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Nursing Staffing Levels and Skill Mix: Ensuring we have the right staff, with the right skills, in the right place

Ruth May Regional Chief Nurse (Midlands & East) NHS England opened today’s Safe Staffing conference with a keynote address focusing on:

• nursing staffing levels and skill mix: meeting the expectations relating to nursing, midwifery and care staffing capacity and capability
• implementing hard truths and 6cs action area 5: ensuring we have the right staff, with the right skills, in the right place
• reporting on staffing and skill mix at ward and organisational level
• an update from NHS England

Ruth's presentation comes after the surprise announcement last week for NHS England to take over the work on safe staffing from NICE.  See RCN - NICE suspends work on safe staffing guidance

In her presentation Ruth made the following points:

- it is the Boards and commissioning responsibility for safe staffing
-'Shape of Caring' could possibly fill the gap till 2017
- it is the accumulation of 12 hour shifts that is the problem, not one offs
- we do still have NICE endorsing some work, these ones still stand. Some great work has been done together.
- workforce supply and demand, national board: this work will now take off at pace
- need recruitment drive but also look after the people that we have already got. Nursing is a proud role but can be physically and emotionally draining

Ruth’s full presentation is available for download at the end of this page.

Ruth was SRO for Action Area 5: ‘ensuring we have the right staff, with the right skills in the right place’. Ruth lead the development of the NQB How to Guide with support from nurses across England which was a huge step in the cultural shift on safe nurse staffing.  

Following the development of the NQB guidance, Boards now sign off and publish evidence-based staffing reviews at least every 6 months. Boards receive monthly updates on workforce information including the number of staff on duty compared with the planned staffing level, the reason for any gaps and the action being taken to address them.  This workforce information is looked at along with quality of care metrics to drive improvements in the quality of care patients receive.  

Ruth and her team have specifically commissioned work to develop guidance and tools for staffing in mental health, learning disability and community settings. The Mental Health Inpatient Staffing Framework which will be released this month has been developed to apply a mental health perspective to the expectations highlighted in the NQB guidance.    

Ruth also delivered on the NHS England commitment to commission research into three important areas to develop a greater evidence base to inform decisions in relation to safe and effective staffing, including:

•    An assessment of ward or community nurse / midwifery leaders having a supervisory role and the impact of this on patient and staff outcomes, to understand what is gained from this investment and to understand how the impact of supervisory status is measured.
•    To investigate the links between staffing levels and outcomes for staff and patients
•    To evaluate the impact of 12 hour shifts on health care assistants, nurses and patients 

The research findings are due to be published later this summer, and these along with other workforce tools and resources, will be available on the NHS England website

Ruth May was appointed as Regional Chief Nurse for NHS England (Midlands and East) in October 2012 following her role as Nurse Director for the NHS Midlands and East SHA and two years as Chief Nurse at NHS East of England. From of 1st July 2015 Ruth May will take up appointment as Nurse Director at Monitor within the Patient and Clinical Engagement Directorate where she will complement the clinical advice provided by Professor Hugo Mascie-Taylor, Monitor’s Medical Director and Executive Director of Patient and Clinical Engagement.

Ruth has a theatre nursing background and nearly 30 years’ experience of working in the NHS.  During her career she has held several high profile NHS leadership roles including two Chief Executive appointments of acute hospitals, Chief Executive of a Primary Care Group and Director of Nursing of a PCT. 

Ruth was a member of the Nursing Care Quality Forum set up in January 2012 by the Prime Minister and the Health Secretary. She supported Sally Brearley as Chair by leading the Patient Experience work stream championing the Friends and Family Test. 

Ruth supported the national work in development of Quality Surveillance Groups which operate as a network of organisations locally and regionally, working together to act as an early warning system for quality. The aim of QSGs is to identify risks to quality at an early a stage by proactively sharing information and intelligence between commissioners, regulators and those with a system oversight role. 

Future related events:

Safe Midwife Staffing in Maternity Settings
Monday 6 July 
Hallam Conference Centre, London

Improving Physical Health for People with Mental Health Conditions
Monday 14 September 
Hallam Conference Centre, London

Effective Ward Manager
Monday 14 September 
Hallam Conference Centre, London

Nursing Staffing Levels and Skill Mix In Accident and Emergency Departments
Monday 9 November 
Hallam Conference Centre, London

Safe Staffing for Nursing in Mental Health Inpatient Units
Monday 16 November 
Hallam Conference Centre, London

Download: Ruth May full presentation

8 June 2015


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