At University Hospitals of Leicester NHS Trust we have a robust process in place to ensure Safe Staffing is maintained and appropriate and staffing concerns can be quickly and easily escalated for attention are in place
All rosters for nursing staff are created eight weeks in advance, using our E-Roster system. This is reviewed and approved by the matron, and signed off as a workable roster.
Key Performance Indicators are reviewed prior to final approval, and are listed below:
- Safety maintained in clinical area
- Roster is effective and meets the plan
- Correct amount of annual leave has been used
- Roster is fair to all staff
- Unavailability of staff is clear
- Roster with allocated budget.
Any vacant shifts on the E-Roster are offered to ward staff to fill as extra for time off or payment and once agreed with staff, staff are moved to fill the gaps.
If there are still vacant shifts to be filled all staffing gaps are escalated to the temporary staffing office 6 weeks in advance of the roster being worked, so temporary staff can be booked in to them for fill those gaps
The vacant shifts are monitored on a daily basis by the ward sister and matron of the area. The matron reviews staffing across all ward areas she/he has responsibility for, and staff are moved to ensure safety across all ward areas.
On a weekly basis the staffing is reviewed by the Matron/Deputy Head of Nursing and the Head of Nursing responsible for the clinical area.
At this point, prior to the roster being worked any shifts that still remain vacant are escalated to agency providers, via the temporary staffing office, to fill the gaps and ensure safety is maintained.
On a daily basis ward base staffing is reviewed at the local staffing/bed meetings, these meetings detail;
- the clinical condition - known as the acuity of the patients on the ward
- the empty beds on the ward
- the activity on the ward, patients going to theatres, patients going home
- staffing gaps and movement of staff across the ward areas
At this meeting, staff are moved if necessary across ward areas. Any staff available in the area, that are not in the planned roster numbers are also instructed to work clinically in the ward areas to ensure safety is maintained, this in most cases is only for a couple of hours.
The staffing requirements for each ward area is escalated to the Head of Nursing, if safe staffing is not maintained, the real time staffing drive is updated in real time, and actions to mitigate any risk undertaken and documented at this point.
Safety Statements are detailed below;
- Ward staffed to establishment/plan, therefore no concerns.
- Ward has manageable shortfall in staffing and is being managed across the CMGs, this will result in all bullet points above being implemented
- Ward has unmanageable shortfall in staffing and Director Support is required, this is extremely rare, and has not occurred in any of our ward areas during May.
If all avenues have been explored and a clinical area is still deemed unsafe, this is escalation to the Chief Nurse for her intervention and action to mitigate any risks identified
Clinical Management Group Ward Information for Safe Staffing;
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Other related documents below:
