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Guidance on safe nurse staffing aims to improve healthcare services

NHS Improvement says resource will help leaders and staff to deliver effective and sustainable patient care.

Guidance on safe nurse staffing has been published for five new healthcare settings, including adult inpatient wards, children and young people’s services, and mental health.


Insufficient staffing can lead to fatigue and burnout. Picture: Neil O’Connor

All five resources call for annual strategic staffing reviews and decision-making based on evidence.

Each set of guidance, which also covers learning disability services and district nursing, includes escalation processes and strategic staffing review guidance that promotes safe, sustainable and productive staffing. The one for children and young people's services is a draft document.

Their publication by regulator NHS Improvement on behalf of the National Quality Board (NQB), which oversees work to improve care quality, comes amid mounting concerns over nursing shortages and their impact on the quality of care.

Unfilled posts and staffing shortfalls

The RCN has previously said that 40,000 nursing posts are unfilled in England. A survey of 30,000 nurses published in September last year found that 55% reported a shortfall in planned staffing of registered nurses on their last shift.

The guidance’s publication also follows last week's publication of a parliamentary inquiry into the nursing workforce.

The release of the documents by NHS Improvement follows previous advice on staffing for urgent and emergency care, and maternity services.

The regulator called for annual strategic staffing reviews to use evidence-based tools, professional judgement and comparison with peers, while also taking into account all healthcare professional groups and the healthcare provider’s financial plans.

Recommendations on board accountability, retention and recruitment, and the expectations on clinical leaders at service and team levels, are also included in the guidance.

The goal of safe and sustainable staffing 

NHS Improvement executive director of nursing Ruth May said: ‘NHS staff work around the clock to care for people in all kinds of health settings, but it is vital for the continued success of the health system that we make sure NHS services are underpinned by safe and sustainable staffing. 

'We have worked with clinicians, leading academics and stakeholders to create these resources, in the expectation that they will support NHS leaders and their staff to deliver compassionate, effective, safe, sustainable and high-quality patient care.’

The new resources align with the National Quality Board’s report, Supporting NHS Providers to Deliver the Right Staff, with the Right Skills, in the Right Place at the Right Time, which was published in 2016.

NHS Improvement says there is no one metric to enable safe staffing; instead, staffing decisions must be taken locally based on patient need, available evidence and supporting guidance.

The mental health services guidance calls for systems and processes to monitor staff well-being and prevent fatigue and burnout.


Read the safe staffing guidance 


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