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Nursing & Midwifery: Workload & Workforce: Planning Project
Footnotes
Response to the Nursing & Midwifery: Workload & Workforce Planning Project by Scottish Executive Health Department
1 In community settings, 'dependency' refers to the community nursing service, rather than patient dependency.
2 21% is the figure recommended in the Audit Scotland report (Audit Scotland, 2002).
3 For definition, see page 16.
Nursing & Midwifery: Workload & Workforce Planning Project
1'Patient', in this instance, also refers to women and their families accessing maternity services.
2 Under Paediatric Intensive Care Society definitions, 'Level 3' is the paediatric equivalent of 'Level 1' in adult general care.
3 NHS QIS brings together five organisations: Clinical Resource and Audit Group (CRAG), Clinical Standards Board for Scotland (CSBS), Health Technology Board for Scotland (HTBS), Nursing and Midwifery Practice Development Unit (NMPDU), and the Scottish Health Advisory Service (SHAS).
4 A project to take forward this agenda has been launched within NHS QIS, supported by SEHD and the Directors of Nursing Group.
5 The Audit Scotland report (Audit Scotland, 2002) refers to the items listed under 'predictable absence' here as 'Time Out'.
6 The Accounts Commission was set up in 1975. It is independent of local councils and of government, can make recommendations, and reports to Scottish Ministers. Audit Scotland helps the Accounts Commission by investigating, on its behalf, various aspects of how public bodies work.
7 The Project Manager conferred with representatives from Audit Scotland, the Social Research Department at the Scottish Executive, the Information and Statistics Division (ISD), Dr Keith Hurst from the Nuffield Institute for Health, representatives from the Royal College of Midwives, senior nurses from primary care and members of the Project Steering Group to inform the questionnaire development process.
8 The State Hospital and NHS24 were not included in the project.
9 106 questionnaires were issued, but four were issued erroneously to Trusts/organisations for whom they were not appropriate. These were not completed by respondents, and were not considered in the data analysis.
10 The Partnership Forum attached to one organisation was unable to provide this endorsement.
11 With the exception of NHS Orkney and NHS Shetland, where video conference calls were held as an alternative to face-to-face meetings.
12 There was some misinterpretation of the question relating to quality of care methods across all questionnaire types, as some respondents did not consider methods such as audit and CNORIS and NHS QIS standards as relevant in their responses. There is sufficient ambiguity in the responses to this question across all areas to cast doubt on the reliability of data.
13 The initial questionnaire returns from the organisation which indicated that it had a 0% predictable absence allowance in parts of the organisation raised concerns. The organisation as a whole seemed to be an 'outlier'. The project Steering Group needed to establish the reasons why, particularly in light of the recommendation on 'time out' within the Audit Scotland report (Audit Scotland, 2002). Two members of the Steering Group visited the organisation and another comparable organisation (in size and activity) to seek clarification of the information provided and to undertake further analysis. The Steering Group is now satisfied that the organisation did not have a 0% predictable absence; the allowance subsequently identified as being included was, however, at the lower end of the scale, averaging around 13%, which represented annual leave and public holiday allowance.
14 This organisation did not use agency staff, and had funds available from within the nursing and midwifery budget to provide staff to cover absences.
15 1:1 care equates to one nurse to one child. 1:2 care equates to one nurse to two children. Respondents were asked to exclude children cared for in ITU or HDU settings as staffing levels are set at higher rates in these designated areas.
16 It should be noted that one organisation entered several responses for the first three choices.
17 Initial indications from this organisation that predictable absence allowance was reported as '0%' raised concerns. Following discussion with the relevant Director of Nursing, it was established that the predictable absence allowance was in fact 18%, which was funded.
18 While two questionnaires were issued to primary care areas, they should be considered in tandem. Not all questions were repeated in each questionnaire, but the combined questionnaires gave coverage across all areas.
19 Initial indications from this organisation that predictable absence allowance was unfunded raised concerns. Following discussion with the Director of Nursing for the organisation, it was confirmed that the 18% predictable absence allowance was in fact funded.
20 The Primary Care Part B questionnaire related to professional groups.
21 This question was unique to the Primary Care Part B questionnaire.
22 The relevant question in the Primary Care Part B questionnaire asked respondents specifically to refer to initiatives implemented in response to the new GMS contract, PMS contract and
Nursing for Health (SEHD, 2001c).
23 'Nurse Directors' refer to those who carry Board-level responsibilities; 'Directors of Nursing' refers to lead nurses in the operating divisions defined within new NHS systems.
24 In community settings, 'dependency' refers to dependency on the community nursing service, rather than patient dependency.
25 Senior charge nurses are commonly found in acute adult settings; those who perform similar functions in psychiatric, paediatric, primary care and maternity settings may hold different job titles, but have similar responsibilities in leading a team.
26 Support was expressed for the equivalent of senior charge nurses in community settings to have less protected time to address these responsibilities - half a day a week for district nurses, health visitors and public health practitioners, for instance - as many of the responsibilities were seen as being inherent to the role and were already addressed within job specifications.
27 21% is the figure recommended in the Audit Scotland report (Audit Scotland, 2002).
28 For definition, see page 16.
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