Agenda Item 8(v)
Board of Directors Meeting
30th April 2014
SOUTH ESSEX PARTNERSHIP UNIVERSITY NHS FOUNDATION TRUST
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 report.
1.0
PURPOSE OF REPORT
The purpose of this report is to provide the Board of Directors with a further update on
progress in respect of Safer Staffing. As the first public paper, this update is a summary of
actions taken since the project commenced to provide an overview of progress, work
underway and planned.
2.0
UPDATE
Previous reports outlined the 10 expectations set by the National Quality Board (NQB)
around delivering safer staffing and this report provides further update on the work being
undertaken to deliver the 9 provider expectations. The Task and Finish Group, led by the
Executive Director of Clinical Governance and Quality / Executive Nurse, continues to meet
weekly to monitor and progress the project. An overview of work in each area is summarised
below:1. Boards 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,
midwifery and care staffing capacity and capability:
i.
A presentation to introduce the project was delivered at a Board development
session.
ii.
Meetings have been held with the Chair and Non-Executive Directors to discuss
progress on the project plan and triangulating staffing information with nurse sensitive
outcome measures in future Board reports.
iii.
The Trust has actively engaged with other NHS provider organisations in order to
share learning and practice.
iv.
Contact has been made and sustained with the Mental Health and Learning Disability
Forum pilot group to ensure work remains aligned to national developments.
2. Processes are in place to enable staffing establishments to be met shift-by-shift:
i.
The shift-by-shift reporting system in place in Beds and Luton Mental Health Services
has been replicated and implemented across all inpatient areas. Reporting has been
live since 1st April 2014.
ii.
Operational teams continue to be supported by the Clinical Governance and Quality
Directorate; mechanisms such as a centralised safer staffing email account have
been put in place to facilitate reporting and collation.
iii.
Work has been taken forward to further refine the data collection tool to capture
actions being taken to address staffing issues. It should be acknowledged that
planned staffing levels not being met is not necessarily a clinical risk on a shift-byshift basis as local leads will take appropriate actions according to the dependency of
the ward and the number of inpatients to ensure potential risks are minimised and
appropriate staffing support is available.
iv.
Widening the use of e-rostering to deliver this information going forward is planned to
take place once the system incorporates bank staffing. This is not expected until late
summer and the current system will continue until then.
3. Evidence-based tools are used to inform nursing, midwifery and care staffing
capacity and capability:
i.
Nationally developed evidence-based tools have been applied across all inpatient
units in both community and mental health services. Data collection took place over
1-4 weeks for each unit in accordance to service type and focussed on local
dependency and acuity to provide recommendations based on best-practice.
ii.
Meetings are progressing in each area with the Executive Nurse and Lead Nurses to
triangulate the recommendations from the tools with professional judgement. A full
report detailing the outcomes and requesting Board agreement for establishments will
be produced in May.
4. Clinical and managerial leaders foster a culture of professionalism and
responsiveness, where staff feel able to raise concerns:
i.
A trust-wide whistleblowing policy is in place.
ii.
Staff can raise anonymous concerns via the ‘I’m worried about’ section on the intranet.
iii.
Datix allows any staff member to formally report staffing issues.
iv.
Work on the staff intranet site is being undertaken by HR and Communication leads
to develop clearer communication to staff on how to raise a concern.
v.
The Nursing Strategy has been disseminated amongst all teams across the Trust to
further reinforce the 6 C’s.
vi.
Local escalation plans are being reviewed by operational teams and a set of
centralised guidelines are currently being developed.
5. A multi-professional approach is taken when setting nursing, midwifery and care
staffing establishments:
i.
Work to review establishment records was undertaken with the involvement of the
project manager, finance and workforce.
ii.
As outlined above, meetings between the Executive Nurse and Lead Nurses to
review the establishments are presently being arranged.
iii.
Discussions have been undertaken across SMTs to update on work in progress and
gain wider involvement of the multi-disciplinary team.
6. Nurses, midwives and care staff have sufficient time to fulfil responsibilities that are
additional to their direct caring duties:
i.
Recommendations on this will be provided to the Board in May following the full
establishment review for each area.
7. Boards receive monthly updates on workforce information, and staffing capacity
and capability is discussed at a public Board meeting at least every six months on
the basis of a full nursing and midwifery establishment review:
i.
Monthly updates have been submitted to the Executive Team and Board. Going
forward monthly updates will include information on the percentage of shifts being
covered, actions taken to address staffing issues, significant trends/hotspots and
relevant nurse sensitive outcome metrics. The first monthly report in this format will
be provided in June following full establishment review.
ii.
The results of the full nursing establishment reviews across all SEPT inpatient areas
will be presented to the Board in May.
8. NHS providers clearly display information about the nurses, midwives and care
staff present on each ward, clinical setting, department or service on each shift:
i.
Boards containing information on staffing each shift, the registered nurse in charge of
shift and the uniforms worn by clinical staff are being rolled out across all inpatient
areas.
ii.
Inpatient information packs are being reviewed with local teams to raise awareness of
the wider MDT by providing details on the roles of all staff working on the unit.
.
9. Providers of NHS services take an active role in securing staff in line with their
workforce requirements.
i.
Robust workforce plans are in place.
ii.
The Trust has a representative at workforce partnership groups which feed into the
regional LETBs.
The Task and Finish Group will continue its oversight of workstreams. It is proposed that
community services are included as a second stage of the project in line with work being
taken forward nationally.
3.0
FURTHER ACTIONS
1. Complete the full establishment review by the use of professional judgement in order
to triangulate establishment figures and recommendations from evidence-based
tools.
2. Present the first 6 month report to the Board of Directors in May which will include the
results of the full establishment review, recommendations on safer staffing levels and
the potential financial implications for these. Monthly reporting will commence
following this in June.
3. Further refine the data collection tool to ensure we capture detailed qualitative
information in relation to causes, mitigating factors and actions being taken to
address staffing levels.
4. Develop a strategy for communicating with service users, carers, internal stakeholder
and the public.
5. Finalise escalation guidance.
4.0
RECOMMENDATIONS
It is recommended that the Board:
1. Note the contents of this report
2. Review and agree actions
3. Identify any further work required to be taken forward.
5.0
ACTION REQUIRED
The Board is asked to:
1. Note the contents of this report
2. Review and agree actions
3. Identify any further work required to be taken forward.
Report prepared by
Sharan Johal, Project Manager
On behalf of
Andy Brogan
Executive Director of Clinical Governance and Quality/Executive Nurse