Evidence-based decision-making on safe and effective staffing is a requirement for all NHS organisations. The National Quality Board (NQB) was established by NHS England to champion high quality patient care. It provides advice, recommendations and endorsement on matters relating to quality.
The National Quality Board states that NHS providers:
- must deploy sufficient suitably qualified, competent, skilled and experienced staff to meet care and treatment needs safely and effectively
- should have a systematic approach to determining the number of staff and range of skills required to meet the needs of people using the service and keep them safe at all times
- must use an approach that reflects current legislation, regulation and guidance where it is available.
KCHFT is committed to ensuring that the NHS standard of having the “right staff with the right skills in the right place at the right time” is adhered to.
A systematic approach is in place to determine the numbers of staff and skill mix required to ensure care and treatment needs are met safely and effectively. This is achieved by using evidence-based tools alongside professional judgement and outcomes, ensuring that there are suitably qualified, competent, skilled and experienced staff available to provide care to the people in both our community hospitals and our community nursing services.
NQB have three key expectations
NQB expectation one – right staff
- Evidenced based workforce planning
- Professional Judgement
- Compare staffing with peers.
Evidenced based workforce planning
KCHFT holds the licence for both SNCT and CNSST.
- SNCT (Safer Nursing Care Tool) is a validated tool that supports safer staffing in hospital settings and has been used within the community hospitals.
- CNSST II (Community Nursing Safer Staffing Tool) is a validated tool that supports safer staffing in community nursing teams. This is a new tool and we anticipate KCHFT will carry out their first census across the community nursing teams in Q1 of 2025.
Professional judgement
- Ensures that staff who understand the speciality or ward area are able to share that knowledge so that the non-quantifiable aspects of running a service, for example, layout of a ward, time critical interventions, ease of observation or visibility, environmental safety, the number of single rooms, multi-professional working and skill mix outside of the rostered nursing staff, are all considered as part of the safer staffing
Outcomes
- This refers to the monitoring and reporting of patient and staff outcomes, such as workforce metrics and local clinical indicators of quality and safety.
- Nurse sensitive indicators, including pressure ulcers, medication errors, deferred care or rescheduling due to capacity should be reported monthly alongside staffing vacancies, turnover and absences.
NQB expectation two – right skills
This can include but is not limited to:
- Ensuring that mandatory training, development and education is maintained by all nursing staff
- Working as a multi-professional team; utilising colleagues outside of the core nursing team
- Stable recruitment and retention.
NQB expectation three – right place, right time
- Productive working and eliminating waste
- Efficient deployment and flexibility
- Efficient employment and minimising agency.
The efficient use of electronic rostering that provides a roster in advance so staff are notified in a timely manner of what they will be working can support recruitment and retention, allow unfilled shifts to be transparent and filled as needed and has been shown to reduce temporary staffing costs.
Information about staffing levels can be found at the end of each of the board papers.
National Return for Staff Staffing publications
Data around safe staffing rota fill rates and CHPPD (care hours per patient day) for our community hospitals is submitted nationally on a monthly basis. The most recent submissions can be viewed below: