A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

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Board of Directors Part 114 June 20137. STAFF REPORT7.1 IntroductionNursing staff were interviewed on nine wards throughout the hospital inFebruary and March 2013 with the aim of providing information from acute,specialist medical, surgical and Medicine for the Elderly units.All staff had been on night duty during the previous months and were informedthat the questionnaire was confidential. An average of 5 staff were interviewedper ward with the intention that this should include 3 registered nurses and 2Health Care Assistants (HCAs). Extra staff were interviewed on wards 1 and24.The total number of nursing staff interviewed was 48, which included:17 HCAs (bands 2 and 3)25 Staff nurses (band 5) and6 Sisters (band 6) (who had in several cases been recently promotedbut had been on night duty in the past few months)Length of time in post varied from 6 weeks to 24 years. 18 (37%) of thenursing staff were on permanent night duty. The full, tabulated results for allwards can be found at Appendix B. A breakdown of the staff results by wardcan be found at Appendix D.7.2 General information on night staffing levelsMedicalAcute admissions, covering the Acute Medical Unit (AMU) and GP admissions- 1 medical registrar and 1 Senior House Officer (SHO)Medical wards - 1 F1 (Houseman) and 1 F2 (SHO). Occasionally the medicalregistrar may be called to see a serious ward problem.Surgical wards - 1 F1 with a registrar who was supposed to be mainly in bedas they were working normally the next day.Clinical Site Team (CST)This consists of either two band 6 sisters or a band 6 and a band 7.PortersThere are 4 or 5 porters on duty at night with one permanently in theEmergency Department (ED). All are on a permanent night rota.7.3 Results and responses7.3.1 Appraisals and trainingA majority of 85% of staff had had an appraisal in the last year and severalof those who had not had one had been in post for less than a year. A9The Hospital at NightQuality/Performance
Board of Directors Part 114 June 2013large majority of 83% had received all mandatory and necessary updatetraining in the past year.However, there was some feeling that HCAs may struggle to obtain theirpersonal development more than registered staff. A few staff membersseemed unclear about what they should be getting in terms of personaldevelopment. There was no impression that working on a permanentnights rota affected the availability or take-up of training.7.3.2 Staffing levels and skill mixAlmost 80% of staff were happy with the number of staff on their wards atnight. The clear exception was the Acute Medical Unit (AMU) where all 5respondents said more staff were needed particularly HCAs and alsoregistered staff. Ward 15 also felt they needed more staff to cope withelderly confused patients.Recent staffing level increases on several of the wards had made a majorimprovement to working conditions and care at night. We understand thatsince the survey took place, extra staff have been appointed to AMU atnight in line with a request from the clinical lead there and the Society ofAcute Medicine’s guidelines.In terms of skill mix, responses were largely positive but several problemswere of concern to many wards:The use of Agency nurses caused general disharmony as theywere unable to perform drug rounds and a number of practicalprocedures and although being paid as band 5s were effectivelyfunctioning as HCAs.It was suggested that the Trust might more effectively andeconomically employ one or two band 5 nurses to act as a “float”nurse around the hospital to fill gaps where needed instead ofemploying Agency staff. Bank staff were held in a better light butstill had their drawbacks.Medical outliers (general medical and medicine for the elderly acuteadmissions that have not been able to be placed on an appropriateward due to the high pressure of acute admissions) on wards raisedproblems for many staff because of a lack of appropriate training,their acute medical problems and patients’ often high levels ofdependence.Moving staff to other wards during shifts caused the remaining staffto be pressurised and over-worked. Sometimes replacing a staffnurse with an HCA made accomplishing more specialised tasksdifficult, particularly on high dependency wards.10The Hospital at NightQuality/Performance
Page 1 and 2: A meeting of the Board of Directors
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provide regular case updates to par
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including in the application eviden
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In certain circumstances, Monitor m
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Non-compliance penaltiesUnder sched
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Notice of Intent (section 90)Where
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AnnexMonitor’s powers of enforcem
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a) has provided, or is providing, a
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Monitor, 4 Matthew Parker Street, L
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Job DescriptionPOST TITLEREPORTS AN
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MEDICAL LEADERSHIPAs Medical Direct
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PERSON SPECIFICATIONQualifications:
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CALDICOTT GUARDIAN ROLE DESCRIPTION
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Board of Directors Business Program
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A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

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