Safe sustainable and productive staffing: case studies
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
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
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
University Hospitals of North Midlands NHS Trust: themes in this case study
Leadership | Learning and development | Skill Mix | Role redesign | Multi-professional | Flexible approach
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
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
Buckinghamshire Healthcare NHS Trust: themes in this case study
Recruitment and retention | Skill mix | Role redesign | Flexible approach
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
Nottingham University Hospitals NHS Trust: themes in this case study
Technology | Leadership | Flexible approach
Safer Staffing in elderly care wards
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
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
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
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
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
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
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
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
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.
Related content
- Supporting NHS providers to deliver the right staff, with the right skills, in the right place at the right time: Safe, sustainable and productive staffing
- Supporting NHS providers to deliver the right staff and skills, in the right time and place
- Update on safe staffing improvement resources for specific care settings