Scores of hospitals’ shift levels fall below minimum

Witney Gazette: Trust chief executive Sir Jonathan Michael Trust chief executive Sir Jonathan Michael

ALMOST 60 staff shifts in the county’s hospitals were below the “minimum safe” level in March, new figures have revealed.

Oxford University Hospitals NHS Trust must now publish their staffing figures every two months.

They show how for March, 58 shifts went to the “escalation” level, meaning staff had to be drafted in from elsewhere.

This was out of 5,947 total shifts, of which about two thirds were at the agreed staffing level.

Staffing numbers are decided by the hospital, ward-by-ward, depending on what staff are needed.

Health bosses have given assurances that they are doing all they can to combat the less than one per cent below “minimum safe” levels.

The trust’s acting chief nurse Liz Wright told the Oxford Mail that ‘minimum safe’ means “there is an increase in activity or short notice sickness but that actions are taken locally to support needs of patients”.

She added: “Should a ward area be identified as having levels below this then the process of ‘escalation’ s means that the matron or divisional nurse will act to move staff around from outside the ward and/or take other actions to support the team.”

And local nursing representatives have said they appreciate work being done to increase recruitment.

Royal College of Nursing officer for Bucks & Oxon, Victoria Couling, said: “We are always concerned about the issue of nursing shortages.

“It is very important that the hospital needs to be staffed to safe levels with permanent staff.

“We are aware that the trust has invested a significant amount of money to increase nursing levels, with Oxfordshire being an expensive recruitment area.

“We have regular meetings with the hospital and we agree this is an important issue.”

Children’s services shifts made up 10 of the below “minimum safe” level, but the trust said seven midwifes had been offered a post and are due to start in September.

A total of 40 of all shifts across the trust had “surplus” staff and about two thirds – 4,257 shifts – were at the full agreed level over the month.

Some 1,690 were classed as the “minimum safe” level, and 58 were the level below “minimum safe”.

These “escalation” shifts meant action had to be taken to fill gaps – but bosses said not all were filled.

The trust would not say how many shifts were not covered when asked by the Oxford Mail, but its report said it took steps to “ensure patient safety”, such as changing workloads, admitting emergencies to other wards and bringing in other ward staff.

It said: “By adopting such measures a safe clinical environment for patients was maintained in all cases.”

The report said escalation shifts “occurred largely due to short notice sickness and/or inability to fill with temporary staff.” It said this was “in spite of a suite of options being considered as part of the process” and, for example, extra staff in other wards being brought in.

The trust said: “It was not always possible to fill all escalation shifts.”
Chairman of official watchdog Healthwatch, Larry Sanders said: “We want good care for the people of Oxfordshire and that requires adequate staffing and therefore this lack of full staffing is very serious.”

Witney Gazette: Andrew Smith

Andrew Smith MP

Oxford East Labour MP Andrew Smith said: “It is vital for patient safety that staffing levels provide proper cover and gaps are filled.”

The figures come after inspectors last week raised concerns about staff shortages at Oxford’s John Radcliffe Hospital.

Concerns made in the Care Quality Commission (CQC) inspection included a “lack of sufficient numbers” in surgery, maternity and operating theatres.

The problems are despite a trust-wide increase in full-time roles from 9,102 to 9,590 in 2013/14.

Trust chief executive Sir Jonathan Michael told last Wednesday’s trust board the figures are “testament to good staffing management”.

He said: “I wouldn’t wish members of the board to be concerned that [minimum safe] equals anything other than safe staffing levels.”

The figures were published under instructions from NHS England and the CQC, which last week rated the trust good under its Hard Truths scheme, which demanded public figures between April and June.

The CQC reported the trust said Oxford’s high cost of living and lack of hospital parking and its cost led to recruitment difficulties.

It saw delays in patients being discharged from intensive care to surgery and this “put pressure on staff” to discharge them.

Staff also reported “high levels of stress and low morale due to workload” and operating theatre lists cancelled about once a week due to shortages.

Neurosurgery doctors told inspectors “sometimes the medical staffing levels felt unsafe” with one junior doctor looking after 74 patients out of hours.

But the trust said its spreadsheet-based recording system is “fragile” and “open to user error” and needs to be replaced by a more “robust” system.

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Comments (1)

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10:21am Tue 20 May 14

Mark L. says...

“We are aware that the trust has invested a significant amount of money to increase nursing levels, with Oxfordshire being an expensive recruitment area"

So why did you cut Nurses pay by ending the recruitment and retention payments last year then. Most shifts my wife works are short staffed. On xmas day and New Years eve, she was the only trained nurse looking after 15 patients. Short staffed, shift after shift yet correct staffing level on the days of the CQC inspections. Easy when you know in advance.
“We are aware that the trust has invested a significant amount of money to increase nursing levels, with Oxfordshire being an expensive recruitment area" So why did you cut Nurses pay by ending the recruitment and retention payments last year then. Most shifts my wife works are short staffed. On xmas day and New Years eve, she was the only trained nurse looking after 15 patients. Short staffed, shift after shift yet correct staffing level on the days of the CQC inspections. Easy when you know in advance. Mark L.
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