SAFER STAFFING & CARE HOURS PER PATIENT DAY (January 2018) Trust Board – in public

Date: 22nd February 2018 Agenda item: 2.4

Executive sponsor Fiona Allsop, Chief Nurse

Report author(s) Fiona Allsop, Chief Nurse

Report discussed previously: N/A (name of sub-committee/group and date)

Action required:

Approval ( ) Discussion () Assurance ()

Purpose of report:

To provide monthly Safer Staffing and Care Hours per Patient Day (CHPPD) information and exception reports.

Summary of key issues

 The Safer Staffing report (January 2018 data) indicates that the Trust has delivered the planned versus actual staffing levels in the inpatient areas and maternity unit against existing template.  Care Hours Per Patient Day (CHPPD) are reported for January

Recommendation:

Add description

 To note the report

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Relationship to Trust strategic objectives and assurance framework:

SO1: Safe – Deliver safe, high quality care and improving services which pursue perfection and be in the top 25% of our peers

SO2: Effective – As a teaching hospital, deliver effective and improving sustainable clinical services within the local health economy

SO3: Caring – Work with compassion in partnership with patients, staff, families, carers and community partners

SO4: Responsive – To continue to be the secondary care provider of choice for the people of our community

SO5: Well led – To be a high quality employer of choice and deliver financial and clinical sustainability around a patient centred, clinically led leadership model

Corporate impact assessment

Legal and regulatory impact Included in the report

Financial impact Included in the report

Patient experience/engagement Included in the report

Risk and performance Included in the report management

NHS Constitution/equality and Included in the report diversity/communication

Attachments

N/A

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SAFER STAFFING & CARE HOURS PER PATIENT DAY (January 2018) Trust Board – in public

Date: 22ND February 2018

1. Introduction

To provide an update to the Board on nursing staffing in relation to planned versus actual staffing, an update regarding safer staffing monitoring and on recruitment activity.

2. Staffing Planned versus Actual – January 2018

RN RN NA Total Total Ward Ward Specialty Entries NA Day Overall Day Night Night Day Night

Abinger Ward 430 - GERIATRIC MEDICINE 31 81.91% 100% 94.35% 100% 88.42% 100% 92.39%

Acute Medical Unit 300 - GENERAL MEDICINE 31 93.35% 99.54% 93.27% 95.97% 93.32% 98.24% 95.57%

Birthing Centre 501 - OBSTETRICS 31 92.99% 80.65% N/A N/A 92.99% 80.65% 86.82%

Bletchingley Ward 430 - GERIATRIC MEDICINE 31 95.16% 100% 83.79% 81.58% 89.89% 89.86% 89.88%

Brockham Ward 502 - GYNAECOLOGY 31 96.42% 95.7% 94.94% 100% 95.93% 96.77% 96.28%

Brook Ward 100 - GENERAL SURGERY 31 98.95% 91.8% 87.1% N/A 94.99% 91.8% 93.73%

Buckland Ward 101 - UROLOGY 31 93.68% 100% 90.65% 96.77% 92.41% 98.39% 94.57%

Burstow Ward 501 - OBSTETRICS 31 93.76% 96.77% 82.61% 87.1% 90.04% 92.9% 91.34%

Capel Annex l Ward 300 - GENERAL MEDICINE 31 94.46% 100% 100% 100% 96.82% 100% 97.97%

Capel Ward 300 - GENERAL MEDICINE 31 90.06% 98.92% 94.35% 98.25% 91.84% 98.67% 94.54%

Chaldon Ward 328 - STROKE MEDICINE 31 92.2% 93.33% 95.41% 97.78% 93.55% 96% 94.38%

Charlwood Ward 301 - GASTROENTEROLOGY 31 92.99% 100% 99.45% 96.77% 95.17% 98.39% 96.45%

Copthorne Ward 100 - GENERAL SURGERY 31 94.35% 98.33% 88.75% 98.33% 92.47% 98.33% 94.77%

Coronary Care Unit 320 - CARDIOLOGY 31 96.77% 100% N/A 100% 96.77% 100% 98.39%

Delivery Suite 501 - OBSTETRICS 31 98.01% 97.31% 90.32% 88.71% 96.09% 95.16% 95.63%

Discharge Lounge 300 - GENERAL MEDICINE 31 95.04% 100% 95.11% 100% 95.07% 100% 96.67%

Godstone Ward 303 - CLINICAL 31 94.53% 98.36% 98.81% N/A 95.9% 98.36% 96.89%

(Haem) HAEMATOLOGY

Godstone Ward 300 - GENERAL MEDICINE 31 81.29% 100% 109.3% 97.85% 91.8% 98.92% 94.84%

(Med)

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Hazelwood 430 - GERIATRIC MEDICINE 31 95.32% 98.39% 92.42% 93.85% 93.84% 96.06% 94.73%

Holmwood Ward 320 - CARDIOLOGY 31 96.13% 98.92% 98.92% 100% 97.18% 99.19% 97.85%

192 - CRITICAL CARE

ITU/HDU 31 97.99% 95.01% 94.13% 93.33% 97.47% 94.9% 96.22% MEDICINE

110 - TRAUMA &

Leigh Ward 31 95.93% 74.44% 96.94% 94.51% 96.4% 84.53% 91.49% ORTHOPAEDICS

Meadvale Ward 430 - GERIATRIC MEDICINE 31 88.44% 100% 96.39% 100% 92.72% 100% 95.22%

Neonatal Unit 420 - PAEDIATRICS 31 97.02% 100% 98.44% 96.43% 97.48% 98.96% 98.21%

110 - TRAUMA &

Newdigate Ward 31 89.88% 73.12% 113.84% 100% 100.07% 86.49% 94.17% ORTHOPAEDICS

Nutfield Ward 430 - GERIATRIC MEDICINE 31 94.75% 100% 101.02% 98.89% 97.13% 99.33% 97.96%

Outwood Ward 420 - PAEDIATRICS 31 92.25% 95.7% 93.75% 86.67% 92.41% 94.44% 93.26%

Rusper Ward 501 - OBSTETRICS 31 98.39% 96.77% N/A N/A 98.39% 96.77% 97.85%

Surgical 100 - GENERAL SURGERY 31 86.29% 96.77% 125.81% 95.16% 94.19% 95.97% 94.98%

Assessment Unit

Tandridge Ward 430 - GERIATRIC MEDICINE 31 86.52% 100% 90.1% 100% 88.62% 100% 92.16%

Tilgate Annex 300 - GENERAL MEDICINE 31 85.07% 96.77% 98.54% 100% 90.04% 98.06% 93.11%

340 - RESPIRATORY

Tilgate Ward 31 94.84% 96.74% 94.5% 103.13% 94.71% 98.39% 95.94% MEDICINE

110 - TRAUMA &

Woodland Ward 31 93.97% 96.77% 89.95% 98.39% 92.46% 97.58% 94.17% ORTHOPAEDICS

Total 93.15% 95.89% 95.69% 96.37% 94.04% 96.07% 94.86%

Planned versus actual commentary The Trust has delivered the planned versus actual staffing profile for January at organizational level. The overall compliance has improved on December but there have again been pressure points during the month.

As previously reported ward has a planned combined agency and substantive staffing model and there were a number of shifts that was one registered nurse short on day shifts but reported a compliance of 92.16% overall. Several areas are showing as amber for day shifts where a number of shifts were unfilled and support was provided by the matron and ward manager.

Newdigate and Leigh wards continue to show as red for RNs at night in January. This is because there has been an increase in the base staffing template from two RNs to three RNs at night but the posts are yet to be filled on a permanent basis. Recruitment is expected to be complete by the end of March 2018.

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Care hours per patient day (CHPPD) – January

Jan-18 Abinger Ward 430 - GERIATRIC MEDICINE 1302 1066.5 1426 1345.5 713 713 713 713 81.9% 94.4% 100.0% 100.0% 697 2.6 3.0 5.5 Acute Medical Unit 300 - GENERAL MEDICINE 3231.5 3016.5 1426 1330 2495.5 2484 1426 1368.5 93.3% 93.3% 99.5% 96.0% 975 5.6 2.8 8.4 Birthing Centre 501 - OBSTETRICS 713 663 0 0 713 575 0 0 93.0% 0.0% 80.6% 0.0% 56 22.1 0.0 22.1 Ward 430 - GERIATRIC MEDICINE 302 - ENDOCRINOLOGY 1426 1357 1230.5 1031 713 713 874 713 95.2% 83.8% 100.0% 81.6% 608 3.4 2.9 6.3 Brockham Ward 502 - GYNAECOLOGY 1382.5 1333 682 647.5 1069.5 1023.5 356.5 356.5 96.4% 94.9% 95.7% 100.0% 542 4.3 1.9 6.2 Brook Ward 100 - GENERAL SURGERY 712 704.5 356.5 310.5 701.5 644 0 0 98.9% 87.1% 91.8% 0.0% 320 4.2 1.0 5.2 Buckland Ward 101 - UROLOGY 1456 1364 1059 960 713 713 713 690 93.7% 90.7% 100.0% 96.8% 600 3.5 2.8 6.2 Burstow Ward 501 - OBSTETRICS 1426 1337 713 589 1069.5 1035 713 621 93.8% 82.6% 96.8% 87.1% 533 4.5 2.3 6.7 Capel Annex l Ward 300 - GENERAL MEDICINE 1444.5 1364.5 1069.5 1069.5 713 713 713 713 94.5% 100.0% 100.0% 100.0% 646 3.2 2.8 6.0 Capel Ward 300 - GENERAL MEDICINE 1543.5 1390 1096.5 1034.5 1069.5 1058 655.5 644 90.1% 94.3% 98.9% 98.2% 598 4.1 2.8 6.9 Ward 328-STROKE MEDICINE 1955 1802.5 1426 1360.5 690 644 1035 1012 92.2% 95.4% 93.3% 97.8% 806 3.0 2.9 6.0 Ward 301 - GASTROENTEROLOGY 1426 1326 728 724 713 713 713 690 93.0% 99.5% 100.0% 96.8% 593 3.4 2.4 5.8 Copthorne Ward 100 - GENERAL SURGERY 1426 1345.5 720 639 690 678.5 690 678.5 94.4% 88.8% 98.3% 98.3% 585 3.5 2.3 5.7 Coronary Care Unit 320 - CARDIOLOGY 1069.5 1035 0 0 713 713 356.5 356.5 96.8% 0.0% 100.0% 100.0% 238 7.3 1.5 8.8 Delivery Suite 501 - OBSTETRICS 2139 2096.5 713 644 2139 2081.5 713 632.5 98.0% 90.3% 97.3% 88.7% 131 31.9 9.7 41.6 Discharge Lounge 300 - GENERAL MEDICINE 775.5 737 705 670.5 356.5 356.5 356.5 356.5 95.0% 95.1% 100.0% 100.0% 128 8.5 8.0 16.6 Godstone Ward (Haem) 303 - CLINICAL HAEMATOLOGY 713 674 336.5 332.5 701.5 690 0 0 94.5% 98.8% 98.4% 0.0% 179 7.6 1.9 9.5 Godstone Ward (Med) 300 - GENERAL MEDICINE 410 - RHEUMATOLOGY 1782.5 1449 1069.5 1169 1058 1058 1069.5 1046.5 81.3% 109.3% 100.0% 97.8% 789 3.2 2.8 6.0 Holmwood Ward 320 - CARDIOLOGY 1782.5 1713.5 1069.5 1058 1069.5 1058 356.5 356.5 96.1% 98.9% 98.9% 100.0% 843 3.3 1.7 5.0 ITU/HDU 192 - CRITICAL CARE MEDICINE 4577 4485 715.5 673.5 4611.5 4381.5 345 322 98.0% 94.1% 95.0% 93.3% 442 20.1 2.3 22.3 Leigh Ward 110 - TRAUMA & ORTHOPAEDICS 1598.5 1533.5 1358 1316.5 1035 770.5 1046.5 989 95.9% 96.9% 74.4% 94.5% 838 2.7 2.8 5.5 Meadvale Ward 430 - GERIATRIC MEDICINE 1272 1125 1482 1428.5 713 713 724.5 724.5 88.4% 96.4% 100.0% 100.0% 696 2.6 3.1 5.7 Neonatal Unit 420 - PAEDIATRICS 1544.5 1498.5 736 724.5 1564 1564 644 621 97.0% 98.4% 100.0% 96.4% 426 7.2 3.2 10.3 Newdigate Ward 110 - TRAUMA & ORTHOPAEDICS 1591 1430 1178 1341 1069.5 782 1058 1058 89.9% 113.8% 73.1% 100.0% 799 2.8 3.0 5.8 Nutfield Ward 430 - GERIATRIC MEDICINE 1762.5 1670 1080 1091 690 690 1035 1023.5 94.8% 101.0% 100.0% 98.9% 859 2.7 2.5 5.2 Outwood Ward 420 - PAEDIATRICS 3110.5 2869.5 368 345 2139 2047 345 299 92.3% 93.8% 95.7% 86.7% 422 11.7 1.5 13.2 Rusper Ward 501 - OBSTETRICS 1426 1403 0 0 713 690 0 0 98.4% 0.0% 96.8% 0.0% 246 8.5 0.0 8.5 Surgical Assessment Unit 100 - GENERAL SURGERY 1426 1230.5 356.5 448.5 713 690 713 678.5 86.3% 125.8% 96.8% 95.2% 257 7.5 4.4 11.9 Tandridge Ward 430 - GERIATRIC MEDICINE 340 - RESPIRATORY MEDICINE 1220 1055.5 1742.5 1570 667 667 667 667 86.5% 90.1% 100.0% 100.0% 795 2.2 2.8 5.0 Tilgate Annex 300 - GENERAL MEDICINE 1819 1547.5 1061.5 1046 1069.5 1035 713 713 85.1% 98.5% 96.8% 100.0% 629 4.1 2.8 6.9 Tilgate Ward 340 - RESPIRATORY MEDICINE 340 - RESPIRATORY MEDICINE 1782.5 1690.5 1045.5 988 1058 1023.5 368 379.5 94.8% 94.5% 96.7% 103.1% 780 3.5 1.8 5.2 Woodland Ward 110 - TRAUMA & ORTHOPAEDICS 1782.5 1675 1069.5 962 713 690 713 701.5 94.0% 89.9% 96.8% 98.4% 693 3.4 2.4 5.8

The report for January is shown above.

The data comparison shows a consistent picture with previous months.

Care hours per patient day are calculated by dividing the total numbers of nursing hours on a ward or unit by the number of patients in beds at the midnight census. This calculation provides the average number of care hours available for each patient on the ward or unit. This tool links with planned versus actual reporting and other data such as safety thermometer, incident reporting, sickness rates, vacancy rates and professional judgement to determine the appropriate staffing levels for a ward or unit.

3. Recommendation To note the report

Fiona Allsop Chief Nurse February 2018

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