Safer Staffing

The Right Staff, with the Right Skills, in the Right Place at the
Right Time

Sara Courtney – Head of Professions SEISD

Wider Policy
Context
National Quality Board Guidance

Available at:
http://www.england.nhs.uk/wp-
content/uploads/2013/11/nqb-how-to-
guid.pdf
Acuity and Dependency Scoring

Evidence Based Tool

Professor Keith Hurst – advisor to NHS England
Origins –
– No basis for historical staff establishments
– Patients on the wards becoming sicker
– Need to determine critical care capacity
– No simple consistent tool
– General managers accepted
– No tool that linked input with outcomes
– Allows benchmarking
– Staffing requirements = quality outcomes
Strengths and Weaknesses of the Tool
itself
Strengths Weaknesses
Allows for most variables – Measures actual – not predictive
discriminates between patients Requires validation of data to
with differing needs prevent ‘gaming’
Measures workload and patient Not suitable for use in small
acuity wards
Measures throughput
Quality measures included
Easy to use and understand
Patient Dependency and Acuity Scoring

Scores classify patients according to their

reliance on ward staff for treatment or care
Higher scores imply more dependent or more
acute patients
 Safer Nursing Care Tool Classifications
Level Descriptor
0 Patient requires hospitalisation Needs met by provision of normal ward cares.

1a Acutely ill patients requiring intervention or those who are UNSTABLE with a GREATER
POTENTIAL to deteriorate.

1b Patients who are in a STABLE condition but are dependant on nursing care to meet most
or all of the activities of daily living.

2 May be managed within clearly identified, designated beds, resources with the required
expertise and staffing level OR may require transfer to a dedicated Level 2 facility / unit

3 Patients needing advanced respiratory support and / or therapeutic support of multiple

organs.
What we need you to do…
Starting on Monday 12th May
Nurse in Charge will be required for 21 consecutive
days to ‘score’ every inpatient bed
Scoring the patient based on their previous 24hr
period dependency and acuity
Scoring should take place ideally during the morning
at approx 1100hrs (pre lunchtime handover)
If a bed is empty a score is not entered
Weekly professional validation will take place to
ensure consistent approach to scoring takes place
At the end of the 21 days…
The scores should be entered onto a Ward Acuity
and Dependency score sheet (will be sent to you
electronically)
This information will be analysed against National
Benchmarked data sets and will form part of a new
12 monthly cycle of Acuity and Dependency Scoring
which will inform Contracting and Budget setting and
baseline establishments for the following financial
year (as agreed at Strategic Workforce Committee)
Scoring will take place 2 x year