Nursing & Midwifery Staffing Levels

From June 2014 all hospitals are required to publish information about the numbers of nurses and midwives working on each ward on their website. The initiative is part of the NHS response to the Francis Report, which called for greater openness and transparency in the health service.

The National Quality Board has published guidance entitled: “How to ensure the right people, with the right skill, are in the right place at the right time: a guide to nursing, midwifery and care staffing capacity and capability.”

The document can be viewed by clicking here.

6 Monthly Reports

It is a requirement every 6 months for the Trust Board to receive a report following a patient acuity and staffing review. The last six month Board paper was in July 2018 can be viewed by clicking here.

The Trust Board receive a monthly update, which includes the Unify return and monthly staffing return for each area. This can be accessed below.

The Trust displays three months of reports on this webpage but all Board papers can be accessed by clicking here.

The Trust Board recognises that although every area is allocated a budget and establishment there are times when planned staffing numbers are over or under the numbers supported in the budget. This may be due to the need for additional staff to provide one –to-one nursing or midwifery care to patients. Conversely, a reduction in staffing may be planned due to a reduction in patient numbers and unoccupied beds.

Monthly Reports

The staffing levels are reported to the Trust Board monthly.

Nursing and Midwifery staffing levels can be viewed by ward or department. Click on each month to view.

Nursing and Midwifery staffing levels

During November one red flag was declared for staffing. On 3 occasions senior oversight by the DHoN /matron was required to support reallocation of staff to ensure patient safety was maintained at all times.

Surgery has experienced a very challenging month due to staff vacancies across all areas; this was effectively managed  via safety huddles led by the Head of Nursing and surgical matron team. Clandon, Ewhurst and Bramshott wards are currently supporting additional beds over the winter period and this has required an increase in the numbers of untrained staff to ensure 1:1 care and to support additional capacity.

Medicine has seen a high number of patients who required 1-1 care, including 7 patients in the trust with DOLS . This has led to a higher use of untrained staff to maintain safety.

During October Albury, Eashing, Merrow, Millbridge, Hindhead wards all required additional HCA’s to support 1-1 care for patients who were at high risk of falls or required 1-1 care to support mental health care needs.

The emergency department experienced 5 shifts during the month due to vacancies that were not covered by bank or agency staff.  In all these incidents the nurse in charge of the shift was supported to ensure the safety checklist was completed for all patients in the department.  In EAU there were a reported 3 red shifts.  Two of these related to vacancy and also a patient under a section 2 of the MHS who required RMN nursing  – however these shifts were unfilled due to lack of availability.  The department was supported by the alcohol liaison team to provide advice to support safety of the patient with mental health needs.

Maternity recognises that there is a shortfall in the number of untrained staff for some night shifts. Staff were redeployed from other areas to ensure that safety was maintained. Recruitment plan in place which will have a positive impact on November’s return.

When there has been inability to fill RN shifts on the surgical wards vacant shifts have been downgraded unfilled to support patient safety . Ewhurst  and Frensham have used additional Patient sitters to support  high risk patients.

The Trust reports to Unify on a monthly basis

Unify Returns

Monthly Reports

Staffing levels are displayed daily for patients and visitors in all our wards and show the planned and actual nursing and midwifery staff on duty.

Further information

Nursing & Midwifery Strategy 2017 – 2022

©2018 Royal Surrey County Hospital

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