NHS Safe Staffing – 6 Key Findings

nhs-Safe Staffing

In our last blog we discussed the increased pressures facing the NHS and how organisations such as NICE, are offering their guidance on achieving safe staffing in the NHS through technology and toolkits. Kronos hosted a series of ‘safe staffing’ workshops with NHS trust managers which offered some valuable insight into the challenges facing NHS trusts today. Of course each trust has quality patient care top of mind, but when it comes to achieving this, there are a number of operational issues they must overcome.

From the three workshops we hosted, the top operational challenges facing trusts at the moment are:

 

  1. Planning efficient rosters and robust ‘sign off’ of those rosters

After much discussion, it was evident that many of the trusts are still battling to successfully embed eRostering into the culture of the trusts. The effective implementation of any technology relies on senior management and CEOs. It requires their understanding and evangelising of the benefits of the solution to the whole team. Furthermore, making is clear how the solution will be used and enforce the processes rigidly.

A recent report from the Royal College of Nursing (RCN) revealed that 72% of staff reported that staff shortages occur frequently. A further 66% have also considered leaving the health service because of increased workloads and the stresses of the job. This makes it clear that action must be taken to keep the workers on the side of the NHS. When these workers feel stressed and overworked it can negatively impact the work they do and patient care they provide. Senior NHS management must therefore recognise the importance of technology in supporting safe staffing initiatives.

 

  1. Inefficient data collection

Inefficient data collection regarding the actual attendance of staffing is a serious issue for three reasons. The first is that the lack of real-time data capture of activity, means ward managers have an administrative overhead caused by retrospectively entering the data. The second is how manual data entry results in the data being more likely to be inaccurate. Lastly, the lack of real-time visibility from this data collection method means important staffing decisions are delayed, ultimately resulting in the quality of care being compromised.

These issues can be resolved if trusts implement time and attendance (T&A) solutions to record, using real-time data capture, the presence and availability of the nursing team.

 

  1. Alignment of the digital data held within trusts

Staff are currently using a range of different technologies in their day-to-day roles. They would like to see how all these technologies and devices could strategically ‘talk’ to one another where possible. This would improve the quality of data gathered because it could be cross referenced with the different measurements being made. It was good to see that, following concerns raised by NHS employees about staffing levels on more than 2,500 occasions in the last year, a government spokesperson said that a national framework for the “reporting of adverse events” will be rolled out. It’s crucial that we begin to see more consistency across trusts in terms of technology and reporting, in order to keep the service aligned and quality of care monitored effectively.

 

  1. High level visibility of actual staffing on shift by shift basis

The operational management of safe staffing was a heavily discussed area in our panels. The process for many trusts would entail a ‘breakfast staffing’ meeting at Matron-level each morning to go through the plan for the whole day.

The general consensus was that scenarios could still change throughout the day, and therefore, the morning meetings can be lengthy and costly in terms of time and efficient use of senior staffing. Systems such as Kronos OptiLink and T&A provide management of staff with the holistic visibility into the staffing on their wards and across the whole trust, freeing up time usually spent on morning planning meetings.

 

  1. Compliance and validity of acuity recording within trusts

It was found to be quite challenging to measure how effective the decision-making is of the nurse logging the acuity recordings. Without an investment of staff resource to either do the recording corporately or to scrutinise the data, there is no real way of measuring this.

Kronos OptiLink makes the capturing of acuity data simple and efficient, using tablet devices. Having acuity data on the tablet devices also helps with handovers between nurses, giving them the ability to review and discuss the recorded conditions of the patients easily.

 

  1. Commissioning

Trusts were keen on the idea of being able to consider detail at a commissioner level and how impactful this could be on future contracts being awarded to a trust and equally, investment in services. They saw the value in being able to articulate the service need more figuratively and identify trends, as well as how this could have a positive outcome.

For more information on Kronos for healthcare solutions visit www.kronos.co.uk/healthcare

 

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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.