« Previous | Contents | Next »
Listen
Nursing & Midwifery: Workload & Workforce: Planning Project
Appendix 1
Steering group membership
Gerry Marr (Chair), Chief Executive, Tayside University Hospitals NHS Trust
Irene Barr, Deputy Director of Nursing, South Glasgow University Hospitals NHS Trust
David Benton, Director of Nursing, Grampian University Hospitals NHS Trust
Professor James Buchan, Faculty of Social Sciences, Queen Margaret University College, Edinburgh
Teresa Crawford, Associate Director of Nursing, North Glasgow Hospitals NHS Trust
Kathy Dallest, eCHIP Project Manager, Primary Care Division, Scottish Executive
Alan Gall, Director of Finance, Grampian University Hospitals NHS Trust
Bridget Hunter, Lead Officer for Nursing, UNISON Scotland
James Kennedy, Director, Royal College of Nursing (Scotland)
Alex Mathieson, Freelance Writer and Editor, Edinburgh
Pauline Milne, Project Manager, Nursing and Midwifery Workload and Workforce Planning Project
Patricia Purton, Director, Royal College of Midwives (Scotland)
Lesley Summerhill, Director of Nursing, Tayside University Hospitals NHS Trust
Neil Wilson, National Workforce Unit, Human Resources Directorate, Scottish Executive
Appendix 2
Examples of nursing and midwifery workload and workforce planning tools in adult acute care, paediatrics and psychiatry
Telford
The Telford Method (sometimes known as the 'consultative approach') utilises the professional views of nurses to determine how many nurses are required to staff a clinical area. There are three main elements to this system:
1) numerical assessment stage
2) transportation stage
3) summary stage.
Nurse per Occupied Bed (NPOB)
This is the average number of nurses per occupied beds. This information is presented as a whole time equivalent figure (WTE), for example 0.86 WTE or 1.1 WTE.
Acuity-Quality Method
Sometimes referred to as the dependency-activity-quality method, this approach includes collection of details on patient dependency, nursing workload and quality. Examples include Criteria for Care, Birmingham, East Dyfed (MDSX) and NISCM.
Timed-Task/Activity Method
This approach utilises nursing care plans with associated timeframes or a detailed listing of the frequency and type of nursing interventions to determine the required number of nursing hours. Examples include GRASP and FIP.
Regression Based Systems
The Regression Method is a system where one variable (the independent variable) is used to predict another variable (the dependent variable). Examples of studies undertaken utilising this approach have used bed occupancy levels or numbers of theatre sessions as examples of independent variables to predict the required number of nurses (dependent variable). The method employs advanced statistical analysis systems to determine the relationship between the independent and dependent variables. An example of this approach is Teamwork.
National Recommendations
Recommendations from professional associations/bodies, such as the National Association of Theatre Nurses' formula for calculating staff required per theatre session, or Royal College of Nursing guidance on skill mix and staffing in children's wards and departments.
Based on Historical Budgets
Nursing or midwifery establishments that have been determined purely by available budgets.
Appendix 3
Examples of maternity-specific workload and workforce planning tools
MatS Model
The MatS model is the result of a research project in 1994, funded by the Chief Scientist Office. The model enables users to calculate midwifery and untrained staff required to provide a system of maternity care as defined by the user. There are two versions of the model - one version is strategic and the other is designed for operational use.
Birthrate Plus
Birthrate Plus is a framework for workforce planning and strategic decision making in maternity services. To determine the case mix for this model, clinical scores are allocated retrospectively to mothers and babies depending on the normality of the process and outcome of the labour. There are five categories of clinical score used in Birthrate Plus.
Patient Journey
A model which follows the woman's experiences covering the following:
Appendix 4
Examples of workload and workforce planning tools used in primary care settings
Caseload Profiling Tool
Involves recording patient characteristics against set criteria and using the information to determine staffing requirements. One example of a measure that may be used in caseload profiling is the Health Visitor's Vulnerability Score.
LHCC (Local Health Care Co-operative) Needs Assessment
The method used to determine the level of need across the local community under the care of the LHCC. It may include measures of deprivation, numbers of individuals in priority areas and the development of neighbourhood profiles, among other measures. Information is then used to determine staffing requirements for the LHCC.
Workload Analysis Tool
Involves reviewing and recording a number of aspects of workload, including: the nursing (or equivalent) time involved in caring for patients with specific needs; group activities; travel time; record keeping; professional practice development. The information is then used to determine the number of staff required to provide care for a specific area or group of patients.
Measure of Dependency on Nursing Service
Requires an assessment of the individual's dependence on the nursing service and is not a measure of the individual's functional ability, state of health or emotional well-being. For example, an individual may be in a high dependency category, but social care staff or the voluntary sector may adequately provide much of the care. The measure is therefore interested in determining the extent of dependency purely on the community nursing service and using this information to predict staffing requirements.
Appendix 5
Partnership Information Network Guidelines
The Partnership Information Network (PIN) Board was established by the NHSScotland Partnership Forum and is linked to the Human Resources Forum. Membership is drawn from trade unions, professional organisations, NHS Board management and the Scottish Executive. It was set up to produce guidelines for the development of good employment practice for use across Scotland.
PIN Guidelines
1. Dealing with Employee Concerns
2. Dignity at Work: Eliminating Bullying and Harassment in the Workforce
3. Equal Opportunities Polices
4. Facilities Arrangements
5. Family Friendly Policies
6. Management of Employee Capability
7. Management of Employee Conduct
8. Personal Development Planning and Review
9. Redeployment
10. Secondment
11. Managing Health at Work
Appendix 6
Establishments
Technical summary
The tables which follow provide details of occupancy rates, number of staffed beds, funded establishment numbers, in-post data and vacancy levels.
The data from the project have been detailed alongside ISD data where they are available and where comparisons are possible. Definitions used within the ISD data are shown in Box A6.1.
Box A6.1 Definitions from ISD Nursing and Midwifery Vacancy Survey
Staff in post All staff in post who are on payroll, including those on annual, sick or maternity leave or on short training courses. Posts under review These are posts that are vacant because they are under review or held open to cover for peak workload or staff on courses, maternity leave or sick leave. They should be vacant and funded posts which the organisation is not trying to fill. Vacancy These are unfilled or vacant posts the organisation is actively trying to fill. Frozen posts being held for financial or other reasons but which the organisation is not trying to fill are excluded. Posts that could be filled by internal candidates if the resulting transfer would create a further vacancy that the organisation would want to fill are included, but those being reserved for internal supernumerary staff who would otherwise be made redundant are excluded. Establishment When publishing workforce statistics, establishment is defined as: Establishment = staff in post + posts under review + total vacancies. |
Analysis of the two sets of data has been undertaken and the total qualified staff in post across all six questionnaire types in the project (at June 2003) has been compared to the ISD figures for qualified staff in post (March 2003). The ISD data were 3.6% greater than the project data.
The ISD vacancy data include specialist nurses, but within the nursing workload data, vacancy rates for specialist nurses are provided separately. Vacancy rates for qualified nursing staff are higher in the project data than in the ISD data for Adult Acute Care, Paediatrics, Psychiatry and Primary Care Teams (Part B). The vacancy rates for Maternity are lower in the nursing workload data than in the ISD. The vacancy rates for Community Hospitals (Primary Care Part A) were slightly higher in the nursing workload data than in ISD data.
There are several possible reasons for the differences between the two sources of data, and these include:
differences between specialisations in the project questionnaires and ISD aggregations
slight seasonal variations
funded establishments may have been increased in April 2003 (as part of the budget-setting process for 2003-2004), but may have remained unfilled at June 2003
the influence of student outflows on March 2003 ISD vacancy data.
In relation to cohorts of student nurses exiting higher education institutes, Table A6.1 provides details of the timing of nurses and midwives completing training programmes. This information should be considered in relation to the establishment and vacancy figures which follow.
Table A6.1 Timing of nurses and midwives completing training programmes
Institute of Higher Education | Nursing | Midwifery |
University of Abertay | September | - |
Bell College | September/February | - |
University of Dundee | October/January | - |
University of Edinburgh | September | - |
Glasgow Caledonian University | October | - |
University of Glasgow | August | - |
Napier University | September/February | - |
University of Paisley | September/February | - |
Queen Margaret University College | July | - |
Robert Gordon University | September/March | Sept/March (3 year) Aug/Feb (18 month programme) |
University of Stirling | September | - |
There was concern that some respondents in the project may have provided data by head count rather than by whole time equivalent (WTE) as requested. To clarify this, a letter was issued to all Directors of Nursing requesting confirmation that the data supplied were in whole time equivalents; all respondents confirmed that they had used WTE.
There is also a potential that data may be skewed for annual ISD census. It is therefore essential that a robust system be in place to ensure key staff involved in supplying data to ISD fully understand the nature of the data being sought. This will help to ensure that data provided are truly indicative of the organisation's position on nursing and midwifery establishments and associated vacancy rates.
« Previous | Contents | Next »