Nursing Staffing Levels and Skill Mix In Accident and Emergency Departments

On the 16th January 2015 NICE announced the outlined draft guidance to help A&E departments ensure there are enough nursing staff available to provide safe care at all times to patients. NICE recommends that organisations consider minimum ratios when planning what nursing staff they need to fund in advance. Minimum ratios can also be used on a shift-by-shift basis to help work out what services can be made available at that time. These are based on the seriousness of a person’s condition and the level of care they need, for example:

Demand in A&E can change rapidly and the draft guideline recommends that when planning the number of nurses for the establishment, departments should allow for enough nursing staff to care for higher than the average number of patients who attend the department on a daily basis. By increasing weekly nursing staff hours to cover above average attendance numbers, staff can deal with unexpected peaks in the demand for A&E services and be moved around the department flexibly to respond to changing situations. NICE 16 January 2015

This conference focuses on implementing the forthcoming NICE guidance on Safe Staffing for Nursing in Accident and Emergency Departments. The guidance which is currently in development is due to be published for consultation in draft form in January 2015 and in final form in May 2015.

The Royal College of Nursing in June 2014 highlighted the need for this guidance stating that “Inadequate staffing in emergency departments across the UK risks undermining the quality of care received by patients.. Over the past year, the RCN has organised emergency care summits in England, Scotland, Wales, and Northern Ireland and found that frontline A&E nurses’ most frequently raised concerns were around staffing levels and poor access to specialist training…The RCN recommends that all A&E departments need to use evidence-based workforce planning tools to ensure safe staffing levels. Dr Peter Carter, Chief Executive & General Secretary of the RCN, said: “Emergency care is a highly pressurised and difficult environment for nursing staff to work in. Too often, A&E departments are being left in a sorry state without enough staff and without enough specialist skills. Our members in emergency nursing are frustrated that this can undermine their efforts to provide the highest possible standards of care for their patients."

This conference, through national updates, case studies including members of the NICE Guideline Advisory Group on Safe Staffing in A&E settings, will provide a guide to implementing the new guidance in practice and ensuring safe staffing in your A&E setting.

“Improving A&E workforce planning and education commissioning is crucial so that departments have enough nursing staff with the right mix of skills, including more nurses with specialist qualifications in emergency care.” Dr Peter Carter, Chief Executive & General Secretary of the RCN