ENC 7
Meeting
Trust Board
Date
29th May 2014
Title of Paper
Monthly Staffing Update Report
Lead Director
Kathryn Halford, Interim Director of Nursing
Author
Kathryn Halford, Interim Director of Nursing
PURPOSE OF THE PAPER
To update the Board staffing across wards and in the community over the winter
period.
SUMMARY OF THE KEY POINTS





To note the results of the safer nursing care tool completed in December
To note the recruitment campaign that is being completed during the summer
Support the additional allocation of staff on a temporary basis to
12,14,15,16,17
The safer nursing care tool will be completed in line with the national timetable
in June 2014
The new cohort of Well Being Apprentices that are being recruited in October
2014 and will start on the wards in November
RECOMMENDATIONS
1. NOTE the content of the report
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LINKS

Strategic Objectives
First class patient experience – safe high quality care is
dependent on high quality clinical staff

Annual objectives
Safe, high quality services – the delivery of safe, high
quality care is dependent on appropriate staffing levels
and skills

Monitor / CQC /
Regulatory
Requirements
IMPACT
A six monthly review of staffing levels are presented to
the quality and safety board

Patient Experience
Good patient experience impacts on the reputation of
the organisation

Quality & Safety
Patients who feel supported by high quality nursing staff
who understand the importance of the Trust Promises
and quality agenda will have more consistent care

Financial
Poor patient experience may impact on the cost of care
delivery

Workforce
Appropriate staffing levels support the clinical needs of
patients and their families

Equality & Diversity
All patients receive the appropriate care from the
nursing staff in the organisation

Estates
NA

IM&T
NA

Communications /
Engagement
The processes used within the organisation encourage
feedback on staff experience.
RISKS

There will be a continued reliance on bank and agency nurses to support the
delivery of safe, high quality care
PREVIOUS CONSIDERATION
 None
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MONTHLY STAFFING UPDATE TO TRUST BOARD
TRUST BOARD MAY 2014
INTRODUCTION
In recent years the Board has received and acted upon a number of staffing papers,
most of which required additional investment and has resulted in improved staffing
levels across the organisation. The National Inpatient Survey results had a
significantly improved score for the question related to the number of staff on duty
when the results were published in 2014.
The focus on the number of staff on duty, specifically on inpatient wards, is
increasing nationally and all Trusts have to have the staffing levels by shift displayed
by ward area with any deficits explicitly included outside ward areas. From June this
data set has to be displayed on the website and will also be available via NHS
Choices. The Secretary of State is driving this national publication and it is probable
that once this data is published these figures may be used to benchmark and rank
Trusts.
SAFER NURSING CARE TOOL
In December 2013 the Board received a paper which included the results of the
Safer Nursing Care Tool conducted over a 3 week period in October/November
2013. The outcome of which was to identify a deficit of £1.4 million within the nursing
budget on the substantively funded wards within the hospital. As a result of that
paper it was agreed that this additional funding would be considered as part of the
annual planning round.
As a result of this work the Board has previously agreed that all

Permanent posts should be recruited to as soon as possible

Over recruitment to ensure that turnover is covered as quickly as possible

Early recruitment to posts so that cover to the winter pressures is available
The Safer Nursing Care Tool has to be repeated every six months with a formal
report on the outcome being taken to the Board. The next planned completion is
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June with a report to the Board in July to comply with the national timetable. As a
result of revisiting the outcomes of the previous audit it has been noted that for the
next round of data completion this should explicitly include the 21% uplift for
education, training and leave as well as the supernumerary status for Ward Sisters
which was inconsistent at the last audit.
There are a number of areas where the Safer Nursing Care Tool is not appropriate
such as Maternity, Children’s services, ITU, HDU and Community. The Heads of
Nursing are currently working on nationally recommended guidelines for these areas.
The recommendations of the next report received will be comprehensive and
inclusive.
CURRENT RECRUITMENT PLAN
The performance, finance and investment committee has requested that a
recruitment drive to cover the positions, as listed above is commenced as soon as
possible. The Human Resources and Senior Nursing Team are working together on
a plan to recruit up to 70 new registered nurses into the organisation ready for the
winter period. This consists of 3 key areas.
1
June recruitment fairs for the students that have been trained by the
Wolverhampton University with their clinical placements within Walsall Healthcare
NHS Trust. The application process for this group has already begun with over 25
applicants.
This number has been supplemented by an additional 22 applications as a result of
the Trust attending local recruitment fairs, a joint initiative between the Human
Resources and Nursing
It is anticipated that once these applicants have been interviewed all of the current
vacancies will be filled, across both the hospital and community.
2
Nationally there will be an initiative to try and encourage people back into
nursing, however this will not be until the autumn. The communications department
are working with local media to try and encourage people to consider completing the
return to nursing course. Currently applicants have to pay for this themselves and
have to give up any employment they may have as it takes 3-6 months to complete.
The Trust is working with the local universities to work on providing a return to
practice course in late summer early autumn. It would be advantageous for us to
recruit these individuals on a training contract and pay them with a pay back clause if
they leave.
When we ran the Social Media Campaign in the autumn of last year we interviewed
a number of people who were working as band 5 registered nurses in nursing and
care homes and although they had the right attitude and demonstrated a
commitment to provide safe, high quality care they were not sufficiently up to date
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with current nursing practice to be appointable. We are currently working with the
local universities to modify their current back to nursing courses to develop a return
to acute nursing course. Initial discussions are positive, if we are able to commission
such as course it is recommended that we recruit to this course on the same basis
as the complete return to practice course
3
Care to join us campaign, this was a successful recruitment campaign run via
social media in the autumn of 2013, currently we are considering whether to re-run
this campaign or go overseas to recruit. The Human Resources department are
scoping the success of this with other local Trusts. Once the June campaign has
been completed, if there is a significant deficit then it would be recommended that
these two options are utilised.
There are costs associated with this and these are currently being identified as part
of the overall recruitment process in preparing for winter.
ADDITIONAL STAFF ON WARD 12,14,15,16,17
These wards have increasingly complex and dependent patients on them. The
quality indicators suggest that the nursing staff are struggling at times to ensure that
all patients receive the care they deserve despite a number of Well Being
Apprentices being placed on them. As a pilot, and from existing monies, an
additional CSW is being allocated to these wards for every early shift to see if this
improves not only the care received by the patients but also the moral of the staff.
the pilot will run from 27th May 2014 until the 30th September 2014. The newly
qualified students will, by this time, have arrived on the wards and will be able to
back fill these posts until they are needed on the extra winter later in the year.
If this is successful there may be a deficit after Christmas if the extra decant ward
opens. At this point a decision employ CSW to cover these areas again will need to
be taken if they have demonstrated an improved patient and staff experience.
NEW COHORT OF WELL BEING APPRENTICES
The Trust developed the Well Being Apprentices as a result of increasing pressure
on the nursing staff to manage patients at high risk of falls or dementia whilst
providing care to the acutely unwell patients. This model has worked vey well and
has been well received by the patients, their families and staff members. The
individuals themselves have had a positive experience with a number of them
already leaving to take up substantive posts or securing further education and
training.
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The current cohort complete their training in October and November 2014. Due to
the success of the project funding has been secured for a further year. Recruitment
to these posts will start in conjunction with Walsall College in September with the
apprentices starting on the wards in October and November later this year.
CONCLUSION
The Board has been received a number of previous papers detailing the plans for
staffing across the organisation. This paper brings together the overall staffing and
recruitment plan with recommended plans to provide a safe, sustainable staffing plan
for the winter of 2014-2015.
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