8.4 WELL-LED
Safe Staffing Levels
Performance
identifiers risk
to delivery
Strategic Objectives
2. Delivery of high quality safe care
5. Best practice employer
No
BAF Risks
2.1 - CQC compliance
5.2 - Recruit, retain & develop
workforce
No
Trust Strategy
Workforce Strategy
No
CQC Outcome
Outcome 4 (care and welfare) and 13
(staffing)
No
Quality Priority
Skilled & Trained Workforce
No
The National Quality Board (NQB) document “How to ensure the right people, with the right skills, are in the right place at the right time” (November 2013) set out
expectations for providers of NHS services. Expectation 7 includes the requirement for boards to receive monthly updates on workforce information, including the number
of actual staff on duty compared to the planned staffing level (day and night and registered and care staff), reasons for any gaps and actions taken to address these and
impact on key quality and outcome measures. A more detailed Board Report is required 6 monthly and this will be included in Q1 and Q3 reporting.
NHS England have subsequently provided further information and a monthly UNIFY submission to record the 'fill rate' has been developed. In addition to this submission
Trusts must publish actual v planned fill rates on a ward by ward basis on their webwards with a link to this from the NHS Choices website. The Board can receive monthly
exception reports, providing the full information is published.
This month - Of the 78 clinical teams providing in-patient services 16 teams reported an occasion of registered nurse staffing shortage and 13 teams care staff shortage.
The graphs provide the 'fill rate' for those teams reporting less than 100%, by staff group and time of day and also 'fill rate' per clinical speciality as recorded on UNIFY.
The table on the left provides a summary of Division and Trust performance.
The exception report for each of these clinical teams outlining the reasons for the shortfall are included overleaf.
DAY % of wards registering a shortage
NIGHT wards registering a shortage
Health
Partnerships
tbc
Local
Services
DAY wards registering a shortage
Forensic
Services
total wards
Trust Actual
Registered nurses
Fill rate - wards reporting an occasion of
staffing shortgage within the month
Trust Target
This Month
78
42
30
6
8
0
8
0
10%
0%
27%
0%
8
3
5
0
10%
7%
17%
1%
tbc
NIGHT % of wards registering a shortage
Trust Actual
Forensic
Services
Local
Services
Health
Partnerships
Trust Target
Fill rate - by service
97.3%
96%
94%
92%
90%
88%
86%
RAMPTON HOSPITALJuniper Ward
RAMPTON HOSPITAL - Firs
Ward
LINGS BAR HOSPITAL Castle ward
LINGS BAR HOSPITAL Forest ward
The Wells Road Centre Seacole ward
RAMPTON HOSPITAL Quantock Ward
UNIVERSITY hospital - A43
ward
BASSETLAW hospital -B1
ward
HIGHBURY HOSPITAL Redwood 1 ward
HIGHBURY HOSPITAL - The
Willows
HIGHBURY HOSPITAL - Orion
Unit
Quality Performance Report MONTH 2 May 2014/15 (Board Report June 2014)
100%
NIGHT - CARE STAFF - Fill rate - sites registering less than
100%
98%
BASSETLAW HOSPITAL - B2
ward
KEY TO ALL CHARTS
99.2%
99.6%
99.7%
99.8%
99.9%
99.9%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100.0%
100%
98%
96%
94%
92%
90%
88%
86%
THORNEYWOOD UNIT
Child Adolescent Psychiatry
Learning Disability
Adult Mental Health
Low Secure
High Sec PEAKS
Lings Bar Rehabilitation
Mental Health Older People
Substance Misuse Services
Hospices
Child Development
Med Sec Wathwood
Med Sec Arnold Lodge
High Sec Womens & Personal Disorder
High Sec Mental Health & Learning…
DAY - CARE STAFF - Fill rate - sites registering less
than 100%
UNIVERSITY HOSPITAL A43
2
33%
HIGHBURY HOSPITAL The Willows
0
0%
BASSETLAW hospital - B2
ward
4
10%
MILLBROOK MENTAL
HEALTH UNIT -Lucy wade
+ PICU
6
8%
tbc
NIGHT % of wards registering a shortage
The Wells Road Centre Seacole ward
0%
RAMPTON HOSPITAL Quantock Ward
23%
HIGHBURY HOSPITAL Orion Unit
0%
NIGHT - REGISTERED NURSES - Fill rate - sites registering
less than 100%
RAMPTON HOSPITAL Hambleton Ward
0
9%
96%
MILLBROOK MENTAL
HEALTH UNIT-Lucy…
6
7
96%
BASSETLAW HOSPITAL B1 ward
30
0
97%
MANSFIELD COMMUNITY
HOSPITAL -Alexander…
NIGHT wards registering a shortage
42
7
97%
HIGHBURY HOSPITAL Redwood 2 ward
tbc
DAY % of wards registering a shortage
78
98%
HIGHBURY HOSPITAL Redwood 1 ward
DAY wards registering a shortage
98%
THORNEYWOOD UNIT
total wards
99%
UNIVERSITY hospital A43
ward
Care staff
Fill rate - wards reporting an occasion of
staffing shortgage within the month
99%
HIGHBURY HOSPITAL Orion Unit
This Month
100%
DAY - REGISTERED NURSES - Fill rate - sites registering
less than 100%
100%
8.4 .1 WELL-LED
Safe Staffing Levels
Site Name
Ward name
UNIFY Speciality
Average fill
Average fill
rate rate - care staff
registered
(%) Day
nurses (%) Day
Average fill
rate registered
nurses (%)
Night
Average fill
rate - care staff
(%) Night
Reason for shortfall
Impact on
quality of
care or safety
LOCAL SERVICES DIVISION
Bassetlaw
B1
715 - OLD AGE PSYCHIATRY
99.1%
98.4%
100.0%
100.0%
Increase in clinical activity, and bank being unable to fill the shift
None
Millbrook
Lucy Wade
710 - ADULT MENTAL ILLNESS
99.3%
100.0%
98.4%
100.0%
Long & Short term sickness in which the ward unable to cover the shift by back due to the timing of the
person ringing in sick. Bank staff cancelled the shift at short notice
None
Highbury
Redwood 1
710 - ADULT MENTAL ILLNESS
98.8%
98.4%
100.0%
100.0%
Increase in clinical activity, and bank being unable to fill the shift
None
Highbury
Redwood 2
710 - ADULT MENTAL ILLNESS
98.8%
100.0%
100.0%
100.0%
Increase in clinical activity, and bank being unable to fill the shift
None
QMC
A43
710 - ADULT MENTAL ILLNESS
97.6%
98.9%
98.4%
100.0%
Vacancies compounded the flexibility to cover short term sickness and the bank being able to cover.
None
97.6%
97.3%
96.8%
100.0%
Timing around staff ringing in sick or Bank team unable to cover the shift
None
None
Highbury
Orion Unit
700 - LEARNING DISABILITY
Thorneywood
Thorneywood
Unit CAMHS
711 - CHILD AND ADOLESCENT
PSYCHIATRY
98.0%
88.7%
100.0%
100.0%
Unit has issues with long term sickness and staff on Maternity leave. Shifts could not be covered by
Bank staff
Highbury
Willows PICU
710 - ADULT MENTAL ILLNESS
100.0%
9780.0%
98.4%
100.0%
Increase in clinical activity, and bank being unable to fill the shift
None
Alexander House
Alexander
House
700 - LEARNING DISABILITY
9880.0%
100.0%
100.0%
100.0%
Bank staff cancelled the shift at short notice
None
Bassetlaw
B2
710 - ADULT MENTAL ILLNESS
100.0%
94.6%
94.8%
100.0%
Long term sickness, with the Trust Bank being unable to cover the shift
None
HEALTH PARTNERSHIPS DIVISION
Lings Bar Hospital
Forest Ward
314 - REHABILITATION
100.0%
100.0%
100.0%
98.4%
Staff member in attendance sent home off sick and unable to cover from agency at short notice.
None
Lings Bar Hospital
Castle Ward
314 - REHABILITATION
100.0%
100.0%
100.0%
98.4%
Staff member ‘sick’ note lasted longer than expected.
None
Unplanned emergency patient admission to local general hospital at night requiring staff to escort and
remain with the patient. Staff were released from these areas to facilitate the escort.
FORENSIC SERVICES DIVISION
Rampton Hospital
Firs Ward
712 - FORENSIC PSYCHIATRY
100.0%
100.0%
100.0%
98.4%
Rampton Hospital
Juniper Ward
712 - FORENSIC PSYCHIATRY
100.0%
100.0%
100.0%
98.4%
Rampton Hospital
Hambleton
Ward
712 - FORENSIC PSYCHIATRY
100.0%
100.0%
96.8%
100.0%
Rampton Hospital
Quantock Ward 712 - FORENSIC PSYCHIATRY
100.0%
100.0%
97.7%
91.3%
Wells Road Centre
Seacole Ward
100.0%
100.0%
97.9%
96.7%
712 - FORENSIC PSYCHIATRY
Staff released to facilitate out of grounds (the same incident linked to Quantock staffing exception
Report)
Quantock on two occasions supplied staff in order facilitate an out of grounds hospital appointment from
the high dependency ward following an incident, however, Quantock Ward was the most suitable ward
for releasing staff.
Sudden and unforeseen admission late evening. Staff depleted from other wards to support admission.
Minimal
None
None
None
PROPOSED ACTION
Local Services -The majority of the shortfall in staff was unavailability of the staff bank to cover shifts. The reasons for this are being explored to determine what action can be taken.
Health Partnerships -No specific actions required
Forensic Services - No specific actions required. In all cases the shortfall was due to unexpected clinical activity or the need to unplanned escorts to acute hospitals and clinical activity on all wards was reviewed to determine where reducing staffing
would have the least impact on clinical care and safety.
Quality Performance Report MONTH 2 May 2014/15 (Board Report June 2014)