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Safe Staffing

In the wake of the Mid Staffordshire NHS Foundation Trust enquiry, the Francis Report (2013) identified unsafe staffing levels and inappropriate skill-mixes as one of the factors leading to many of the identified failings within the Trust.

It emphasised the need for all Trusts to ensure that they provide safe services to their patients and critical to this is having appropriate staffing levels on wards to deliver safe care.

Recent reviews by Keogh (2013), Berwick (2013), and Cavendish (2013) regarding mortality rates, patient safety, and the roles of health care assistants and support workers, also emphasised the risks to patients of not prioritising professional skill-mix and staffing levels.

In 2013 and 2016 , the National Quality Board (NQB), in collaboration with the Chief Nurse for England demonstrated its commitment to ensuring that staff with the necessary skills, are in the right place and at the right time, by publishing a guide to nursing, midwifery and care staffing capacity and capability (2013).

This guide set out ten national expectations to help providers, commissioners, staff and patients work together to make these expectations a reality.

One of these expectations is that each NHS Trust reviews staffing levels within their organisation on a six-monthly basis (using nationally recognised and evidence-based tools and professional judgement) and reports on staffing rotas on a monthly basis.

The Carter report (2016) introduced a metric for staffing utilisation, Care Hours Per Patient Day (CHPPD). The purpose of this metric is to provide a single consistent way of recording and reporting deployment of staff working on inpatient wards/units that have adopted CHPPD. CHPPD can be used to describe both the staff required and staff available in relation to the number of patients. It is calculated by adding the hours of registered nurses to the hours of healthcare support workers and dividing the total by every 24 hours of in-patient admissions (or approximating 24 patient hours by counts of patients at midnight). The Carter report required that from April 2016 the CHPPD becomes the principal measure of nursing and care support deployment. This is reported monthly to NHS Improvement; please see Trust Board Workforce Reports for historical data.

Reviewing staffing levels at Bedford Hospital

At Bedford we conduct reviews of staffing levels as above. From May 2017 reporting of Nursing and midwifery staffing has been enhanced in a monthly report.

On occasions there are shortfalls in staffing levels and incidents relating to these. The senior nursing team review these situations to ensure the appropriate actions are being taken. Summary information is included in the Nursing and midwifery monthly report. Staffing levels are reviewed regularly each day to monitor and react to staffing requirements and mitigate any shortfalls.

The next Safer staffing review is currently in progress and will be reported in September 2017

Reporting staffing levels at Bedford Hospital

To download staffing information on a ward by ward basis (including staffing data and commentary), please click on the links below:


Nursing and Midwifery Workforce Report – September 2018

Nursing and Midwifery Workforce Report – October 2018

Nursing and Midwifery Workforce Report – November 2018

Nursing and Midwifery Workforce Report – December 2018


Nursing and Midwifery Workforce Report – January 2019

Nursing and Midwifery Workforce Report – February 2019

Nursing and Midwifery Workforce Report – March 2019

Nursing and Midwifery Workforce Report – April 2019

Nursing and Midwifery Workforce Report – May 2019

Annual Safe Staffing Reports

Annual Nursing and Midwifery Safe Staffing Review 2018

BHT Staffing Mid Year Review Feb 2019 v1.5 – Final