NHS England to develop new indicator for nurse staffing levels

More than a third of hospitals had a fill rate for nursing shifts of more than 100% during May, according to data published for the first time yesterday.

Data on nurse staffing was one of three new indicators published on the new patient safety section of the NHS Choices website, as part of the government’s new Sign up to Safety campaign.

Greater transparency around nurse staffing data was a central to the government’s response to the Francis report last year.

However, while trusts were rated either “good”, “bad” or “OK” for performance against other factors, such as infection control and incident reporting standards, trusts have not been judged for their staffing levels.

This decision was taken in response to concerns about how valid comparisons could be made between organisations on staffing without a national standard.

Instead, staffing data has been reported as a percentage of planned nursing hours that were filled during the month.

Just 7.6% had fill rates of less than 90%, while half of trusts had fill rates of 90-100%.

However, the data is an aggregate of all registered nurse and healthcare assistant hours over the month, so may mask situations where a shortage of registered nurses has meant more healthcare assistants have been used or wards with regular understaffing.  

Fill rates of more than 100% are likely to have been driven by increases in patient acuity which meant more staff were required than originally planned, such as one to one “specialling” of particularly vulnerable patients.

NHS England chief nursing officer Jane Cummings said it was too soon to say from the data which organisations had concerning levels of staffing and the most valuable aspect of the information at the moment was the ward level data trusts were required to publish on their own websites.

Asked about plans to rate trusts on their staffing levels in future, she said a composite indicator would be developed over the next six months, which would also look at factors such as sickness absence rates and use of temporary staffing.

Ms Cummings said the idea would be to start with an indicator for acute trusts and move into other sectors when the National Institute for Health and Care Excellence developed guidance for them.

The development of staffing guidance by NICE was a key recommendation of the Francis report. Draft guidance on staffing adult inpatient wards was published for consultation in May.

The staffing data on NHS Choices comes from more than 20,000 shifts across 6,700 wards.

Only two trusts failed to submit their May data by the deadline: North Bristol Trust because staff and services were moving into a new hospital during the month, and Guy’s and St Thomas’ Foundation Trust because they had been recording the data in a different format.

Source Nursing Times