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Safe Staffing - Care Hours per Patient Day (CHPPD)

Oncology nurses organising medications

The Trust is committed to ensuring safe, high quality care. Concerns over nurse staffing arrangements have come out of a number of high profile national inquiries and reviews which have been played out in the professional and national media over recent years, including the Francis Inquiry (2010) and the Francis Report (2013) which was published following the public enquiry into the care provided at the Mid Staffordshire NHS Foundation Trust. As a result of these reports, Trusts are now expected to take more robust action in ensuring safer staffing in all of our inpatient areas.

Since May 2014 all hospitals are required to publish information about the planned and actual number of nursing and midwifery staff working on each inpatient ward. The intention is to demonstrate how Trusts across the NHS ensure the safety of their staffing levels and skill mix. This information is displayed in the 3 ways:

  • The total number of hours for the month for Registered Nurses and Care Staff.
  • The percentage of cover in the day and at night by  Registered Nurses and Care Staff.
  • Care Hours Per Patient Day (CHPPD) displays the average amount of direct patient care a patient receives in a 24 hour period from Registered Nurse and Care staff.

The use of CHPPD results in the use of a single figure that can simultaneously represent both staffing levels and patient requirements, unlike actual hours as previously reported

This information is contributing to improved care for patients by ensuring that effective staffing levels are presented, challenged, owned by Trust Boards, but more importantly shared with the public. 

In the national strategy for nursing and midwifery (DH and NHSCB, 2012) clear expectations of Chief Nurses and Directors of Nursing are set out around presentation and discussion of nursing metrics at Board meetings held in public at least twice a year. The National Quality Board (NQB, 2013) identified 10 key expectations in their guidance on staffing levels which have been followed more recently by further guidance from the Care Quality Commission (CQC, 2014) for organisations to deliver the commitments the Government made in ‘Hard truths: the journey to putting patients first’ to make staffing information more publically available.

Information is displayed on boards for patients and visitors in our wards to show the planned and actual staffing available at the start of every shift. This information also advises what is being done to manage any shortfalls in staffing in order to maintain safety.

I hope that you find this information useful, together with information on NHS Choices, but we welcome feedback and questions which should be directed either to the relevant Head of Nursing or through our PILS service.


Best Wishes

Eleanor Meldrum
Acting Chief Nurse



Useful links:

http://www.nmc-uk.org/About-us/Safe-staffing/