NHS – The Operational Challenges of Safe Staffing

NHS Safe StaffingAs an election year looms, the pressure on the NHS continues to build. The future of the service continues to be a heavily debated topic and a clear battle ground for the main parties. The issue of privatisation remains prominent with many public thinkers expressing doubts over whether the service will soon cease to be free. Whilst others suggest taking the pressure off hospitals and GP clinics by spreading patient treatment across pharmacies instead.

Undoubtedly, the biggest concern for all must be the quality of patient care. The NHS care watchdog recently warned of a risk to patient care due to a shortage of doctors and nurses. Then its annual report assessing NHS and social care services, the Care Quality Commission (CQC) said recently that while much care is excellent, “the variation in the quality and safety of care in England is too wide and is unacceptable”.

Against this backdrop, organisations are continuing to offer their guidance to NHS leaders in order to improve patient care. For example, recently the National Institute for Health and Care Excellence (NICE) endorsed a decision support toolkit to be used alongside its guideline on safe staffing for nursing in acute hospitals.

It’s clear that as the service continues to face financial challenges, technology will play a key part in supporting staff in their roles.

Kronos recently hosted a series of NHS workshops following the initial guidelines published by NICE. These were attended by a broad spectrum of healthcare professionals from NHS trusts across the UK. The aim of these workshops was to help NHS trust managers meet safe staffing obligations, control labours costs and improve patient care. Through the discussions at these workshops, a number of consistent challenges were highlighted.

One of these issues were the Unify reports. These report templates are a government requirement for trusts to report their staffing levels. But there appears to be inconsistencies and a disparity in the way trusts are reporting safe staffing. These inconsistencies arise from Trusts recording the supernumerary/supervisory status of nurses as clinical hours or not. In addition, there are some discrepancies with how the wards are recording the hours in terms of long or short days.

The unify report simply asks for hours on day and hours on night shifts. With enough detail lacking in these logs, it could negatively impact some trusts, especially if they are logging reports differently. The hope is that soon enough, there will be thorough guidance provided on reporting expectations.

But, how is the staffing data impacting upon patients right now?

The consensus here seems to be that patients are not using the data or they cannot understand the data. Staffing numbers are not currently being quoted in complaints, for example. Trusts believe that patients are either not interested in the numbers, or are not aware of the relevance. This will change though, and it will be interesting to measure the impact upon service requirements for those having patient choice for surgery, etc. There was a clear consensus from our panels that whilst data is not used during normal clinical visits, it could be used in future complaints or legal cases. Therefore, in the future it is imperative that trusts will need to have access to accurate records. And those that fail to manage this process will find themselves under immense scrutiny from public sector leaders and the public.

Keep an eye out for our next blog, where we’ll discuss the operational challenges facing trusts today.

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