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Safe Staffing Tools for Mental Health and Learning Disability Services

The National Quality Board requires NHS Trusts to use ‘evidence based tools to inform staffing capacity and capability’. A Health Education England supported programme has led work across the West Midlands to provide tools that help Mental Health and Learning Disability Services consider their staffing numbers mix and contact time.

Health Education England West Midlands office has been worked closely with mental health and learning disability trusts in the region and around England to develop speciality staffing tools.


Phase 1 (complete)

Was concerned with how trusts calculated safe staffing and developed a Mental Health Staffing Framework.

Phase 2 (complete)

This further developed one of the staffing tools and worked in collaboration with Keith Hurst to:

  • increase the sample size of quality assured benchmarked data from inpatient units
  • update the dependency descriptors
  • develop and build the benchmark database for community staffing tools for community mental health and learning disabilities teams

Each of these tools can be used in three ways and can be found in related documents below:

  • Option 1: Use the published multipliers to calculate staffing needs based on dependency levels.
  • Option 2: Use observed practice to calculate your staffing need and identify contact time and potential areas of need and efficiency.
  • Option 3: Undertake a full analysis based on observation as in Option 2 combined with a quality assurance exercise.  Observations gathered in this way may also contribute to the national benchmark if sufficient quality is observed.

The latest multipliers from Keith for Option 1 are available in the related documents below.  If you would like to use Options 2 or 3 please contact keithhurst.research@yahoo.co.uk directly who will provide materials and training for Options 2 and 3.

Please contact: keithhurst.research@yahoo.co.uk or tim.devanney@hee.nhs.uk for more information.

This data should not be used outside the NHS or in electronic staffing tools without permission from Keith Hurst.

Phase 3 (underway)

Phase 3 will develop to multiplier tool, making it applicable to a greater range of mental health services.

Context of Care Tool Learning Disability Services

Findings from a systematic review of literature on learning disability nursing staffing levels, and its relationship to the safety, quality and the delivery of compassionate nursing care (Mafuba, Gates, and Shanley, 2014) identified a series of factors thought to be necessary for the delivery of safe and compassionate learning disability nursing care to people with learning disabilities in inpatient settings. These were categorised into eight key themes and University of West London (UWL) developed these into a peer assessment tool to measure the ‘Context of Care’ see related documents for the delivery of safe and compassionate learning disability services, designed for use at unit/ward level, as well as directorate level in an organisation for Board reporting.

Fundamental to the ‘Context of Care Tool’, is a belief that focusing purely on numbers of nurses alone will not address any potential short comings in practice or services, rather in addition to addressing the numbers of staff the capability and capacity of nurses must be empowered in their context of practice to deliver safe and compassionate nursing care.

Within the tool, ‘context’ has been operationalised into 56 separate statements in total. Clinicians are required to rate each statement, drawing on a range of evidence to support their clinical judgment, to measure compliance with the statements, thus proving a valid and reliable measure for the delivery of safe and compassionate learning disability nursing care to people with learning disabilities in in-patient and community settings.

More Information

Please contact: keithhurst.research@yahoo.co.uk and Tim.Devanney@wm.hee.nhs.uk for further information


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