Ensuring the correct numbers of Nurses, Midwives and Care Staff in inpatient areas (hospital wards and departments where patients stay overnight)

There are many factors that impact on the quality of care that is delivered to patients and their families. One of these factors is making sure that the numbers of registered nurses, registered midwives and care assistants in our wards and departments are at the right levels.

Additional factors that impact on patient safety, the levels of effectiveness of care delivery and the overall patient's experience include:

• The numbers of patients, service users, carers and their families that need care and support.
• The level of need of each patient (otherwise known as the levels of patient dependency, care complexity or acuity).
• The numbers of other clinical personnel that are available as part of the overall clinical multidisciplinary team to deliver the required levels of care. These include: doctors, physiotherapists, occupational therapists, speech and language therapists, specialist nurses / midwives.

National requirement to publish nursing and midwifery staffing levels

As part of its response to the findings from 'The Mid Staffordshire NHS Foundation Trust Public Inquiry', the National Quality Board, sponsored by Jane Cummings, Chief Nursing Officer for England, published the following document to support providers and commissioners of NHS care to make the right decisions about nursing, midwifery and care staffing capacity and capability:

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.

The guide:

• outlines a set of expectations of providers and commissioners relating to staffing, and provides advice on how they can be met;
• signposts readers to existing evidence-based tools and resources, and provides examples of good practice;
• outlines individual responsibilities of different parts of the workforce in relation to staffing;
• describes approaches to organisations' reporting on staffing levels on a monthly basis; and
• explains what national organisations will do to underpin the expectations.

Jane Cummings, Chief Nursing Officer in England said:

We have very clear evidence of a link between appropriate staffing and the outcomes of our patients. This evidence must be used to set staffing levels locally. Patients and the public are therefore entitled to know that we have the right number of people in place to provide safe, quality care every time.

We first encouraged a move towards greater transparency on staffing levels in my nursing strategy, but we are now going further. Hospitals will have to publish this information – at ward level – and present the evidence they have used to determine staffing levels in public.  That is the right way to ensure there is rigour around decisions that are taken, as well as to provide hospitals and other services with the flexibility they need to get the right staff in the right place. We need the right level of staffing in every locality – and that cannot be mandated centrally.

Download the Safer Staffing – How To Guide

This webpage provides information on how we are addressing these matters at Hull University Teaching Hospitals NHS Trust. I hope this information is helpful to you. However, I would also welcome any constructive feedback on whether this information is easy to understand and answer any queries that you may have.

If you have any further queries, please contact the Trust via the following email address, stating clearly the nature of your enquiry: steve.jessop@nhs.net

Alternatively, if you are a patient, service user, carer or a relative and have specific queries pertaining to the ward or service that you are using, please do not hesitate to ask to speak with the ward sister / charge nurse or nurse or midwife in charge in the first instance.

Thank you for your interest in this matter.

Mike Wright, Chief Nurse at Hull University Teaching Hospitals NHS Trust