Safe staffing

The National Institute of Health and Care Excellence (NICE) released a safe staffing guideline (2014) making recommendations on safe staffing for nursing in adult inpatient wards in acute hospitals.

From June 2014, all hospitals are required to publish monthly information about the number of nursing and midwifery staff working on each ward, together with the percentage of shifts meeting safe staffing guidelines.

We are committed to ensuring that levels of registered and unregistered, match the acuity and dependency needs of patients within clinical areas across the Trust. This includes an appropriate level and skill mix of nursing staff to provide safe and effective care. These staffing levels are viewed along with reported outcome measures, and for inpatient wards and departments – “registered nurse to patient ratios”, the percentage skill mix ratio of registered staff to unregistered staff and the number of staff per shift required to provide safe and effective patient care.

There is a requirement for all Trusts with in-patient beds to publish their staff fill rates (actual versus planned) in hours, taking into consideration day and night shifts and Registered and Unregistered staff. This information appears on the NHS Choices website. Patients and the public are now able to see how hospitals are performing on this indicator on the NHS Choices website. This data sits alongside a range of other safety indicators.

The staffing huddle identifies any shortfalls in staffing, and those present, will identify and agree next steps in order to promote safe staffing and maintain patient as well as staff safety. Any day-to-day issues with nurse staffing are resolved at this meeting or managed by the Clinical Manager, Site Manager or Duty Manager when on shift out of hours.

When staffing levels fall short of the expected or required levels and attempts to increase the hours of part-time staff or offering time in lieu have been unsuccessful, the use of (1) Staff Bank, (2) staff overtime then (3) agency staff should be considered in this order

In recognition of the valuable contribution our senior nurses make to patient care, our Ward Nurse Managers (Sisters/Charge Nurses) now have a supervisory role across the working week. This means that they are, in addition to the rostered nurses on duty, visible to patients and families and focussed on leading the nursing team in enhancing the quality and safety of care delivered on their wards.

Each inpatient ward is also required to publicly display staff numbers on a shift by shift basis on a Staffing Board. Staffing information is required to be updated at the start of each shift by the nurse in charge – detailing the number of expected staff on each shift together with the actual number of staff on each shift. Any shortfalls in numbers will be managed as per the identified process within this policy

Each month we publish a template of the planned and actual numbers of nursing staff who were on duty on each ward.

Information about nursing staffing levels for our wards and services can be found below.