Safe sustainable and productive staffing: case studies

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How providers and commissioners are working to ensure they are providing safe and sustainable staffing.

Earlier this year, the National Quality Board (NQB) published a safe staffing resource for NHS provider boards to help assure the delivery of compassionate, effective, safe and sustainable high quality patient care. 

As one of the bodies on the NQB, our initial engagement work involved spending time talking to front line services to collect staffing and workforce case studies which provide examples of best practice and innovation improvement from NHS providers and commissioners across a range of care settings. 

The case studies cross over different themes and are linked to the three expectations set out in the NQB guidance; right staff, right skills, right place and time

To help you navigate your way through, we’ve grouped them by sector and identified which themes they cover.

Acute

FOR-Ward: increasing ward team patient contact time using a rapid improvement approach PDF, 36.3 KB

Derby Teaching Hospitals NHS Foundation Trust: themes in this case study

Leadership | Learning and development | Culture/behavioural change | Skill mix | New staffing model

Improving care and safety of at-risk patients - from 'specialling' to enhanced care PDF, 39.8 KB

University Hospitals Coventry and Warwickshire NHS Trust: themes in this case study

Learning and development | Skill Mix | Role redesign | Flexible approach | New staffing model

Improving patient experience by reducing therapy interventions using integrated therapy roles PDF, 36.0 KB

University Hospitals of North Midlands NHS Trust: themes in this case study

Leadership | Learning and development | Skill Mix | Role redesign | Multi-professional | Flexible approach

Introducing registered ward-based therapists to improve care quality and lessen the impact of registered nurse vacancies PDF, 36.0 KB

East Lancashire Hospitals NHS Trust: themes in this case study

Technology | Recruitment and rentention | Skill Mix | Role redesign | Multi-professional | Flexible approach

Introducing the band 4 assistant practitioner role in haemodialysis PDF, 37.8 KB

East and North Hertfordshire NHS Trust: themes in this case study

Learning and development | Recruitment and retention | Skill mix | Role redesign | Flexible approach | New staffing model

Nursing skill mix in spinal cord injury rehabilitation - improving recruitment, retention and quality PDF, 38.3 KB

Buckinghamshire Healthcare NHS Trust: themes in this case study

Recruitment and retention | Skill mix | Role redesign | Flexible approach

Retaining our skilled workforce – introducing a careers clinic and transfer process to advance knowledge and skills, and develop a career pathway PDF, 40.7 KB

University College London Hospitals NHS Foundation Trust: themes in this case study

Leadership | Learning and development | Recruitment and retention | Flexible approach

Safe staffing app - real time monitoring of nurse staffing levels PDF, 38.2 KB

Nottingham University Hospitals NHS Trust: themes in this case study

Technology | Leadership | Flexible approach

Safer Staffing in elderly care wards PDF, 37.5 KB

Mid Yorkshire Hospitals NHS Trust: themes in this case study

Skill mix | Flexible approach | New staffing model

The Nurture Programme - providing a flexible workforce to deliver one-to-one care in labour PDF, 38.5 KB

Portsmouth Hospitals NHS Trust: themes in this case study

Skill mix | Role redesign | Flexible approach | New staffing model

Community

Working in partnership to transform community nursing workforce model to meet changing demands PDF, 39.5 KB

Doncaster Clinical Commissioning Group and Rotherham Doncaster and South Humber NHS Foundation Trust: themes in this case study

Leadership | Recruitment and retention | Culture/behavioural change

Ambulance

Introducing mental health nurses to the emergency operations centre at the London Ambulance Service PDF, 41.2 KB

London Ambulance Service NHS Trust: themes in this case study

Technology | Leadership | Learning and development | Culture/behavioural change | Multi-professional | Flexible approach | New staffing model

Reducing unnecessary journeys and admission to emergency departments for frail elderly people who fall at home PDF, 36.3 KB

London Ambulance Service NHS Trust: themes in this case study

Skill mix | Role redesign | Multi-professional | Flexible approach | New staffing model

Mental health

Delivering best practice in supportive observation PDF, 38.0 KB

Mersey Care NHS Foundation Trust: themes in this case study

Learning and development | Culture/behavioural change

Developing a no-force culture to improve quality and safety on mental health wards PDF, 40.3 KB

Mersey Care NHS Foundation Trust: themes in this case study

Leadership | Learning and development | Culture/behavioural change | Skill mix

Redesigning multidisciplinary ward teams across inpatient mental health services PDF, 33.9 KB

South Staffordshire and Shropshire Healthcare NHS Foundation Trust: themes in this case study

Recruitment and retention | Skill mix | Role redesign | Multi-professional | Flexible approach | New staffing model

Glossary

Technology

The right use of technology can help staff to improve and innovate, enabling new ways of working in an environment of growing demand and rapid change. 

Leadership

Good leadership involves staff and teams feeling empowered to make key decisions where required and implement change to delivery of care to improve quality and productivity.

Learning and development

The organisation analyses learning and development needs and uses this information to help identify, build and maximise the skills of existing staff to support the delivery of safe and effective care to patients.

Recruitment and retention

The organisation has effective strategies to recruit, retain and develop their staff, as well as managing and planning for predicted loss of staff to avoid over-reliance on temporary staff.

Culture/behavioural change

Organisations need to have a co-ordinated approach and the right leadership skills in place to drive continuous improvements in patient outcomes and productivity. They should do this by developing the appropriate culture and behaviours, where staff and teams are engaged in developing their organisations and they are supported, respected and valued.

Skill mix

Clinical capacity and skill mix are aligned to the needs of patients as they progress on individual pathways and to patterns of demand, thus making the best use of staffing resource and facilitating effective patient flow.

Role redesign

Clinical leaders should use the competencies of the existing workforce to the maximum, further developing and introducing new roles as appropriate to their skills and expertise, where there is an identified need or skills gap.

Multi-professional

The organisation recognises the unique contribution of nurses, midwives and all care professionals in the wider workforce. A stronger multi-professional approach avoids placing demands solely on any one profession and can support improvements in quality and productivity. 

Flexible approach

It is important to ensure that clinical workforce planning forecasts reflect the organisation’s service vision and plan, while supporting the development of a flexible workforce able to respond effectively to future patient care needs and expectations.

New staffing model

Your workforce will need to have the right competencies to support new models of care. Staff will need to receive appropriate education and training to enable them to work more effectively in different care settings and in different ways. 

There may be a need to collaborate across your local health and care system, with commissioners and other providers, to ensure delivery of the best possible care and value for patients and the public.

Case study summary

Case study summary PDF, 86.1 KB

Use this to navigate through the case studies by theme.

Submit your case studies

We will be sharing more case studies and we are keen to hear from you if you have any examples of improvement projects focusing on safe sustainable and productive staffing across any of these areas:

  • maternity
  • children’s services
  • acute inpatient
  • mental health
  • community
  • learning disability services
  • urgent and emergency care

Do you have a story to share? Please email your case studies through to laura.maclean5@nhs.net.

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