Five safe, sustainable and productive staffing improvement resources

NHS Improvement has published five safe, sustainable and productive staffing improvement resources in the areas of maternity services, adult inpatients in acute care, district nursing services, learning disability services and mental health.

5 years on: responses to Francis: changes in board leadership and governance in acute hospitals in England since 2013

This report, written by the Health Services Management Centre, University of Birmingham in partnership with the University of Manchester and the Nuffield Trust, reveals that hospital boards report that they are placing a high priority on care quality and safety, and many invested significantly in nurse and medical staffing in the wake of the Francis Report. However, some hospital boards reported feeling that quality assurance as a pressure, as the demands of multiple external regulators was reported to sometimes feel burdensome, threatening to distract from a focus on the actual work of service improvements.

Workload and wellbeing quarterly survey

The BMA keeps track of doctors' workload and wellbeing with the BMA quarterly survey (formerly known as the omnibus or tracker survey).

Each quarter the survey focuses on topical issues as well covering questions on workload, morale and work-life balance, which are repeated every quarter.

Key findings from our most recent survey:

• 71% of hospital-based respondents reported rota gaps in the departments in which they work. This figures remains consistent.
• 65% of hospital speciality respondents reported that there are medical doctor vacancies in their departments, while 47% of GPs had GP vacancies in the practice where they work.
• 89% of respondents believe their contribution to the NHS was valued by patients and 62% believed it was valued by managers, but only 17% felt valued by the government and politicians.

Safe, sustainable and productive staffing in urgent and emergency care

Draft resource from NHS Improvement to help standardise safe, sustainable and productive staffing decisions in urgent and emergency care.

Safe, sustainable and productive staffing for neonatal care and children and young people's services

Draft resources from NHS Improvement to help standardise safe, sustainable and productive staffing decisions in neonatal care and children and young people's services.

NIHR Signal Early discharge ‘hospital-at-home’ gives similar outcomes to in-patient care

Supported early discharge, where patients receive on-going hospital-level treatment in their own home, had no effect on mortality compared with standard in-patient care. Patients had shorter hospital stays, were more likely to be satisfied and less likely to end up in residential care.


This updated Cochrane review identified 32 international trials comparing early discharge hospital-at-home with hospital in-patient care. Most evidence related to people recovering from a stroke, where NICE already recommends supported discharge if this is appropriate. Other patient groups included those recovering from orthopaedic surgery and older people with various conditions. Trials were relatively small and the overall evidence quality was moderate to low.


The review aimed to see whether early discharge has an effect on NHS costs, but found insufficient evidence. Training, staffing and equipment costs need to be measured against patient outcomes in different therapy areas. Early supported discharge needs to be driven in areas where it can make the most difference and give the greatest benefit.


From NIHR Dissemination Centre

Sustainable staffing in our emergency departments

NHS Improvement has developed a plan with the Royal College of Emergency Medicine (RCEM), NHS England and Health Education England to grow the workforce, reduce attrition in medical training and ensure emergency departments are attractive places to work.

This year's most important health strategy is the one you might not read

If it ignores the upcoming Industrial Strategy White Paper, the NHS will miss the opportunity to boost its future financing, provision and staffing through strategic local economic partnerships, notes Michael Wood


The Industrial Strategy White Paper is expected to be published around the same date as the Chancellor’s 22 November statement. The word “Industrial” in the title probably means that both NHS leaders think it’s not for them and industry leaders think it’s not for us. In fact, both would be wrong.
To obtain this full article please contact: libraryw@uhcw.nhs.uk

Safe and effective staffing: nursing against the odds

The Royal College of Nursing has launched the results of a survey of nursing and midwifery staff in the UK.

More than 30,000 responses were received in just two weeks, and clearly describe the impact of poor staffing on patient care and nurses’ wellbeing, says the RCN.

Under pressure? NHS maternity services in England

This briefing finds that NHS maternity units are more likely to close towards the end of the week and during holiday periods due to low staffing levels. It reviews the evidence on the long-run pressures faced by maternity units from changes in the number of maternity admissions and the case mix.

While the number of maternity cases has remained largely constant since 2010, the case mix continues to change, with women giving birth later in life and with more complex health conditions. There are implications for maternity units if this evolving case mix of mothers requires more care in terms of staffing or other resources.

Incidences of rota gaps surge

Around two-thirds of hospital doctors have experienced rota gaps in the last 12 months, a new survey has found.

The BMA quarterly survey also found that 65 per cent of hospital doctors and 48 per cent of GPs reported vacancies in their departments and practices.

Safe And Effective Staffing: The Real Picture

This report from the RCN calls for the rest of the UK to follow the example of Wales and enshrine safe staffing levels in law following analysis which shows that there is approximately 40,000 unfilled nurse posts in England with a further 12,000 health care support worker vacancies.

NMC increases flexibility of overseas application process

The Nursing and Midwifery Council (NMC) has announced changes to its application process for nurses and midwives trained outside EU/EEA. These changes will provide additional flexibility by increasing the number of times a nurse or midwife can sit a key component of the test they need to pass in order to practise in the UK.

Read more HERE.

A day in the life of social work

This research, carried out in partnership with Community Care, finds that many social workers are struggling with their caseloads and longer working hours due to staff shortages and budget cuts. These insights are taken from feedback from over 2000 social work professionals and it aims to provide an insight into the typical working day of social care staff.

• Report

Safe, sustainable and productive staffing in mental health services

This resource is developed by NHS Improvement to help commissioners and providers of NHS-commissioned services create, review and sustain, safe and effective specialist mental health services. We're asking for feedback on this before publishing a final, revised version later this year.

NHSI Midlands and East masterclass: Improving bank use and reducing agency spend

This masterclass is designed to support trusts in the Midlands and East region to increase the use of bank staff and reduce the use of high cost agency staff. Using the success of Northampton General Hospitals Trust (NGH) as a live case study, the session will provide you with practical support tools to help improve your trust’s bank utilisation.

Takes place 24th February 09.30-15.00 at Northampton General Hospital

Preventing suicides: staff perspectives

Prisons need a profound culture change to prevent people from losing their lives through suicide, according to a report published today by Centre for Mental Health and the Howard League for Penal Reform.

Preventing suicides: staff perspectives, is the last of four reports from a year-long investigation into suicide in prisons by the two charities, find that distress, self-harm and suicide attempts are too often seen as manipulative rather than signs of need and vulnerability among prisoners. And staff shortages, a ‘toxic’ working environment and a failure to recognise the traumatising impact of prison for both prisoners and staff all contribute to an unsafe environment.

Rise in social workers quitting or switching jobs in adult services

NHS Digital report also finds shift of wider social care roles from councils to independent sector continues.

Turnover among social workers in adults’ services rose last year, official figures reveal.
One in six (16%) social workers in English council adults’ services departments quit or changed their jobs in 2016, up from 13% the previous year, according to the latest NHS Digital report on social care staffing. Almost one in five social workers (19%) started their jobs within the year, up from 15% in 2015.

Safe staffing in learning disability services

A guide to help standardise staffing decisions for learning disability services in community and inpatient settings.

Reducing agency spend

Northampton General Hospital NHS Trust has reduced how much it spends on agency nurses by more than £2 million since October 2015 by motivating them to join the in-house staff bank.

 The trust’s communications team was instrumental in helping implement this and used the trust’s Facebook page and localised targeted advertising to promote the campaign.