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Patient experience tool highlights nurse staffing as factor

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Nurse staffing levels are a key factor in achieving good patient experiences, according to a new framework put together by the NHS regulator for England.

The Patient Experience Improvement Framework, which is partly based on reviews of Care Quality Commission reports, found that where staffing levels were well below the recommended limit care was not always safe and patients felt let down.

“The patient experience improvement framework is an important tool for NHS providers”

Ruth May

The document has been drawn up by NHS Improvement to help organisations assess whether their leadership, culture and processes put patient experience at the centre of what they do. Planning for nurse vacancies was a crucial factor in providing a good patient experience, the framework said.

“Where nursing vacancies lead to nurses being moved throughout the hospital to support patients, they may not be familiar with the ward or the specific needs of patients and this seems to have a negative impact on patient experience,” it stated.

On the other hand, the framework said that “staff did not appear to feel the burden of nurse vacancies when staffing levels and skill mix were planned, implemented and reviewed to keep patients safe at all times”.

Staffing pressures could lead to care becoming “task-focused”, leaving little chance of a good interaction with patients, the report said.

“If staff are not involved in developing their own workforce they feel under increased pressure, especially if feeling understaffed and overburdened with training,” it said.

“We hope it will support healthcare providers in consistently improving patient experience”

Ruth May

The document focuses on five key themes – leadership, organisational culture, compassionate care, safe staffing levels and consistent incident reporting and learning lessons.

On the last factor, it said: “Where there was a strong ‘no blame’ culture staff felt empowered to report incidents and recognised the importance of reporting them to ensure patient safety”.

The framework also features an assessment tool to help hospitals and NHS trusts to perform an audit of their systems.

This includes looking at whether the board celebrates innovation by frontline staff and asks whether there is a process in place to celebrate achievements by staff who exceed patient expectations.

In addition, it asks whether staff are engaged in setting staffing levels and whether professionals are empowered to raise concerns “and believe they will be listened to and supported”.

NHS Improvement said the framework was intended to support both NHS trusts and foundation trusts to achieve ‘good’ and ‘outstanding’ ratings in Care Quality inspections.


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Ruth May

The regulator developed it in partnership with trust heads of patient experience in response to requests for an improvement tool.

Ruth May, executive director of nursing at NHS Improvement, said: “The patient experience improvement framework is an important tool for NHS providers, and was developed in partnership with trusts and patients to support increased focus on the key factors that help enable a patient-focused organisation.”

She added: “This is a key part of the journey for trusts in progressing to ‘good’ and ‘outstanding’ from a CQC perspective and we hope it will support healthcare providers in consistently improving patient experience.”

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