One of these factors is making sure that the numbers of
registered nurses, registered midwives and care assistants in our
inpatient areas, where patients stay overnight, are at the right
Factors that impact on patient safety, the levels of
effectiveness of care delivery and the overall patient's experience
As part of its response to the findings from 'The Mid
Staffordshire NHS Foundation Trust Public Inquiry', the National
Quality Board published guidance to support providers and
commissioners of NHS care to make the right decisions about
nursing, midwifery and care staffing capacity and capability.
CLICK HERE to download this guidance from the NHS England
This webpage provides information on how we address and monitor
these matters at County Durham and Darlington NHS Foundation
We would welcome your feedback on whether this information is
easy to understand and answer any queries that you may
have. Email us at firstname.lastname@example.org
Alternatively, if you are a patient, service user, carer or a
relative and have specific queries about the ward or service that
you are using, please do not hesitate to ask to speak with the ward
sister / charge nurse or nurse or midwife in charge in the first
Noel Scanlon, Executive Director of Nursing
& Patient Experience
We have information boards outside the entrance to each
inpatient ward which are updated daily (see below).
These show the numbers of staff that are planned to be on duty
compared to those that are actually on duty. This is broken
down by registered nurses (or registered midwives for maternity
wards) and care assistant / support staff. These are
healthcare assistants, support workers and auxiliary nurses.
Reviewing the staffing areas in wall wards and departments is
something that ward sisters / charge nurses and matrons undertake
every day / shift.
The numbers of planned staff sometimes differs from those that
are actually available on the day.
Sometimes the actual number can be lower if a member of planned
staff suddenly becomes sick and unable to work. Where this is
the case, we will always make a judgement as to whether the
remaining available is sufficient to manage the patient caseload
safely. If this is still not sufficient, the ward sisters / charge
nurses and matrons work together to try and secure extra help from
other wards. Also, matrons work clinically on the wards often
to support particularly busy periods.
On some occasions, we may be required to close some beds on a
ward, if extra staff cannot be obtained. This is always a last
resort but may be necessary in order to keep patients as safe as
Also, there may be occasions when there are more staff actually
on duty than the number planned originally. This is usually
where extra / additional staff have been booked to look after, for
example, extremely sick patients or those that are confused or at
risk of falling and harming themselves.
The boards also display the number of patients per registered
nurse. As a guide and during the busiest times on a ward, during
day time hours, we would generally aim for no registered nurse to
have more than 8 patients to look after.
At nights, the patient caseload activity is usually lower than
that required during the daytime. However, if this is not the case,
then we will try and increase staffing levels to help support the
ward team and to provide the right levels of care to patients.
It is important to note that the numbers of available staff is
only one of the contributory factors to ensuring that patients are
Where concerns exist, efforts are made to move staff to help out
and, also pool efforts and resources to help busy areas out.
Any undue concerns that cannot be resolved are reported
to the Lead Nurse for the area and, if necessary to the
Executive Director of Nursing or one of the associate nursing
'The treatment I have received from all the staff has been
excellent and could you extend my thanks to them all. A very
thankful and relieved patient'.
Patient, Dermatology Outpatients Department, University Hospital
of North Durham