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

Board of Directors Part 114 June 20137.4 ConclusionsThe overall impression was that nursing staff worked to the very best oftheir ability and enjoyed their work at night.A high proportion of staff had both an appraisal in the last year andappropriate training. Being on permanent night duty seemed noimpairment to receiving training.The availability and speed of response of doctors were deemedinadequate and some staff commented that it impaired good medicalcare. More doctor cover is required to cope with the busy workload.Despite the current high levels of patient activity in the Trust, 80% of staffinterviewed felt there was adequate nursing staff on their ward.Additional staff appointed in the last few months had made aconsiderable difference on some of the wards. However, AMU felt theywere still under-staffed and ward 15 commented they needed more staffto cope with elderly confused patients.The Clinical Site Team also felt an extra nurse was needed for theirteam.The staff mix was generally satisfactory. The main negative commentsconcerned the limited role of Agency nurses on wards. A smaller degreeof discontent was expressed regarding bank staff. There was moreunhappiness about moving staff to other wards.There is a perception among some HCAs on a few wards that trainednurses are reluctant to help them with administering basic nursing care,even when the HCAs are under pressure.Many nursing staff commented on problems relating to outlier patients ontheir wards. Lack of training in managing elderly and confused patientswith co-morbidities was seen as a barrier to good clinical care. Acutemedical patients on surgical wards may also not receive the level of careexpected where staff are less experienced in delivering a particular typeof care.Nursing staff were generally very happy with both the support andavailability of the Clinical Site Team. Many felt, as did the CST members,that the Team would benefit from a further member.Portering services at night are both slow and inadequate. The current ITsystem for summoning a porter is cumbersome and repetitive and takestoo long. Responses for aggressive or confused patients need to beimproved.Nearly all staff felt happy to discuss concerns with their Team Leader ormanager.15The Hospital at NightQuality/Performance