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Exclusive: Nurse training to be launched 'to combat incorrect use of safe staffing tool'

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Nurses across England are to be offered specialist training about how to use an endorsed safe staffing tool, after it was discovered that some organisations have been using the aid incorrectly.

The Safer Nursing Care Tool (SNCT), first developed by chief nurses in 2006 for adult inpatient wards, uses patient acuity and dependency to determine how many nurses are required for a ward’s establishment.

“We are aware the tool has been taken and applied by NHS hospitals in other ways than it was designed”

Ann Casey

It was updated in 2013 and endorsed by the National Institute for Health and Care Excellence. But since then, those behind the tool’s development, have found some nurses may have been merging parts of the old version with the new one, and mixing up calculations that risk leading to unsafe staffing levels.

They hope the new National Safe Staffing Fellows programme, funded by regulator NHS Improvement, will ensure nurses are using the tool consistently.

The new master’s level fellowship training programme, which has the backing of some of the country’s most senior nurses, will run for 18 to 24 months and be open for applications from March. There will be five places available at each of the four NHS regions in England. It will initially be run as a pilot.

Organisations will also be stopped from using the tool if they are found to be utilising an incorrect version, under a new licensing agreement.

Its design is now protected through intellectual property rights secured by the Shelford Group of 10 top performing trusts, which led the development of the tool through its network of organisations.

University College London Hospital

Ann Casey

Ann Casey

Health service trusts and independent employers will have to secure a licence from Imperial Innovations before being able to use the SNCT. It will be free for NHS hospitals.

The new copyright protection will also apply to other types of the SNCT – for acute assessment units, and its latest version for children and young people’s inpatient wards, being launched this week by the Shelford Group.

It is hoped these steps will mean the SNCT is used “appropriately” and that its evidence base is not compromised, according to Ann Casey, clinical workforce lead at NHS Improvement,

“We are aware the tool has been taken and applied by NHS hospitals in other ways than it was designed,” she told Nursing Times. “We want to make sure that doesn’t continue to happen.”

Ms Casey, who has been involved in its development since her previous role as assistant chief nurse at University College London Hospitals NHS Foundation Trust, said it was not known how many trusts had been applying the tool incorrectly.

But she said she was concerned that organisations may not be planning “appropriate” staffing levels as a result.

“Most organisations apply the tool well, but there are instances where it has not been interpreted correctly and in some cases the criteria has been changed which alters the evidence base,” said analyst Dr Keith Hurst, who has also helped to develop the tool.

“The definitions and the multipliers shouldn’t be tampered with. The old versions of the tool [from before 2013] need to be shelved”

Keith Hurst 

The tool involves patients being placed into acuity and dependency categories. A set of multipliers are then used to convert the number of patients in each category into a staffing establishment.

However, Dr Hurst explained that there had been a danger of trusts mixing up the different versions of the two parts of the tool.

“We know of one place where they have used the old definitions but the new multipliers, for example,” he said. “That is unforgivable.” 

“I don’t think that was through malice – it was through ignorance. Hence the fellowship programme, which it is hoped will go a long way to stopping these problems from happening,” added Dr Hurst.

“The definitions and the multipliers shouldn’t be tampered with. The old versions of the tool [from before 2013] need to be shelved and no longer used,” he told Nursing Times.

Dame Hilary Chapman, chief nurse at Sheffield Teaching Hospitals NHS Foundation Trust and co-founder of the SNCT, said: “We know the Safer Nursing Care Tool works and I am delighted that by collaborating with Imperial Innovations, the CNO and NHS Improvement we now have the ability to share tool more widely.”

“The fellows program is the first of its kind in England and its aim is to ensure that we create a lasting expert legacy”

Ruth May

Dr Ruth May, executive director of nursing at NHS Improvement, said: “The pioneering work of the Safer Nursing Care Tool led by Shelford Group has led the way in ensuring that the NHS has one of the best tools internationally to support decision making on safe, effective and sustainable staffing.

“The fellows programme is the first of its kind in England and its aim is to ensure that we create a lasting expert legacy started by the Shelford Safer Nursing Care Tool team,” she said. ”This program is open to all nurses to apply and we expect it to be a fantastic development opportunity.”

Professor Jane Cummings, chief nursing officer for England, added: “I am pleased to see and support work taking place to further develop the safe staffing and safer national care tool, now available to NHS organisations across England.

“This is collaborative, partnership working at its best, ensuring we have the right staff to help us provide safe, patient focused care,” she said.

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Readers' comments (1)

  • Instead of having ward managers sitting at a computer in the office using this tool to fudge the figures, their time could be used far more practically by rolling up their sleeves and helping out on busy wards.

    Most of it is expensive box ticking anyway.

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