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What are safe staffing levels?

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I can’t find any guidance for safe staffing here in the UK.  I would like to know how Trusts decide their staffing template.  Who decides, how it’s decided and if that is adhered to.  

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Hi Claire,

there is some guidance available in this area.

Trusts must utilise a professional judgement tool to map activity/acuity to define the required establishment position. This of course isn't an exact science and could be open to bias driven by financial/recruitment of workforce barriers etc.

Nice offer guidance for general adult inpatient settings.


For Emergency departments the Royal College of emergency medicine have issued guidelines (service delivery and workforce tool kit), as have the RCN in the guise of their BEST tool.




From a regulatory perspective, organisations are measured against their pre-determined establishment.
This can be a flawed process if there are failures in defining the appropriate establishment in the first place.

If you Intentionally over establish as part of continuity planning - you may not be able to meet the ambition position and therefore receive a regulatory notice, even if in reality your staffing figures are higher than other organisations figures in the same clinical context.

By the same reasoning it is possible for an organisation to set low establishment figures and achieve them, whilst effectively running on a shortfall comparative to other organisations staffing levels.

We require a robust and reliable systems approach to define what is safe and in which clinical context, otherwise we will never achieve system wide staff safety,






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