Safe staffing improvement resources for specific settings

These improvement resources support and enable NHS providers to make safe and sustainable staffing decisions in specific care settings.

They have been designed by service users and a multidisciplinary group of health professionals to be used by those involved in setting, approving and deploying the clinical establishment for NHS staff across a range of care settings and levels, from the ward manager to the board of directors.

These resources outline the principles of safer staffing processes within the following areas:

The resources provide a systematic approach for identifying the organisational, managerial, and clinical setting factors that support safe staffing. They also make recommendations for developing models of care, staffing, tools, and monitoring, and acting on staffing issues and risk to meet patients’ and service users’ needs.

When using these resources, you should also refer to the National Quality Board’s guidance Supporting NHS providers to deliver the right staff, with the right skills, in the right place at the right time: Safe, sustainable and productive staffing.

Adult inpatient wards in acute hospitals

This improvement resource is based on the National Quality Board’s expectations that to ensure safe, effective, caring, responsive and well-led care, NHS trusts will employ the right staff with the right skills in the right place and at the right time.

The resource builds on NICE guidelines on safe staffing for nursing in adult inpatient care in acute wards.

Urgent and emergency care

This improvement resource is designed to help standardise safe, sustainable and productive staffing decisions in urgent and emergency care.

It describes the principles for safe urgent and emergency care nurse staffing to ensure patients receive high-quality, safe care appropriate to their needs and wishes.

Neonatal care

This improvement resource is designed to help providers of NHS-commissioned services, boards and executive directors to support their lead nurses working in neonatal care implement safe staffing.

This resource builds on guidance from NICE, the Department of Health and Social Care and the British Association of Perinatal Medicine.

Maternity services

This resource describes the principles for safe maternity staffing across the multi-professional team to ensure women and their families receive joined-up care appropriate to their needs and wishes.

It builds on standards and recommendations from the Royal College of Midwives, Royal College of Obstetrics and Gynaecology, Royal College of Anaesthetists and the Care Quality Commission, and is informed by NICE Midwifery staffing guideline (NG4).

Children and young people’s services

This resource offers guidance to support safe staffing in children and young people’s inpatient wards in acute hospitals and builds on standards and recommendation from the Royal College of Nursing, Royal College of Paediatrics and Child Health, Paediatric Intensive Care Society (2015) and Care Quality Commission.

Learning disability services

This resource is designed to help commissioners and providers of NHS commissioned services, create, review and sustain safe and effective specialist health services for people with a learning disability, autism or both, who have a wide range of needs and varying levels of disability.

Our ambition was to make a difference to the quality and consistency with which safe and therapeutic services for people with learning disabilities, autism or both are delivered.

The resource draws on evidence from a commissioned rapid review of literature and professional review of practice. It aims to provide principles and an assurance framework to help standardise approaches to making decisions about staffing in a multidisciplinary learning disability setting, within organisations and across the system supporting the patient experience and outcomes.

Mental health services

This resource supports commissioners and providers of NHS-commissioned services to create, review and sustain safe and effective specialist mental health services.

It has been informed by work from NICE and a summary of literature reviews in the public domain, which specifically looked at the staffing structures in mental health services associated with improved service user outcomes, including safety, effectiveness and service user experience.

District nursing services

This is an improvement resource to support nurse staffing in district nursing services and is designed to be used by staff involved in clinical establishment setting, approval and deployment from the team leader of the district nursing service to the board of directors.

The resource builds on the evidence review made available by NICE on safe staffing for adult nursing in the community, which focused on the district nursing service and on community matrons. This has been supplemented with an additional evidence review, focusing specifically on the concept of ‘safe caseloads’ in the district nursing service.

Other resources