A guide to help standardise staffing decisions in adult inpatient wards in acute hospitals | NHS Improvement
This resource is based on the National Quality Board’s expectationsopens in a new window that to ensure safe, effective, caring, responsive and well-led care, trusts will employ the right staff with the right skills in the right place and at the right time.
We’ve designed this to be used by everyone involved in clinical establishment setting, approval and deployment – from the ward manager to the board of directors.
outlines a systematic approach for identifying the organisational, managerial and ward factors that support safe staffing
makes recommendations for monitoring and taking action if not enough staff are available on the ward to meet patients’ needs
builds on NICE guidelinesopens in a new window on safe staffing for nursing in adult inpatient care in acute wards
This year, a new system has been introduced which permits a little more analysis of the operational pressures facing NHS hospitals in winter | Nuffield Trust Blog
Trusts have been required to record any days on which they have reached any of four different Operational Pressures Escalation Levels, known as OPELs. OPEL 1 involves ‘meeting anticipated demand within available resources’, and OPEL 2 denotes a trust ‘starting to show signs of pressure’. Levels 3 and 4 correspond more closely to the old terms such as ‘black alert’ or ‘major incident’.
So far this winter we have had data published since the start of December, allowing us to get a sense of how the NHS is coping with the considerable pressures it is facing. While it may be too soon to tell how winter 2016/17 is affecting the running of NHS hospitals, a look at the OPEL data does offer us an early clue.
The figures published by NHS England for the period 1-27 December show that:
Around a third (50) of the 152 trusts that sent data into NHS England declared an OPEL 3 or 4. Of those, seven were OPEL 4s.
In total, 201 OPEL 3 or 4s were declared between 1-27 December, of which 15 were OPEL 4s.
The start of the weeks of the 12th and 19th of December saw two peaks in number of trusts at OPEL 3 and 4.
The worst day in this period was Tuesday 13 December, with 23 trusts at the highest levels, including four at OPEL 4.
A third of hospital trusts in England issued alerts warning they needed urgent action to cope with the pressure of patient numbers last month | BBC News
In the most serious cases – seven of the 50 trusts that issued alerts – the hospitals declared they were unable to give patients comprehensive care. BBC Radio 4’s Today programme has been told operations have been cancelled and patients left waiting on trolleys.
NHS England said tried-and-tested plans were managing the pressures. Dr Taj Hassan, president of the Royal College of Emergency Medicine, said there was an “absolute and urgent need” to help emergency departments.
Nagurney, J. M. et al. Annals of Emergency Medicine. Published online: January 6 2017
Study objective: Among older persons, disability and functional decline are associated with increased mortality, institutionalization, and costs. The aim of the study was to determine whether illnesses and injuries leading to an emergency department (ED) visit but not hospitalization are associated with functional decline among community-living older persons.
Conclusion: Although not as debilitating as an acute hospitalization, illnesses and injuries leading to an ED visit without hospitalization were associated with a clinically meaningful decline in functional status during the following 6 months, suggesting that the period after an ED visit represents a vulnerable time for community-living older persons.
Algorithm-based chat service will search database of symptoms and is designed as alternative to NHS’s 111 helpline | The Guardian
An app that helps people get medical advice on their smartphones is to be trialled by NHS England, it has been announced. The technology uses an algorithm to run a chat service that will search a database of symptoms, before advising whether to see a GP, go to hospital, visit a pharmacy or stay at home.
NHS 111 is designed as an alternative to the NHS’s non-emergency 111 helpline, which has seen an increase in demand from 2m to 15m calls a year in four years. But concerns have been expressed that the introduction of the app targets a symptom, rather than the cause, of the pressure on NHS services.