Safe Staffing 2015

December 2015

  • Community hospitals continue to have vacancies and this poses our biggest risk to safe staffing, however Recruitment and management of the staffing resource to manage the existing bed base continues. Alongside additional Mitigation and monitoring, Use of the escalation processes continue alongside different models of staff and skill mix options being explored.
  • Louth Hospital.  Fill rates for  remain low for unqualified, but staff continue to work across both departments to respond to patient need, in addition to lowered bed occupancies overnight on Carlton ward ( chairs). Further action continues including further consideration of skill mix (assistant practitioners), rationalisation of meetings and use of bank staff, and staff working flexible start and finish times over busy periods and overtime. Bed occupancy continues to be monitored to ensure staff are able to cope with the dependency and needs of patients.
  • Skegness wards have further staff starting in January. Low levels of qualified staffing in December have been mitigated by an increase in skill mix to maintain staffing numbers and staff working across the site providing support.
  • Johnson hospital continues to recruited as well as exploring any professional vacancy changes (therapists) to reflect the new model for the ward. Staffing shortages have been mitigated by the use of additional skill mix staff and the ward manager being clinically-based. Quality continues to be closely monitored, while the new model for the Welland ward is being implemented.
  • Scotter ward has continued to mitigate risk appropriately and staff support has been sourced internally. The Clinical Team Lead continues to be clinically based as required, full or part shift, to provide additional support while staff undertakes preceptorship.
  • Butterfly hospice fill rates in December has been slightly down on unqualified staff  however in addition to volunteer support, the hospice sourced additional support from skill mix and support from local community teams and specialist nurses are already part of normal cover arrangements so care has not been compromised.

  December 2015 Safe Staffing 


October 2015

All wards continue to respond to the challenge of safer staffing and staffing vacancy’s continue to influence core fill rates, particularly on our Louth Hospital site. Staffing levels have been improved by increasing skills mix support available , Staff working flexible shifts across busier parts of the day and using staff across 2 areas has also provided additional support when most needed. Ward basing managers to provide addition ‘on ward’ support is also utilised if required. Managing Bed availability continues to be used to maintain safety of patients to ensure resource available matches patient need. All vacancies continue to be recruited too and additional qualified staff are presently on preceptorship and not included in the ‘numbers’. Due to the dependency and number of patients to be cared for the above actions have supported the maintenance of safety when fill rates of trained staff have fallen below target.

  October 2015 Safe Staffing


September 2015

All wards continue to respond to the challenge of safer staffing and staffing vacancy’s continue to influence core fill rates, particularly on our Louth Hospital site. Staffing levels have been improved by  increasing skills mix support available , and due to the dependency and number of patients to be cared for this has supported the maintenance of safety when fill rates of trained staff have fallen below target (Skegness). Staff working flexible shifts across busier parts of the day and using staff across 2 areas has also provided additional support when most needed. Ward staff have worked extra hours as well as ward basing managers to provide addition ‘on ward’ support. Bed restrictions continue to be used to maintain safety of patients to ensure resource available  matches patient need (Johnson). All vacancies continue to be recruited too and additional qualified staff are booked on future trust inductions or are presently on preceptorship.

  September 2015 Safe Staffing


August 2015

Community Hospitals:

  • 100% coverage on all wards has not been achieved over the month as current vacancies continue, which are impacting on resource availability. Recruitment and management of the staffing resource to manage the existing bed numbers continues and  additional actions are undertaken to ensure patient safety staff working overtime and ward basing managers to focus on providing direct clinical care.
  • Mitigation, monitoring and escalation processes continue alongside different models of staff and skill mix options being explored as part service improvement and work undertaken by the Community Hospital Programme Board.
  • Louth fill rates for August remain low, but staff continue to work across both departments to respond to patient need. Additional staff are due to start within the next month as staff complete induction and preceptorship.. Further action taken in month includes further consideration of skill mix (assistant practitioners), rationalisation of meetings and use of bank staff and overtime.
  • Skegness wards have filled most of their vacancies with staff on preceptorship and September inductions. Low levels of staffing in August (fill rates 66.7% trained staff on night duty) was mitigated by an increase in skill mix to maintain staffing numbers and staff working across the site providing support

  August 2015 Safe Staffing


July 2015

All wards continue to respond to the challenge of safer staffing and staffing vacancy’s continue to influence core fill rates. Staffing levels have been improved by  increasing skills mix support available , staff working flexible shift across busier parts of the day and using staff across 2 areas. Ward staff have worked extra hours as well as ward basing managers to provide addition ‘on ward’ support. Bed restrictions have been used to maintain safety of patients to ensure resource available  matches patient need.

  July 2015 Safe Staffing


June 2015

Community hospitals continue to recruit to all present vacancy’s and manage the available beds as appropriate, based on patient numbers, staff availability, staff flexibility and use of our Bank staff, as well as patient need. Mitigation and escalation continues and different models of staffing and skill mix continue to be explored by some ward areas based on local need, as part service improvement plans. At ward level the quality of patient care and patient safety as well as the experiences reported by our patient’s continues to be the main priority. The ward teams continue to measure and monitor all aspects of quality, with any further action taken as appropriate on a shift by shift basis, including escalation of any issues within the business unit and to board level.

 Staffing Levels in our Community Hospitals - June 2015


May 2015

All wards continue to respond to the challenge of safe staffing and staffing vacancy’s continue to influence availability/ Mitigations has included increasing skills mix support available , staff working flexible shift across busier parts of the day and using staff across 2 areas. Ward staff have worked extra hours as well as utilise Bank staff. Senior staff have been ward based to support safety and bed restrictions have been used to maintain safety of patients. In addition the increased dependency of some patients has required the staffing baseline to be reviewed as patient’s have required continual 1:1 support

 Staffing Levels in our Community Hospitals - May 2015


April 2015

  Safe Staffing - April 2015


March 2015

In March 2015, four out of six hospital wards failed to consistently achieve 95% staffing across all shifts, although mitigation taken at ward level continues to maintain a safe environment for existing patients and staff.. Ward staff managed and risk assessed the workload, escalating concerns accordingly via the established process. Recruitment to key posts continues to be an ongoing challenge, with a number of qualified vacancies remaining vacant at the time of reporting.

  Safe Staffing - March 2015


February 2015

Three out of six hospital wards failed to consistently achieve 95% staffing across all shifts during February however fill rates are increasing month on month, ward staff managed the workload and escalated concerns accordingly to ensure safe levels. Recruitment continues to be a challenge and is ongoing with WTE vacancies presently under recruitment across all inpatient areas.

Mitigating actions this month included, use of bank / agency staff and staff working extra hours to rostered shift, staffing working flexibly across 2 ward sites to respond to patient dependency, ward basing clinical leads to focus on direct care full time as opposed to operational and leadership duties and increasing numbers of skill mix Welland ward is presently receiving additional direct support from community teams and specialist nursing staff. All areas following mitigation actions are reporting internally safe staffing levels, but due to the potential risk involved continue to escalate and incident report any shortfalls.

 Staffing Levels in our Community Hospitals - February 2015


January 2015

Four out of six hospital wards failed to achieve 100% staffing across all shifts during January, although percentages deficits are now reducing as more staff completed preceptorship packages and induction programmes. Ward staff managed the workload and escalated concerns accordingly to ensure safe levels. Recruitment continues to be a challenge for some ward areas but recruitment is ongoing.

Mitigating actions this month included, fully ward basing team leaders/ward sisters, use of bank staff and staff working extra hours to rostered shift, staffing working flexibly across two ward sites to respond to patient dependency, restricting leave to basic minimum and utilising staff from other areas teams when available both Welland and Scotter ward have had additional support from redeployed staff to ensure maximum capacity was available due to an increase in demand due to winter pressures. If wards have not been able to source a third trained member of staff additional care staff have been utilise as well as a staff nurse undertaking a twilight shift.

All areas following mitigation actions are reporting internally safe staffing levels.

 Staffing Levels in our Community Hospitals - January 2015