1. Safer Staffing The Right Staff, with the Right Skills, in the Right Place at the Right Time Sara Courtney – Head of Professions SEISD

2. Wider Policy
Context

3. National Quality Board Guidance
Available at:

4. 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

5. Strengths and Weaknesses of the Tool itself
Allows for most variables – discriminates between patients with differing needs
Measures workload and patient acuity
Measures throughput
Quality measures included
Easy to use and understand
Weaknesses
Measures actual – not predictive
Requires validation of data to prevent ‘gaming’
Not suitable for use in small wards

6. 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

7. Safer Nursing Care Tool Classifications
Level
Descriptor
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.

8. 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

9. 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