Care hours per patient day guide

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Our updated guide covers all in patient care settings across acute, community and mental health and help trusts to more productively deploy nursing associates and AHPs who are increasingly becoming part of the inpatient establishment and rostered as part of the team delivering patient care.

Why is CHPPD important?

Staff are our biggest asset and trusts have an obligation to strike the right balance between patient safety, cost and efficiency. 

CHPPD was developed, tested and adopted to provide a single, consistent and nationally comparable way of recording and reporting deployment of staff on inpatient wards.

  • It produces a single comparable figure that represents both staffing levels and patient requirements, unlike actual hours or patient requirements alone.
  • It enables wards within a trust, and wards in the same specialty at other trusts, to be compared. As CHPPD is calculated after dividing by the number of patients, the value does not increase due to the size of the ward, enabling comparisons between wards of different sizes.
  • It offers the ability to differentiate registered nurses and midwives from healthcare support workers for reporting purposes, ensuring skill-mix is well-described and the nurse-to-patient ratio is taken into account in staff deployment, along with an aggregated overall score.

Comparing CHPPD reflected by the set establishment with CHPPD available on the roster can support ward leaders in managing the workforce to meet patient need. This data, particularly if tracked over time, provides an informative picture of staff deployment. It can be used in productivity and efficiency discussions as well as highlighting areas that may require establishment setting or skill-mix review.

CHPPD is therefore valuable because it consistently shows how well patient care requirements are met alongside outcome measures and quality indicators.

The care hours per patient day required to deliver safer care can vary in response to local conditions, for example the layout of wards or the dependency and care needs of the patient group it serves. Therefore, higher levels of CHPPD may be completely justifiable and reflect the assessed level of acuity and dependency. Lower levels of CHPPD may also reflect organisational efficiencies or innovative staffing deployment models or patient pathways.

Guidance for all inpatient trusts

If you have any questions, please email nhsi.nursing-productivity@nhs.net.

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