N U R S E S T A F F I N G R E P O R T

Transcription

1 N U R S E S T A F F I N G R E P O R T INTRODUCTION This paper fulfills the nationally mandated, post Francis II requirement for monthly Board Reports detailing achievement against required nurse staffing levels. The paper continues to provide compliance rates reportable against minimum staffing levels as set out by the National Quality Board in Revised reporting is reflective against updated guidance issued by the National Quality Board in July 2016 and following discussion at Quality and Safety Committee in September ACTUAL Vs. PLANNED NURSE STAFFING LEVELS COMPLIANCE The table below gives aggregate figures for compliance of actual vs planned staffing levels. Urgent Care Planned Care Women & Children s Trust Overall % 96.69% 95.41% 91.82% 98.21% Appendix 1 demonstrates ward-level compliance data for actual vs planned staffing, alongside quality indicators. The report covers the period September 1 st 30 th ANALYSIS OF NURSE STAFFING RELATED KPIs (Appendix 1) including highlighted areas of concern Seven areas fell below the threshold set for red RAG rating (<90% compliance) during this review period. When areas fall below the threshold of 90%, this prompts a more in-depth analysis of the quality and safety of care provided on those areas and triangulates the data against a set of key performance indicators which aim to demonstrate whether the reduced availability of nursing staff has impacted on patient care. This can be seen in the table below: * Safe staffing levels RAG rated: Green - safely staffed with no immediate patient safety concerns Amber safely staffed but close watch due to concerns Red not safely staffed Ward Area % Compliance Commentary FESS 84.52% Vacancies high, (11wte band 5) Substantive Staff continue to support from ITU and EAU to cover shortfalls. NHSP fill rate increased by 10%. Safely Staffed* 11B 89.62% Vacancies- 7 band 5, Bed occupancy % Part of

2 generic recruitment event in Oct. NHSP fill rate decreased by 12% in month Sept. 14B 82.86% Vacancies- 7 band 5. Part of generic recruitment event in Oct. NHSP fill rate increased by 1%. Bed occupancy %. PIU 89.13% PIU remains funded for 5 days not 7. Bed occupancy 100% Workforce vacancy continues to be supported via NHSP/agency. NHSP fill rate decrease by 6% Current day case lounge staff continue to support this area. District Nursing Teams Southport & Formby & West Lancashire DN Team % Compliance Commentary Tarleton 88.25% Agency was utilised to address the shortfalls. Sickness remains high in this area and cross cover is being utilised. Churchtown 84.51% Increased sickness in the team, managed in accordance with policy. Additional agency staff booked and approved. Appointment to band 7 post and vacant posts out to advert. Patient care is prioritised. Agency staff availability has been limited. Support provided from other teams as required. Hillside 74.56% Long term sick post holder now left and post is advertised. Agency staff to backfill though this is limited. Staff working additional hours. Support provided from other teams as required. Safely Staffed* Conclusion and Recommendations teams continue to experience high demand, with significant pressures on staffing levels that is being managed locally with cross cover, bank and agency use. The services are actively recruiting to all vacant posts but this is proving difficult due to the current tender process. A decision is expected for all services at the end of October /early November, this will hopefully provide more stability to the services and aid recruitment. There are a number of projects currently in progress to ensure safe staffing levels: capacity and demand audit across the DN teams, introduction of a dependency tool to identify team work loads, introduction of NHSP to the community services ensuring the agencies currently used join the cascade on NHSP, introduction of electronic rotas to enable an overview of sickness and agency spend, introduction of community activity / pressures to the morning escalation meeting held in the hospital. Escalation meetings that include staff review continue three times a day. Key issues around ongoing high sickness levels remain across many areas within the organisation. All sickness is managed according to Trust policy. Many areas are receiving new staff to their workforce numbers over the coming months.

3 Care Support Worker Development (CSWD) Trainees commence 31 st Oct Twenty candidates commence with the majority of them being in post by 30 th Nov All Southport site areas are being supported by the CSWD nurses inclusive of AED, AED OBS and A ward ODGH. The Trust made a further 14 conditional offers against Band 5 vacancies following the local recruitment event in October. All wards have been reviewed not only on compliance against staffing levels, but also against a number of key performance indicators for safe care. The Board is asked to: a) Note the content of the report. Public Sector Equality Duty Southport & Ormskirk Hospital NHS Trust has a duty under the Equality Act 2010 to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations between people from different groups. The Act protects against discrimination on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, gender and sexual orientation. We have thought about how the issues dealt with in this paper might affect protected groups. We believe the paper will not have any adverse impact upon these groups and that the Trust has fulfilled its duty under the Act. Exempt information None of this report is exempt from publication under the Freedom of Information Act Angela Kelly, Acting Director of Nursing, Quality & Risk

4 Realtime Staffing CHPPD % Temp Staffing of Nursing in post - Registered % Temp Staffing of nursing in post - Non Registered Nursing Vacancies Staffing related Incidents Medication - Missed Doses Post Fall # Neck of Femurs Falls Pressure Sores Bed Occupancy VTE Risk Assessments * Total Relating to clinical treatment Relating to attitude FFT - % recommended Sickness - Registered * Sickness - Non Registered * % of Obs that were late Mandatory Training - Registered Mandatory Training - Non- Registered Staffing Incidents Harms Complaints FFT Sickness VitalPac Training Sep-16 Trust 98.21% % 17.37% (5) 0 44 (44) 3 (3) 84.89% 98.79% 51 (29) 21 (13) 9 (3) 89.35% 6.22% 9.82% 16.15% 72.10% 72.04% Urgent Care % % 29.24% 78 (81) 14 (11) 1 (1) 0 31 (31) 2 (2) 95.74% 98.63% 18 (15) 9 (8) 4 (3) 87.56% 6.01% 12.77% 16.40% 72.05% 70.94% 7A % % 45.83% % % % 13.31% 16.24% 25.29% 59.17% 50.83% 7B % % 42.47% % % % 1.83% 14.77% 14.59% 60.40% 80.00% Stroke Unit % % 30.89% % 95.65% % 8.26% 32.53% 12.12% 58.46% 71.43% FESS 84.52% % 29.05% % % % 0.83% 0.28% 5.90% 78.29% 78.57% EAU 98.81% % 44.79% % 97.88% % 0.68% 0.14% 34.60% 76.00% 77.50% SSU % % 34.38% % % % 7.40% 0.00% 19.38% 73.14% 77.00% 11B 89.62% % 36.54% % 83.33% % 0.00% 1.07% 5.26% 74.67% 66.15% 14B 82.86% % 20.00% % % % 0.37% 12.57% 6.36% 43.75% 42.14% A&E % N/A 24.21% 11.03% N/A N/A % 5.39% 11.21% N/A 70.85% 81.82% Obs 98.12% % 15.53% % 98.32% % 17.36% 17.35% 39.48% 71.56% 68.57% Rehab % % 54.91% % N/A % 12.76% 28.90% 0.97% 88.98% 85.71% Critical Care 90.08% % 12.50% % 97.06% N/A 8.96% 15.84% N/A 83.62% 85.00% Women & Childrens 95.41% % 2.76% -2 (-1) 8 (6) 2 (2) % 94.65% 7 (5) 3 (1) 2 (0) 83.33% 3.73% 1.36% 13.87% 76.57% 76.76% E Ward % % 3.77% % 89.84% % 0.39% 0.00% 13.87% 84.74% 86.25% Maternity 91.79% % 5.57% % 99.39% % 3.53% 1.54% N/A 67.39% 69.57% NNU 98.68% % 0.00% % N/A N/A 0.36% 0.92% N/A 88.38% 85.96% Childrens Ward 96.40% % 0.00% % N/A % 4.46% 0.89% N/A 89.30% 81.12% Childrens A&E 99.72% N/A 7.39% 0.00% N/A N/A % 8.21% 1.86% N/A 82.50% 83.12% PAB 95.83% N/A 0.00% 0.00% % N/A N/A 0.00% 0.00% N/A 60.00% N/A Planned Care 96.69% % 15.14% 53 (41) 14 (11) 1 (1) 0 12 (12) 1 (1) 91.00% 99.62% 17 (8) 7 (3) 1 (0) 95.28% 7.94% 10.02% 13.70% 66.67% 71.50% PIU 89.13% % 47.50% % 98.85% % 19.51% 3.62% 10.80% 57.27% 65.00% 14A 91.10% % 22.46% % % % 11.03% 5.91% 17.57% 58.94% 69.38% 15A 98.92% % 69.31% % 99.19% % 1.04% 25.94% 13.52% 60.67% 68.75% 15B % % 31.75% % % % 7.49% 6.43% 11.07% 68.75% 73.30% Spinal Unit 95.62% % 7.52% % % N/A 4.68% 5.85% 17.60% 72.50% 68.05% G Ward % % 14.94% % % % 20.00% 4.27% 11.65% 82.73% 73.33% Treatment Centre N/A N/A 0.00% 0.00% N/A 99.73% % 2.19% 9.27% N/A 71.48% 71.54% Theatre N/A N/A 11.85% 0.00% N/A N/A N/A 13.49% 0.00% N/A 57.50% N/A Radiology N/A N/A 0.00% 0.00% N/A N/A N/A 33.33% 0.00% N/A 90.00% N/A & Continued Care 91.82% N/A N/A N/A 25 (8) 3 (0) 1 (1) 0 1 (1) 34 (33) N/A N/A 7 (1) 2 (1) 1 (0) % 8.02% 10.64% N/A 73.49% 69.68% Burscough D/Ns 91.61% N/A N/A N/A N/A N/A N/A 15.15% 0.00% N/A 60.00% 60.00% Hillside D/Ns 74.56% N/A N/A N/A N/A N/A N/A 9.60% 0.00% N/A 64.00% 75.00% Hants Lane D/Ns % N/A N/A N/A N/A N/A N/A 7.18% 63.64% N/A 65.09% 30.00% Sandy Lane D/Ns 95.18% N/A N/A N/A N/A N/A N/A 11.36% 70.09% N/A 72.00% 80.00% Tarleton D/Ns 88.25% N/A N/A N/A N/A N/A N/A 10.33% 0.00% N/A 73.95% 90.00% Ainsdale D/Ns 97.50% N/A N/A N/A N/A N/A N/A 4.49% 0.00% N/A 80.00% N/A Churchtown D/Ns 84.51% N/A N/A N/A N/A N/A N/A 26.99% 6.25% N/A 78.18% 70.00% Curzon Road D/Ns 95.81% N/A N/A N/A N/A N/A N/A 12.58% 28.33% N/A 71.63% 68.42% Formby D/Ns 95.74% N/A N/A N/A N/A N/A N/A 0.42% 0.00% N/A 71.25% 50.00% NB. All Trust & CBU totals relate to all wards and departments within these groups. The numbers in brackets relate to the total of the areas shown in this report. * Figures subject to change Red <90% N/A 15%> 15%> N/A N/A N/A N/A N/A N/A 93%> <94% N/A N/A N/A <80% 7%> 7%> 15%> <80% <80% Amber 90-95% N/A 10-15% 10-15% N/A N/A N/A N/A N/A N/A 85-93% 94%-95% N/A N/A N/A 80-94% 4-7% 4-7% 10-15% 80-89% 80-89% Green 95%> N/A <10% <10% N/A N/A N/A N/A N/A N/A <85% 95%> N/A N/A N/A 94%> <4% <4% <10% 90%> 90%>

5 Locations not above Staffing Related Incidents Complaints Urgent Care Urgent Care 1 x MDU 1 x Access & Booking 1 x Skelmersdale WIC 1 x Outpatients 1 x Not attributed to a particular ward 1 x West Lancs HC Women & Childrens Women & Childrens 1 x Gynae Clinic 1 x AnteNatal Clinic 1 x Paediatric 1 x Not attributed to a particular ward Outpatients Planned Care Planned Care 2 x Orthopaedic OPD 5 x Outpatients 1 x Medical Secretaries 2 x Access & Booking 1 x Fracture Clinic 1 x Continence 1 x MFU 1 x Detetics 1 x Out of Hours DN's 2 x Pain Management 1 x Podiatry 1 x Long Term Care Pressure Sores Admin 1 x Audiology 1 x CERT 1 x Patients Home