"High quality, compassionate care is about people, not institutions. In every ward and clinic, in every hospital, health centre, community service and patients home across the country, nursing, and care staff work to provide care and compassion to people when they need it – whether it is at the beginning, or end of their life; in times of illness or uncertainty; or as part of helping people with long term conditions to stay as healthy and live as independently as possible.
"Getting the right staff with the right skills to care for our patients all the time is not something that can be mandated or secured nationally. Providers and commissioners, working together in partnership, listening to their staff and patients, are responsible and will make these expectations a reality."
Jane Cummings, Chief Nursing Officer for England
Board Assurance (Unify reports)
We take full responsibility for the quality of care provided to patients, and as a key determinant of quality, take full and collective responsibility for nursing and care staffing capacity and capability. Our Board ensures there are robust systems and processes in place to assure themselves that there is sufficient staffing to provide high quality care to patients on all wards, clinical areas, departments, services or environments day or night, every day of the week.
We submit our staffing levels nationally on a monthly basis, and monthly data is reported to our Board. The report give a percentage figure whereby 100 percent would indicate a full: as expected roster. Where we see shift fill rates below 80% and above 130%, we gives reasons for the exceptions and inform the Board as to the required actions taken. You can view some of our reports below. From September 2018 onwards this information is presented through our integrated quality and performance report.
We work together to review our in-patient staffing establishments on a six monthly basis. We facilitate this as a workshop, with representatives from all of our care groups coming together to review our establishments. This takes account of patient need first and foremost, and in recent times has helped us to plan how we will increase our peer workers (experts by experience) into our establishments as well as the new Nursing Associate role. Please see below the reports that we prepare for our Board.
In patient staffing escalation policy (Safer staffing exception reports)
We have a process in place for monitoring staffing on a shift by shift basis on all of our wards. There is also an in patient escalation policy in place which details the process for escalating any concerns and ensuring actions are taken to ensure that our wards are at a safe level for staffing. Ward Managers and Service Managers monitor this on a shift by shift basis and the ward manager will step in to work clinically if required due to staff shortages. By doing this, we are able to ensure we have qualified staff on duty at all times. We are currently updating our In-patient staffing escalation policy and will share it here as soon as we have agreed it. Please see below the reports that we prepare for our Board.
Recruitment and Retention
We have ongoing work in place to address our recruitment and retention of staff. We address this in our professional strategies and our people strategy. We are pleased that we are recruiting up to 100% of our student nurses when they qualify. This is as much as a 60% increase on two years ago! We have creative recruitment and retention initiatives and are currently being supported by NHS Improvement to implement a retention programme. This is being led by the trust’s Deputy Director of Nursing and Practice, in partnership with the Deputy Director of HR and care groups. Our aim is to recruit and then retain committed and caring staff that have the required skills to best care for our patients in a sustainable way.