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Consultation on safe staffing guidance for mental health care

NHS Improvement’s draft guidance for community and inpatient mental health services does not recommend minimum staff-to-patient ratio
Ian Hulatt

A consultation has been launched on draft guidance for achieving safe staffing levels in mental health services.

The document, published by NHS Improvement (NHSI), is for community and inpatient mental health services across all specialties.

Staff contribution

While it doesnt recommend a minimum staff-to-patient ratio, it does include use of the Care Hours Per Patient Day metric and suggests all staff contribute data to help set up new reports, known as dashboards.

These dashboards are commonly compiled electronically and include information on factors such as how long patients stay within a service, any delays in transferring between services and self-harming rates.

RCN professional lead for mental health Ian Hulatt was part of the working group that

A consultation has been launched on draft guidance for achieving safe staffing levels in mental health services.


The guidance is not just about staff numbers, but ensuring staffing is effective,
says RCN professional lead for mental health Ian Hulatt. Picture: David Gee

The document, published by NHS Improvement (NHSI), is for community and inpatient mental health services across all specialties.

Staff contribution

While it doesn’t recommend a minimum staff-to-patient ratio, it does include use of the Care Hours Per Patient Day metric and suggests all staff contribute data to help set up new reports, known as dashboards.

These dashboards are commonly compiled electronically and include information on factors such as how long patients stay within a service, any delays in transferring between services and self-harming rates.

RCN professional lead for mental health Ian Hulatt was part of the working group that prepared the draft guidance. He said: ‘Mental health is changing, with possibly the most significant issue being how we collect and use data. This guidance recommends creating a dashboard that covers the whole clinical setting in a comprehensive way.

‘This means it’s not just about nurse numbers and how many beds are on a ward, but you have to factor in incidents of self-harm, restraint, falls, unexpected deaths and so on. There are also complaint numbers, readmission rates, delays in transfer, length of stay. All this information is so useful in flagging up things that might be going wrong.’

Information shared

The guidance recommends this information be made available at three levels:

  • Team or ward: to provide clinical managers with a local view of staffing levels and indicators.
  • Service, locality or network: to enable clinical leaders and service managers to monitor and systematically deploy staff across multiple sites where demand is greatest or risk is highest.
  • Trust-wide: giving boards a whole-organisation view of staffing levels and indicators.

The work on mental health services is one of eight projects being overseen by NHSI, which took over safe staffing guidance from the National Institute for Health and Care Excellence in June 2015.

Mr Hulatt added: ‘The fact this guidance exists at all is significant as it finally addresses an issue long debated. It is not just about safe staffing in terms of numbers, but also ensuring that staffing is effective.

‘While there are many different roles on teams, nurses are the largest part of the mental health workforce and spend the most time with patients, so it is vital they have their say.’

The consultation runs until 28 April. To access it, click here


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