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. This paper provides a compliance report against minimum staffing levels as set out by the National Quality Board in Compliance against revised staffing requirements will commence for October Trust Board. This will follow the updated guidance issued by the NQB 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 Community Trust Overall 98.72% 98.11% 96.74% 88.56% 98.14% Appendix 1 demonstrates ward-level compliance data for actual vs planned staffing, alongside quality indicators. The report covers the period August 1 st 31st ANALYSIS OF NURSE STAFFING RELATED KPIs (Appendix 1) including highlighted areas of concern Five areas fell below the threshold set for red RAG rating (<90% compliance) during this review period. When ward areas fall below the threshold of 90%, this prompts a more in-depth analysis of the quality and safety of care provided on those wards 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 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 82.18% Vacancies high, (11wte band 5) but new staff commenced in Oct. Staff moved from ITU and EAU to cover shortfalls Poor NHSP fill rate throughout summer escalated Safely Staffed*

2 11B 85.66% Vacancies band 5, new Filipino staff nurse in post band 2 CSWD staff start October. Monitored three times a day. 14B 78.03% Vacancies band 5. New CSWD starting in October. Sickness 3.53% Critical Care 80.45% Admissions are not being cancelled/delayed due to staff shortage and 1-1 nurse-patient ratio for level 3 patients and 1-2 for level 2 patients are being adhered. PIU 89.53% PIU remains funded for 5 days not 7. Vacancies not always backfilled by NHSP/ agency. As the day case lounge is not functioning the staff are being utilised to fill the shortfalls. Community District Nursing Teams Southport & Formby & West Lancashire DN Team % Compliance Commentary Sandy Lane 87.28% Agency was utilised to address the shortfalls. Sickness remains high in this area and cross cover is being utilised. Tarleton 77.59% Agency was utilised to address the shortfalls. Sickness remains high in this area and cross cover is being utilised. Churchtown 87.10% 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. Formby 85.88% Long term sick post holder now left and post is advertised. Agency staff to backfill though this is limited. Staff working additional hours. Safely Staffed* Conclusion and Recommendations Community teams continue to experience high demand, with significant pressures on staffing levels that is being managed locally with cross cover and bank and agency use. 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 expecting new staff to commence in post 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.

3 The Board is asked to: a) Agree the contents of this paper Angela Kelly, Acting Director of Nursing, Quality & Risk

4 Realtime Staffing % Temp Staffing of Nursing in post - % Temp Staffing of nursing in post - Non Staffing related Incidents Bed Occupancy Falls Pressure Sores C-Diff Cases MRSA Total Relating to clinical treatment Relating to attitude FFT - % recommended Sickness - Sickness - Non Vacancies % of Obs that were late Agency usage Harms Infection Complaints FFT Sickness Aug-16 Trust 98.14% 8.96% 19.80% % % 6.05% 7.96% % Urgent Care 98.72% 14.94% 33.52% % % 5.62% 9.58% % 7A % 36.91% 61.00% % % 13.13% 15.03% % 7B % 27.12% 71.26% % % 8.47% 9.26% % Stroke Unit % 27.20% 54.49% % % 9.33% 40.52% % FESS 82.18% 45.83% 32.37% % % 1.10% 0.16% % EAU 98.52% 11.20% 43.65% % % 0.00% 2.62% % SSU % 17.73% 37.50% % % 7.71% 0.65% % 11B 85.66% 26.07% 40.61% % % 1.48% 0.00% 8 5.4% 14B 78.03% 31.51% 20.00% % % 1.10% 5.53% 7 5.7% A&E % 21.68% 10.16% 2 N/A % 5.22% 7.28% 3 N/A Obs % 30.08% 3.07% % % 14.14% 11.02% % Rehab % 21.24% 58.08% % % 15.82% 20.70% 1 0.3% Critical Care 80.45% 3.20% 9.31% % N/A 7.49% 11.22% 9 N/A Women & Childrens 96.74% 2.60% 5.34% % % 2.78% 2.75% % E Ward % 9.11% 1.26% % % 0.00% 0.81% % Maternity 95.85% 2.85% 14.17% % % 2.28% 5.40% 0 N/A NNU 95.70% 0.56% 0.00% % N/A 0.35% 0.00% 1 N/A Childrens Ward 95.08% 2.78% 0.00% % % 6.64% 0.85% -3 N/A Childrens A&E % 1.24% 0.00% 0 N/A % 2.17% 0.00% 2 N/A PAB 94.35% 0.00% 0.00% % N/A 0.00% N/A 2 N/A Planned Care 98.11% 15.04% 15.95% % % 8.27% 7.91% % PIU 89.53% 41.02% 56.00% % % 19.97% 16.13% % 14A 91.54% 31.90% 27.43% % % 21.02% 3.40% % 15A % 26.48% 58.37% % % 9.24% 1.83% % 15B % 50.06% 41.27% % % 16.04% 7.25% % Spinal Unit 95.97% 19.17% 8.33% % N/A 7.08% 7.06% % G Ward % 17.07% 11.03% % % 13.28% 4.63% % Treatment Centre N/A 0.00% 0.00% 0 N/A % 3.05% 3.64% 1 N/A Theatre N/A 16.70% 0.00% 0 N/A N/A 9.00% N/A 10 N/A Radiology N/A 0.00% 0.00% 0 N/A N/A 0.00% N/A 0 N/A Community & Continued Care 88.56% N/A N/A 3 N/A 2 36 N/A N/A % 8.11% 5.13% 24 N/A Burscough D/Ns % N/A N/A 0 N/A 0 2 N/A N/A N/A 15.15% 0.00% 2 N/A Hillside D/Ns 95.51% N/A N/A 1 N/A 0 0 N/A N/A N/A 0.35% 0.00% 1 N/A Hants Lane D/Ns 98.15% N/A N/A 1 N/A 0 7 N/A N/A N/A 13.15% 63.64% -1 N/A Sandy Lane D/Ns 87.28% N/A N/A 0 N/A 0 1 N/A N/A N/A 10.20% 70.09% 0 N/A Tarleton D/Ns 77.59% N/A N/A 0 N/A 0 3 N/A N/A N/A 9.74% 0.00% 0 N/A Ainsdale D/Ns 99.60% N/A N/A 0 N/A 0 4 N/A N/A N/A 4.75% 0.00% 1 N/A Churchtown D/Ns 87.10% N/A N/A 0 N/A 1 7 N/A N/A N/A 10.10% 0.00% 2 N/A Curzon Road D/Ns 91.11% N/A N/A 0 N/A 0 7 N/A N/A N/A 17.04% 0.00% 0 N/A Formby D/Ns 85.88% N/A N/A 0 N/A 0 2 N/A N/A N/A 7.95% 0.00% 0 N/A Red <90% 15%> 15%> N/A 93%> N/A N/A N/A N/A N/A <80% 7%> 7%> N/A 15%> Amber 90-95% 10-15% 10-15% N/A 85-93% N/A N/A - - N/A N/A N/A 80-94% 4-7% 4-7% N/A 10-15% Green 95%> <10% <10% N/A <85% N/A N/A 0 0 N/A N/A N/A 94%> <4% <4% N/A <10%

5 Locations not above: Complaints Urgent Care Staffing Related Incidents Urgent Care 2 x Discharge Planning/Bed Management 5 x Skelmersdale WIC 2 x West Lancs HC Planned Care 1 x Skelmersdale WIC 1 x Access & Booking 1 x Outpatients 1 x Dermatology Women & Childrens Community 2 x Paediatrics Outpatients 1 x Continence 1 x Gynae Clinic Planned Care Falls 7 x Access & Booking Urgent Care 3 x Orthopaedic OPD 1 x GPAU 2 x Eye Clinic Planned Care 1 x Appliances 2 x Outpatients 1 x Dermatology 1 x F Ward 1 x MFU Community 1 x Not attributable to a ward/dept 1 x Adult Therapies 1 x Outpatients Dept C ommunity 7 x Podiatry 2 x CERT 1 x Continence 1 x Discharge Planning 1 x MCAS 1 x Pain Management 1 x Physiotherapy