved frameworks for procuring agency staff must be mandatory. There must be an annual ceiling for total agency spending. The NHS spending has b een put focus on due to the overspending. It has been described as the worst for a generation. The seriousness of the spending allocation of NHS was thus highlighted. Overspending on shortfall of permanent staff, agency staff, inefficient use of permanent staff and difficulties in recruitment are constantly affecting NHS (gov.uk 2016). The Health and Social Care Act 2012 puts forward major changes to the NHS in England. The progressions specifically gives attention to general practitioners and different experts known as clinical commissioning groups (CCGs). The Act brings about the transfer of of a large portion of the obligations that previously resides with the Department of Health to politically independent NHS Commissioning Board which was then later called NHS England. Moreover, the Act brings into focus the health related monetory controller with a demand for making preparations for anti-competitive actions. The Act has provisions for extensive refurbishing of the basic structure of NHS England. It sets recommendations for options on financial matters. There has been much critical analysis of the actions taken up by the NHS. On on hand, the Health Minister was found to be stating that NHS has been doing good in maintaining fund over the lasr few years. On the other hand, the Health Secretary stated that the p resent government cannot be trusted with the funding issues. There may be a collision in the actions taken up the NHS. The policies have resulted in a downfall in services which has put forward longer waiting lists, difficulties for patients to access GP services. It has been noticed that 3billion has been wasted on reorganisation which sees frontline staffing levels reduced. With the NHs struggling to make sure that there is a safe staffing levels, there is a shortage found in nurse workforce. Cummings (2003) opines that by ensuring the proper right staff at the right palce nad at the right time, patients would be given the care they need and is supported by NICE. The author also suggests that on safe staffing for nursing care must be given by introducing red flag events that warn staff in charge that there are insufficient staffing levels on wards (massnurses.org 2016). The Royal College of Nursing recommends that health departments must undertake work needed for identifying the efficacy and prevalence of planning approaches for better nurse staffing. Inexpensive and effective systems need support by the different health departments. Staffing reviews require board level commitment. Decisions must not be taken in the vacuum, and all significant decisions must involve the nurses. Regular evaluation is needed and the results must be heeded and implemented in a constant manner (rcn.org.uk 2016). UNISON is a large trade union in the United Kingdom. A significant part of the organisation are NHS registered nurses and NHS managers and clinical support workers. The organisation puts up valuable comment in relation to nursing staffing (Gillen 2015). UNISON states that safe staffing levels have not witnessed improvement over the past year. This comes up in spite of the fact that government claims to have an increase in nursing numbers. The annual UNISON study conducted on 2015 showed that there is an issue of overstretched and demoralised nursing workforce, and inadequate staffing delivers undignified, unsafe and uncompassionate care for the patients. The respondents of the survey think that staffing levels have got worse since 2010. The survey carried out by UNISON states that staffs are still not able to take care of all the patients they are supposed to take care of. Some comments included that the government must always put patient care on the top of the priority list, and mon ey must not be the concern and that staff stress must be given more attention. Moreover, UNISON says that NHS is under operation in an environment where financial straightjacket is prevalent. As there is no money for funding adequate staffing levels, midwives and nurses are finding it difficult to keep their health services going. There is no doubt that midwives and nurses have no acceptance of the guidance that is present for nursing staffing as such guidance does not meet the requirements and need of the nurses either. This puts up the need for having a nationally set compulsory minimum patient-to-nurse ratio that is solely based on the needs of the patients (unison.org.uk 2015). The report comes up a year after the National Institute of Clinical Excellence (NICE) put up guidance on safe staffing levels. More than sixty percent of the respondents stated that NICE guidelines have not made any significant differences and staffing levels have not seen improvement. The survey reveals that when red-flag events occur as a result of a nursing staffing shortage, actions are not taken up in an appropriate manner at all times (Nice.org.uk 2014). UNISON is suggesting the National Institute for Health and Care Excellence (NICE) guidance to be amended so that care for eight patients or more is classed as a red-flag event. Red-flag events are those events that indicate emergency or need for immediate action on a certain issue. It is a demand that actions need to be taken up. NICE has drawn up a list of such red-flag events that can be reported by omissions in medication administration, lack of patient monitoring and delays made in pain relief intervention (Kleebauer 2014). The Berwick review into patient safety, undertaken on 2013, is an independent report from the Department of Health, the United Kingdom, on how to improve patient safety in the NHS. A significant part of this element is nursing staffing. The review puts up some valuable recommendations. Staffing levels must be steady with the proof on safe staffing and must be adjusted to the local context and patient acuity. The primary recommendation is that NICE must undertake steps for developing guidance based on data. Organisations must routinely analyse and give the proper response to local measures that are warning signals of safety issues like staffing levels (gov.uk 2016). The Department of Health, the United Kingdom, has put forward a report called Hard Truths that is a government response to the case of Staffordshire hospital scandal. In the report, it has been mentioned that all NHS bodies must ensure that all shifts and all wards must ensure that they have the necessary staffing level for patient care. The Care Quality Commission will monitor the actions taken and performance delivered so that no patient is put on the risk of harm and suitable staffing levels is one the core elements of the registration regime of the Care Quality Commission (gov.uk 2016). The Department of Health, the United Kingdom, has put forward a report known as the Patients First and Foremost report that is the first government response to the report of the NHS public inquiry on the scandal of Staffordshire. This report stated that proper staffing as measured by skills and a number of nurses is vital for giving proper care but minimum ratios, and staffing numbers lead to a lack of flexibility to seek a minimum level of staffing. The report recommends that the Care Quality Commission needs to use evidence-based tools for determining staffing numbers (gov.uk 2016). Ethical principles of health care comes into focus in the context of the need of delivering high quality care. Proper staffing is needed for maintaining ethics in the delivery of quality care. The ethical concerns that are present in delivery of nursing care are autonomy, beneficence, no-maleficence, justice or fairness. Emphasis is on establishing a relation, collaborative care and maintaining human dignity. The main aim is to do no harm to the patients and not neglect the needs of the patient. They must be given justified care (Lillemoen and Pedersen 2013). In conclusion, it can be said that on an overall basis, there is an accumulating proof of the relation between nurse staffing and outcomes of patients. This is specially in relation to higher skill mix of the nurses. There is emerging evidence that curvilinear relation lies between the two aspects, suggesting that cost-effectiveness of using registered nursing levels, as a tool for quality improvement will become less cost-effective. Policymaking must be done according to the fact and evidence present for the particular issue. A rapid change in thr health care sector, by implementing different policies, is crucial for enabling effective care to patients. Fundng issues is a major challenge in the path of high quality care. One such aspect is nurse staffing. In spite of political differences between all parties, the funding system within the NHS is in crisis it is under-resourced and unfair. Insufficient budgets appear to take the frontline. Changes in financial concerns are needed. In adequate staffing levels are impacting on treatment and the recovery process for patients within the NHS and other services including the adult health care service. A call for action is needed once achieved tangible rewards are ahead for the NHS staff and patients. There is a need to incentivise good health a better future is possible and nurses and other professionals are the leaders who can influence changes in a system that is under enormous pressure. References Aiken, L.H., Sermeus, W., Van den Heede, K., Sloane, D.M., Busse, R., McKee, M., Bruyneel, L., Rafferty, A.M., Griffiths, P., Moreno-Casbas, M.T. and Tishelman, C., 2012. Patient safety, satisfaction, and quality of hosptal care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States.Bmj,344, p.e1717. dailymail.co.uk, (2014).Just ONE nurse for 84 patients at Mid-Staffs death hospital: As court lays bare scale of neglect, still no official is held to account. [online] Available at: https://www.dailymail.co.uk/news/article-2564962/Nursing-staff-scandal-hit-Stafford-Hospital-set-fail-court-told.html [Accessed 14 Jan. 2016]. England.nhs.uk, (2016).NHS England Safe staffing. [online] Available at: https://www.england.nhs.uk/ourwork/safe-staffing/ [Accessed 14 Jan. 2016]. Francis, R., 2014. Culture, compassion and clinical neglectprobity in the NHS after Mid Staffordshire.Journal of medical ethics, pp.medethics-2013. Gillen, S., 2015. Unison calls on nurses and midwives to take part in staffing levels survey.Nursing Standard,29(22). gov.uk, (2016). [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/170701/Patients_First_and_Foremost.pdf [Accessed 14 Jan. 2016]. gov.uk, (2016). [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/270368/34658_Cm_8777_Vol_1_accessible.pdf [Accessed 14 Jan. 2016]. gov.uk, (2016). [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/226703/Berwick_Report.pdf [Accessed 14 Jan. 2016]. gov.uk, (2016). [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/453181/Agency_engagement_document.pdf [Accessed 15 Jan. 2016]. Hyun Shin, J., 2013. Relationship between nursing staffing and quality of life in nursing homes.Contemporary nurse,44(2), pp.133-143. kcl.ac.uk, (2016). [online] Available at: https://www.kcl.ac.uk/nursing/research/nnru/policy/Policy-Plus-Issues-by-Theme/Whodeliversnursingcare(roles)/PolicyIssue21.pdf [Accessed 14 Jan. 2016]. Kitson, A., Marshall, A., Bassett, K. and Zeitz, K., 2013. What are the core elements of patient centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing.Journal of Advanced Nursing,69(1), pp.4-15. Kleebauer, A. (2014). NICE calls for use of red flags to trigger immediate review of care.Nursing Standard, 28(46), pp.7-7. legislation.gov.uk, (2016). [online] Available at: https://www.legislation.gov.uk/ukpga/1999/8/pdfs/ukpga_19990008_en.pdf [Accessed 14 Jan. 2016]. Lillemoen, L. and Pedersen, R., 2013. Ethical challenges and how to develop ethics support in primary health care.Nursing ethics,20(1), pp.96-108. Mashimo, A., Akiyama, T., Fukui, T., Ueno, M. and Tanaka, A., 2013. Survey of the nurse staffing system including the patient classification system and issues in nurse resource management in japan.Journal of Nursing and Care S5-005. doi,10, pp.2167-1168. massnurses.org, (2016). [online] Available at: https://www.massnurses.org/files/file/Legislation-and-Politics/hospital_costs.pdf [Accessed 15 Jan. 2016]. Mohammed, M.A., Lilford, R., Rudge, G., Holder, R. and Stevens, A., 2013. The findings of the Mid-Staffordshire Inquiry do not uphold the use of hospital standardized mortality ratios as a screening test for badhospitals.QJM, p.hct101. Nice.org.uk, (2014).NICE unveils safe staffing plans for nursing care in wards | News and features | News | NICE. [online] Available at: https://www.nice.org.uk/news/article/nice-unveils-safe-staffing-plans-for-nursing-care-in-wards [Accessed 14 Jan. 2016]. Nice.org.uk, (2014).NICE unveils safe staffing plans for nursing care in wards | News and features | News | NICE. [online] Available at: https://www.nice.org.uk/news/article/nice-unveils-safe-staffing-plans-for-nursing-care-in-wards [Accessed 14 Jan. 2016]. Nursing Staffing Shortfall Escalation Policy. (2016). 1st ed. [ebook] Available at: https://file:///C:/Users/lap55/Downloads/09114%20Staffing%20Shortfall%20Escalation%203.0.pdf [Accessed 14 Jan. 2016]. Paek, S.C., Zhang, N.J., Wan, T.T., Unruh, L.Y. and Meemon, N., 2015. The Impact of State Nursing Home Staffing Standards on Nurse Staffing Levels.Medical Care Research and Review, p.1077558715594733. Potter, P.A., Perry, A.G., Stockert, P. and Hall, A., 2013.Fundamentals of nursing. Elsevier Health Sciences. rcn.org.uk, (2016). [online] Available at: https://www2.rcn.org.uk/__data/assets/pdf_file/0005/353237/003860.pdf [Accessed 14 Jan. 2016]. Safestaffing.org.uk, (2016).Safe Staffing Alliance | Demanding safe staffing levels to ensure quality nursing care. [online] Available at: https://www.safestaffing.org.uk/ [Accessed 14 Jan. 2016]. Shin, J.H., Park, T. and Huh, I.S., 2014. Nursing staffing and quality of life in western New York nursing homes.Western journal of nursing research,36(6), pp.788-805. unison.org.uk, (2015).Unsafe nurse staffing levels continue to put patients at risk | Article, News, Press release | News | UNISON. [online] Available at: https://www.unison.org.uk/news/article/2015/04/unsafe-nurse-staffing-levels-continue-to-put-patients-at-risk/ [Accessed 14 Jan. 2016]. Van den Heede, K. and Aiken, L.H., 2013. Nursing workforce a global priority area for health policy and health services research: a special issue.International Journal of Nursing Studies,50(2), pp.141-142.