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  • Workforce planning and transformation to improve patient and staff safety and outcomes across all settings of care


    Health and social care faces a conflict between safe and appropriate staffing and the (government) directive to be cost efficient. In a time of clinical and support staff shortages, increasing demand for services and financial austerity, there is a need for a consistent approach to workforce analysis, benchmarking and planning across the health and social care to enable informed decision-making across finance, HR and nursing management to put the patient and their safety at the centre of all we do.

    'Establishment Genie' is an online workforce planning, safe staffing and benchmarking tool. It has been co-developed and tested with more than 300 teams across acute, community, residential care, hospice and independent providers of care. This has been supported by input from NHSE, NHS Professionals, The Florence Nightingale Foundation, Safe Staffing Alliance, Royal College of Nursing, Health Education England, Queen’s Nursing Institute and academic nurse staffing experts.


    Case study examples

    The following case studies show how trusts have been using the tool. Roles and responsibilities of staff have been reviewed and new workforce plans have been co-designed with staff at the frontline to deliver new ways of working that put the patient at the centre of care – whatever the setting.

    The Hillingdon Hospitals - Safety Supervision and Savings.pdfThe Hillingdon Hospitals - Ward Reconfiguration for Safety.pdf

    GIG Cymru NHS Wales - Residential Nursing homes Case Study.pdfChelsea and Westminister Hospital Case Study - Empowering Staff.pdf

    GIG Cymru NHS Wales - District Nursing Principles Case Study (1).pdfBerkshire Health Community Nursing Case Study.pdf

    Organisational benefits

    Integrated care levels, costs and common language enables clinical and corporate leads to collaborate and meet the requirements of a next-generation health and social care workforce:

    • Precise staffing profiles and options appraisal support CIP development and budgeting.
    • Gap analysis compared to budget and standards for exact hours and WTE requirement for each band.  
    • Uplift for leave is specific to each role and expected joiners, avoiding blanket uplifts that may not fit the needs of the unit.
    • Governance and control underpinned by agreed, costed roster templates, with ready reckoners to keep within range.
    • Improved recruitment and retention with evidence of staffing levels and support.
    • Outcomes track quality, with benchmarking to assure.

    Clinical benefits

    Professional judgement in workforce planning is supported by this NICE-endorsed tool:

    • Planning care levels and WTE for expansion, efficiency, reconfiguration and new service models.
    • Evaluating alternative shift models to reorganise, invest or save.
    • Modelling skill-mix and impact of new roles.
    • Understanding and validating variation.
    • Challenging peaks and troughs in cover to improve safety, release capacity and release cost savings.
    • Benchmarking and triangulation of patient care levels, with outcomes for correlation.
    • Mapping other staff group input across each setting.

    Background on 'Establishment Genie'

    Creative Lighthouse was founded in response to frustration at the focus on financially led decisions in health and social care management that did not consider the safety and care of patients or staff. We set out to build a platform that would allow all management groups in the healthcare sector to collaborate on safe staffing and financial governance. 

    Creative Lighthouse self-funded the development of a unique workforce-planning tool under the brand name ’Establishment Genie’, endorsed by the National Institute of Health and Care Excellence (NICE) in 2017.

    In April 2017, the Creative Lighthouse team were awarded a grant from Innovate UK to continue to develop the tool to include all settings of care in the knowledge that patient safety and workforce planning is not only the responsibility of acute services, but of all providers and commissioners of care. This is a critical aspect of enabling the improvement of quality and patient outcomes in a cost effective way, whilst providing data driven analytics to support professional judgment. 

    About the author

    I am a healthcare professional with over 15 years’ experience working in and consulting to public and private health and social care organisations. I have worked with a variety of health and care sector clients in the delivery of complex change, from transformational change and organisational design process to programme leadership and execution.

    I am passionate about the safe staffing agenda, recognising that in order for any organisation to ensure appropriate care and evidence for professional judgement, there must be consistency in approach and a way of linking staffing levels to quality outcomes that can then be benchmarked within and across organisations. This passion resulted in the birth of ‘Establishment Genie’.

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