Background to learning

The coronavirus pandemic has meant nursing and midwifery staff are working in new ways – sometimes in unfamiliar care settings and outside their normal scope of practice. During the response to Covid-19 these changes have often happened rapidly in order to meet increased demand whilst ensuring the care provided continues to be high-quality. This case study focuses on how trusts have built systems to enabled flexible deployment of nursing resource.

Learning and advice to be shared

At the Trust’s Luton and Dunstable Hospital site, nurses recognised the need to support colleagues working differently and systematic preparations were made to support staff who were likely to be redeployed:

• Daily drop-in sessions strengthened clinical skills such as; IV drug administration updates, venepuncture and cannulation updates (if competent previously held), use of IT systems (and associated documentation), time to practice on simulated patients, clinical device refresher (e.g. use of observation and IV equipment), and, ‘donning and doffing’.
• Key critical care training was also provided; such as care of an ET tube, care of CVC and arterial lines, sampling from these lines, complex eye and mouth care.
• Systematic follow-up contact with previously redeployed staff has asked about follow-up training requirements and some staff are being supported to work occasional shifts every 2 months in critical care areas to maintain relevant skills. Critical care study days are planned for around 30 redeployed staff.
• Skills, preferences and availability were recorded to match staff to specific areas – helping both staff and wards to plan and avoid ad-hoc assignments. Here, senior nurses also coordinated offers of help from external partners.
• The trust emphasised shift handover de-briefs to maximise help to staff and provided opportunities to seek support from colleagues when they are working in new surroundings. For example, extended availability of senior nurse and ‘business cards’ being handed to staff so they knew who to contact.

CNO national Shared Professional Decision-Making Council members also noted positive practice around systematic and structured plans for offering redeployment.  Council members reflected on the importance of transparent communication systems where staff were matched to and informed about redeployment options. Members observed that open communication with colleagues led to better experiences for redeployed staff.

Coordinated approaches to training, team huddles, staff shielding and collaboration between Trusts and other organisations all supported flexibility within the workforce.

Would it be beneficial to retain these changes?

The pandemic has tested many components of service resilience over a sustained period right across local systems. Council members noted the importance of organisations ensuring that the learning from the response during the pandemic supports longer-term winter and major incident planning.

Introduction of a systematic approach to deployment and redeployment helps to support covid-19 resilience but also enhances the response to other predictable challenges such as winter. The value of communications to support workforce flexibility, understanding the need for and availability of vital clinical skills will continue to be important beyond the pandemic.

Systems that support transparency and openness during this time of change help to engage nurses and midwives so that they can both make informed decisions about their own situation as well as help shape the available offer.  This is not only important for redeploying staff but provides a helpful platform from which trusts can engage with staff it may draw on from outside the trust.

For any further detail on this case study or to connect with Blenda, please contact england.1professionalvoice@nhs.net