Following the public inquiry into healthcare at the Mid Staffordshire NHS Foundation Trust the Inquiry chairman, Robert Francis QC, concluded that there had been ‘serious failings’ that had caused ‘appalling suffering’. The Public Inquiry (2013) made many recommendations including those that relate to safe levels of care, and how the Trust and the public can be reassured about levels of care and raise concerns where necessary.
In response, the Chief Nursing Officer for NHS England has published guidance to support Trusts to make the right decisions about nursing, midwifery and care staffing capacity and capability. This clarifies the expectations on all Acute Trusts to ensure that every ward and every shift has the staff needed to ensure that patients receive safe care.
The National Institute of Health Care and Excellence produced some guidance on safe staffing for nursing in adult inpatient wards in July 2015.
NHS England and the Care Quality Commission (CQC) have required all Trusts to publish ward level information on whether they are meeting their planned staffing requirements. This data will be produced every month. At Homerton University Hospital NHS Foundation Trust the Safe Staffing framework and Safer Nursing Care Tool (SNCT) will inform the levels of staffing required on completion of a period of data collection. The Director of Nursing reviews and reports safe staffing to the board on a monthly basis, with a formal report to the board twice a year.
The trust is committed to ensuring the right people, with the right skills, are in the right place at the right time and to provide timely and transparent reporting of staffing levels.
Staffing levels will be recorded and updated on a daily basis on each ward. Every month the Trust will publish a summary of the previous month’s staffing levels on this website.
The trust will analyse the data to ensure that nursing levels are sufficient to provide safe nursing care. Where actual numbers of staff fall below planned levels the trust will take remedial action.
The data explained
The Trust is required to show on a daily basis, for every ward, the difference between the planned number of staff required and the actual number of staff that worked. This difference is shown as a percentage – where the percentage is less than 100% then actual numbers of staff are lower than planned, while a percentage greater than 100% represents more staff than planned.
The actual numbers of staff employed on any day might differ from the plan for very good reasons. For example - the ward may have fewer patients than normal and this would lead to a decrease in the numbers of staff required. Alternatively, the ward may have admitted a very ill patient who requires 1:1 care and this has led to a higher number of actual staff in comparison to the plan.
- Registered staff include all qualified nurses and midwives
- Unregistered staff include unqualified healthcare and midwifery assistants
- Day and night shifts – A night shift is one within which midnight falls. Any other shift is a day shift.