Safe Staffing in Acute Hospitals Elaine Inglesby-Burke Executive Nurse Director Salford Royal NHS Foundation Trust

Staffing levels should be: Consistent with the scientific evidence Adjusted to patient acuity and local context Made public and easily accessible to patients and carers NICE will produce definitive guidance on safe and efficient staffing levels in a range of NHS settings Staffing

Staffing Expectations 1.Boards take full responsibility 2.Processes are in place to enable staffing establishments 3.Evidence-based tools 4.Culture where staff feel able to raise concerns 5.Multi-professional approach 6.Sufficient time to fulfil responsibilities 7.Boards receive monthly updates on workforce information 8.Clearly display information about staff present on each ward/department 9.Providers secure staff in line with their workforce requirements 10.Commissioners get assurance that the right people, with the right skills, are in the right place at the right time

The Patient Experience Report provides information about feedback received from Salford Royal’s patients and includes: 1.Near Real-time Patient Feedback question changes Highlighting the reduction of questions asked 2.The Nursing Assessment and Accreditation System (NAAS) Continually improving picture. 25 wards now at ‘SCAPE’ status. The Community Assessment and Accreditation System (CAAS) recommenced January 2014 following the recruitment of a Corporate Matron. The Outpatient Assessment and Accreditation System (OPAAS) commenced in May areas assessed, 5 green, 1 amber. 3.Staffing Overview Update - link to patient experience, SRFT approach and current actions described within the paper.

Ratios – of what to what? Staff erosion – from plans to reality Planned staffing (Full budgeted establishment) Employed staff in post (Establishment minus vacancies) Available Staff (staff in post minus absent staff) Planned staff for each shift (off-duty) Actual staff per shift (Planned minus unfilled gaps)

What’s your role in ensuring staffing levels are safe? Have you got it right in your organisation? What tools are being used to plan staffing to match patient need and workload? Do you know the RN:pt ratios where you work? How do they compare to elsewhere? Are professional guidelines (eg. in to ITU, neonates) followed? Would normative staffing help? How do you know when you've got it right...or wrong? How is quality being measured? Is it being related to differences in staffing? What can you do?

Safe staffing is your smoke detector for safe care and improved performance Know your business