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New safe staffing indicator to be launched for NHS in England

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A new safe staffing indicator for hospitals across England will be launched this summer.

The new composite indicator will give trusts a red, amber, or green rating based on a range of staffing data.

This will sit alongside a new recommended twice yearly assessment of the amount of time nurses spend giving direct care to patients.

Trusts will be rated and the results published on the NHS Choices website. The indicator will include:

  • sickness absence data
  • rate of compliance with mandatory training
  • rate of appraisals in the previous 12 months
  • views on staffing from the national staff survey
  • views on staffing from patient surveys

The development of the indicator is part of the safer staffing focus since the publication of the Francis report into poor care at Mid Staffordshire Foundation Trust in 2013.

“It will provide comparable information for trusts to use and for patients and service users to make an informed choice”

Jane Cummings

The majority of the data used in the indicator is already reported in national staff and patient surveys, or via the Health and Social Care Information Centre and electronic staff records.

In a letter sent to trusts and nurse directors, NHS England chief nurse Jane Cummings said: “These indicators will support the patient safety information already published on NHS Choices and provide comparable information for trusts to use and for patients and service users to enable them to make an informed choice of care provider.

“It will also be used by the regulatory bodies as part of their trust assurance process,” she added in the letter seen by Nursing Times’ sister title Health Service Journal.

However, some trusts ar understood to have expressed concern over the validity of the indicator and whether trusts will follow a consistent methodology for assessing the contact time for nurses.

“It is a million miles away from what is happening on a ward shift by shift, day-by-day”

James Buchan

Nursing workforce expert Professor James Buchan, from the school of health sciences at Queen Margaret University in Edinburgh, also said he had concerns over how the indicator would be presented.

He said: “If you look at the elements for the composite indicator, such as the staff survey for example, [it] is a once a year snapshot of a sample so at best is giving some indication of overall morale and training etcetera but it is a million miles away from what is happening on a ward shift by shift, day-by-day.

“Several elements in the composite will lack the detail, the specificity and timeliness to really give a hard and fast indication of how things are going at a particular point in time,” he added.

Yeovil District Hospital Foundation Trust plans to use an iPad app for student nurses to collect contact time data more regularly as part of a university study.

The trust’s director of nursing, Helen Ryan, said: “It will be helpful for nurse directors to have that information so we can make good, sound judgement on our staffing levels. What I would be slightly fearful of would be benchmarking trusts against other trusts.

“These are valid things to measure but time will tell on how sensitive a composite indicator can be and whether that informs the public,” she said.


  • New indicator will give trusts a red, amber or green rating
  • Indicator will take in trust, staff and patient level data
  • Concerns over methodology and presentation of information


An NHS England spokeswoman said: “Hospital nurse staffing levels have been rising dramatically and every trust in England is now required to publish staffing levels at ward level.

“From the summer, patients and the public will have access to more information on safe staffing at hospitals as we will publish nurse staffing indicators and an overall rating on their safe staffing performance,” she said.

As revealed by Nursing Times earlier this year, senior nurses hope that a mobile “app” will revolutionise the collection of safe staffing data by drastically reducing the time taken to record and analyse information.

The Safer Nursing Care Tool app will be available to all trusts free of charge from this month.

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