At Newcastle Hospitals, we take patient safety very seriously. As well as ensuring the best clinical outcome from the care we deliver, we aim to provide you with healthcare at its very best with people at our heart, and are proud of the nursing and midwifery care we provide in all of our hospitals.
Staffing is complex and not as simple as just numbers. It requires understanding about the skills of staff and workload on a ward at a particular time.
Nurse staffing is constantly being reviewed and considered when there are changes in services.
All of our wards have both senior and junior Sisters and, or Charge Nurses, and are supported by Matrons and Associate Directors of Nursing. This provides a professional framework to support safe and effective staffing.
Nurse staffing review
Since 2013/2014, we have been undertaking reviews of Nursing and Midwifery staffing. From April 2014 we have also been regularly using the ‘Safer Nursing Care Tool’ (SNCT) and Birth Rate Plus to help inform our reviews. This tool measures each patient’s dependency/acuity on a daily basis.
A calculation is applied to determine the number of staff required to care for those patients. The SNCT and Birth Rate Plus were endorsed by NICE in September 2014 and again in 2018, and have been promoted by NHS England/Improvement as the primary establishment setting tool nationally.
These tools provide us with a snapshot in time and are used for information about trends. The results of the SNCT and Birth Rate Plus, along with the professional judgment of the Sisters, Charge Nurses, Matrons and the clinical workforce team, were all used to determine each ward’s staffing levels. In line with National Quality Board guidance, an in-depth review of nursing staffing and establishments is undertaken yearly with a review at 6 months.
Newcastle Hospitals continually monitor the Nursing workforce as services grow and develop, and have invested in additional posts as part of the Nurse Staffing Review process.
Publishing staffing information
All hospitals are required to publish information about staffing levels. This means, the number of Nurses, Midwives and support (care) staff working on our wards and departments. This is displayed separately for day and night duty and tells you how close the actual staffing levels are compared to the planned staffing levels.
From June 2016, Care Hours per Patient Day (CHPPD) has been added to the data to be published. This is calculated by dividing the number of staff on duty over a 24 hour period by the number of patients on the ward at 23.59 hours. This is provided as an overall figure and broken down by registered professionals and support staff. Wards are expected to vary as patient acuity / dependency is not accounted for in this calculation.
In addition, wards which include day case beds or outpatient areas will have a higher ratio as fewer patients will be on the ward at 23.59 hours.
The full reports are available from the data files below. Some of the figures may be over 100% and this is due to the ward having more than the planned number of staff. This is likely to be as a result of a shortfall in one grade of staff being replaced by another to ensure adequate overall numbers are on duty to provide care or, on occasions when additional staff are required to meet specific demands on the ward, such as enhanced care observation of patients with unexpectedly complex needs.
Of course, like every other hospital, we do have occasions where the planned staffing levels are not achieved due to staff sickness or other legitimate reasons. At Newcastle Hospitals we have Senior Nurses on duty 24 hours a day with clear escalation processes to ensure safe staffing levels are maintained. We also display both actual and planned staffing on a shift by shift basis on all of our wards for patients and visitors to see.
In 2018, Newcastle Hospitals invested in an application within our electronic rostering system called SafeCare, which enables the Senior Nursing team to deploy staff efficiently and safely throughout our hospitals.
Any daytime shortfall of registered staff below 85% is reviewed at the Nurse Staffing and Clinical Outcomes group, and reported to the Executive Chief Nurse with an explanation of the shortfall and cross referencing the fill rates with CHPPD metrics.
Safe Staffing updates are also regularly provided to the Trust Board, a copy of which can be found at the link below:
Public meetings of our Board of Directors
