The National Quality Board, sponsored by Jane Cummings, Chief Nursing Officer in England, published new guidance in November 2013 to support providers and commissioners to make the right decisions about nursing, midwifery and care staffing capacity and capability: 'How to ensure the right people, with the right skills, are in the right place at the right time : A guide to nursing, midwifery and care staffing capacity and capability'.
There are nine key expectations that apply to our Trust:
- Boards take full responsibility for the quality of care provided.
- Processes to be in place to enable staffing establishments to be met on a shift by shift basis.
- Evidence based tools to be used.
- Clinical and Managerial leaders foster a culture of professionalism and responsiveness where staff feel able to raise concerns.
- Multi-professional approach is taken when setting staffing establishments.
- Sufficient time to undertake caring duties in practice.
- Boards receive monthly updates on workforce information and staffing capacity and capability which is discussed in public Board meetings at least every six months.
- Clearly display information about the nursing and care staff present on each ward, clinical setting or service on each shift.
- Providers to take an active role in securing staff in line with their workforce requirements.
In line with this guidance, the Trust published its first full review of inpatient ward staffing in May 2014 a copy of the board report can be found via this link. The next full establishment review is due to be reported in October 2014. We also publish our core planned and actual staffing levels on each ward, as part of our Quality and Performance report. (this document is updated each month and can be found on our Trust Board Papers page).
The staff on the wards will, at times, take the decision to work below their planned numbers, this would be when they level of need on the ward can be safely managed with fewer staff. This might be due to there being vacant beds on the ward or due to the other activities on the ward not occurring, such as Doctors meeting at weekends and bank holidays. A more detailed explanation of why staffing was not always at the planned level can be found in the Board staffing report.
We have published the agreed core planned staffing levels for each ward (see above right). The table shows the area or locality the ward is based in, the ward type, the ward name and the number of beds. It then describes the number of staff that should be on the ward for each shift. The UNIFY Data (see above right) shows the planned and actual shifts worked on a monthly basis.