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Safe staffing framework for mental health inpatient wards

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A safe staffing framework for inpatient mental health wards has been released by NHS England, with the aim of ensuring the right numbers and skill mix are in place.

It follows the revelation earlier this month that NHS England would be taking over the programme of safe staffing work previously being carried out by the National Institute of Health and Care Excellence.

However the framework released today was commissioned before it was confirmed NHS England would be taking over from NICE.

“The framework aims to ensure that mental health inpatient wards have the right staffing level for their specific needs”

Jane Cummings

NHS England has told Nursing Times it will be producing further guidance for mental health inpatient wards under its new remit for safe staffing later on this year, which will be led by its Mental Health Taskforce.

It added that today’s Mental Health Staffing Framework – which was developed by an independent group of directors of nursing who carried out a “rigorous” review of available evidence – would feed into this future work.

To develop the framework, NHS England assessed current evidence and found wide variations in both the costs and levels of staff recorded in inpatient settings, noting that deficits in qualified staff may be contributing to the variation in money spent.

It also found higher numbers of qualified staff were associated with reduced levels of aggression among patients.

“Currently there are no fixed staffing levels for UK mental health inpatient wards,” said the framework document. “To do so may result in less consideration for local needs, and underestimating number of staff required to ensure care delivery maintains therapeutic benefit.”

The framework includes a review of two workforce calculator tools and also features a checklist for lead clinicians to present to their board to ensure the wider organisation understands the differences in providing safe staffing on mental health wards compared to other settings.

In addition, it provides practical advice on how mental health service leaders can carry out a review of their workforce planning.

Jane Cummings

Jane Cummings

Chief nursing officer for England Jane Cummings said: “There is a clear absence of best practice guidance available for mental health staffing at the moment, which is why this newly developed framework is so important.

“Staffing requirements for mental health wards are completely different to a regular inpatient ward,” she noted.

“The focus is obviously more on psychological than physical care, but reactive and unplanned interventions are also more common, people stay for longer and higher percentage of people are detained rather than there by choice,” she said.

Ms Cummings added: “Developed by nurses for mental health leaders, the framework aims to ensure that mental health inpatient wards have the right staffing level for their specific needs.

“This is just one component of a significant ongoing programme of work that NHS England and its partners are undertaking to ensure the NHS is safely staffed with the right people, with the right skills,” she said.

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