Guidance: Safe staffing and Human Factors

Hospital doctors

10 / 4 / 2014 Midnight

In response to the Mid Staffordshire NHS Foundation Trust Public Inquiry, the National Quality Board (NQB) - which brings together the different parts of the NHS system with responsibilities for quality, alongside patients and experts - published two sets of guidance in 2013:

  1. Safe staffing guidance 
  2. Human factors in healthcare concordat

In March 2014, NHS England and the Care Quality Commission published further guidance to help providers implement the safe staffing guidance.

1. Safe staffing guidance

The NQB worked with the Chief Nursing Officer for England to develop guidance to help providers and commissioners implement one of the key recommendations in the Francis report.

'How to ensure the right people are in the right place at the right time' , is a guide to nursing, midwifery and care staff capacity and capability.

Download the NQB guidance.

In March 2014, NHS Employers and NHS England held workshops for service and education providers and commissioners to look in depth at the NQB guidance, and consider their responsibilities in terms of implementing it.

Access more information, including the materials from the workshops, here.

Following this, NHS England and the Care Quality Commission published further guidance at the end of March, including a timetable of actions for trusts, and FAQs about what is expected of them. In brief, this includes:

  • Every trust's board is to receive and consider a report on staffing capability and capacity every six months, from June 2014
  • Every ward is to clearly display information about all staff present and planned on each shift
  • A monthly update on planned and actual staffing is to be considered by each board, and made available to the public
Employers in the NHS maintain that although numbers are important, workforce planning needs to be driven by local patient need, and a focus on effective multi disciplinary team working and adequate skills mix on wards is paramount.

Download NHS England's documents, issued on 31 March 2014, as follows:

Letter to providers

Timetable of actions for providers

Frequently asked questions

We are working with NHS England to make sure that you have access to the information and resources to support you to implement these measures. We will keep you informed via our bulletins and website.

Access NHS England's news story here.

2. Human Factors in Healthcare Concordat

The Human Factors in Healthcare Concordat has been signed by its member organisations and other partners. The Concordat demonstrates the NQB’s commitment to embedding a recognition and understanding of Human Factors across the NHS and in the activities of national organisations and in provider and commissioning organisations, reflecting the value it can offer in respect of improving the quality and productivity of  health services. 

Much of the activity to embed Human Factors in healthcare sits with frontline providers and the NQB commits to working with NHS organisations, clinicians and NHS staff to understand their current capabilities and establish their requirements. This will inform the development of a programme of tailored support that enables NHS organisations to maximise the potential that Human Factors practices and principles can offer in relation to patient safety and experience, efficiency and clinical effectiveness.  NHS England and Health Education England will lead the work to support the NHS in taking forward this important aspect of the patient safety agenda, working with other partners across the system.

Download the Concordat.


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