EDITORIAL EDITORIAL Consultant Consultant Editor EditorAlison AlisonWhile While Professor of Community Nursing, King’s College London
Editor Rowan Dennison Editor Oisin Sands [email protected] [email protected] Sub-editor Peter Bradley Farhad Buffery Commercial Manager Commercial Manager Andrew Wright [email protected] [email protected] Group Classified Manager Rachel McElhinney Group Classified Manager Rachel McElhinney [email protected] [email protected] Circulation Director Sally Boettcher Circulation Director Sally Boettcher [email protected] [email protected] Production Manager Jon Redmayne Production Manager Jon Redmayne Production Assistant Larry Oakes Production Assistant Larry Oakes Editorial Peter Constantine PublishingMake-up DirectorExecutive Anthony Kerr Publisher Anthony Kerr [email protected] Associate PublisherJulie Tracy Cowan Associate Publisher Smith Publishing Director Adrian Johnston Chief Executive Officer Ben Allen
Chief Executive Officer Ben Allen
EDITORIAL BOARD
Ben Bowers BOARD EDITORIAL Queen’s Nurse, Community Mandy Bowler Cancer Nurse Specialist, Senior Nurse for Planned Cambridgeshire Community Care Sunderland Services NHS TrustPCT David Briggs Mandy Bowler Senior Lecturer, University of Clinical Business Manager, Hertfordshire South Tyneside NHS Foundation Trust Ann Bryan Julie HeadBliss of Community and Head Department: Mental ChildofHealth, Chester Health, King’s College London University David Briggs Julie Clennel Senior Lecturer, Head of Professional University of Hertfordshire Development, Directorate of Julie Clennell Nursing, NHS Darlington Head of Clinical Governance, Health Partnership County Durham & Centre Darlington Dr Maria Horne NHS Foundation Trust Health Visiting Lecturer/ Jane Griffiths ResearchinFellow Manchester Lecturer Community Nursing, University of University Manchester Dr Gill Hubbard Vanessa Heaslip Fellow, Cancer Research Senior School StirlingLecturer, University of Health and Social Care,
Bournemouth University Maria Horne Kay Kane Senior Lecturer in Public Nurse Manager, Health, School of District Health Nursing,University Belfast HSC Trust Studies, of Bradford Prof Hughes Catriona Kennedy Julie Schoolof Director, Napier Head Quality Compliance, University Marie Curie Cancer Care Kay Kane Dr Karen Ousey Independent Consultant Divisional Head, University Catriona Kennedy of Huddersfield School Director, Vera Todorovic Napier University Manager, Dietetics and Brian Nyatanga Nutrition Service, Bassetlaw Senior Lecturer, Hospital, Worksop University of Worcester John Unsworth Tricia Robinson Head of Nursing St. Division, Nurse Consultant, George’s Northumbria University Hospital, University of London Dr Tricia Wilson Vera Todorovic Senior Lecturer, Manager, Dietetics and Nutrition Bassetlaw UniversityService, of Hertfordshire Hospital Tricia Wilson Senior Lecturer, University of Hertfordshire
UK PERSONAL PERSONAL SUBSCRIPTION SUBSCRIPTION RATES RATES UK Quarterly Quarterly Direct Direct Debit Debit Annual Direct Annual Direct Debit Debit
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MA Healthcare Ltd is part of the Mark Allen Group
www.markallengroup.com The British Journal of Community Nursing is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: +44 (0)20 7738 5454 Website: www.bjcn.co.uk © MA Healthcare Ltd, 2014. 2012. All rights reserved. No part of the British Journal of Community Nursing may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, (electronic, mechanical,photocopying, photocopying,recording, recording,or orotherwise otherwise) without prior written permission of the Publishing Director. ISSN 1462-4753 Printed by Pensord Press Ltd, Blackwood, NP12 2YA Cover picture: iStock/ACMPhoto istockphoto.com
The paper used within this publication has been sourced from Chainof-Custody certified manufacturers, operating within international environmental standards, to ensure sustainable sourcing of the raw materials, sustainable production and to minimise our carbon footprint.
A shortage of direction
T
he Francis report on care quality at Mid Staffordshire NHS Foundation Trust and the crisis that preceded it had wide-reaching implications for health care in the NHS. Moreover, it brought some of the problems that had been quietly developing within the service for many years to the attention of the public (Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013). A key recommendation from the report was the need for a more ‘systematic and responsive’ approach to determining nurse staffing levels (Royal College of Nursing, 2013). Debate rages on in the national media about understaffed trusts and hospitals, and—just as significantly—how the definition of staff shortage should be understood, with as many as half of UK hospital wards now claimed to be understaffed (ITV, 2013). Predictably, the figures vary wildly, and calculations by different organisations yield very different results. As with so much media discussion, this obscures the basic need for change underlined by the Francis report. Furthermore, the community element of staffing problems goes almost unreported, despite the fact that the drop-off in district nursing numbers has been known about for many years (Queen’s Nursing Institute (QNI), 2011). It is imperative that practical steps are taken to address problems of understaffing, and this will require close cooperation between government bodies and trusts themselves. Many community trusts are currently involved in efforts to find some solutions to the problems of understaffing and the overburdening of individual health-care professionals. To support and document these attempts, over the coming months BJCN will be publishing a series of articles on ‘Caseload and Workforce Planning’, detailing some of the projects occurring in various regions and trusts around the country aiming to provide a more ‘systematic and responsive’ approach to staffing. As Ben Bowers and Kay Durrant remark on page 58 in the inaugural feature in this series, the problem of accurately calculating ‘safe’ levels in the community is extremely difficult—perhaps even more so than in the hospital setting: ‘variable workloads, patients changing dependencies, fluctuating travel times and local variances in what work district nursing teams actually do makes identifying appropriate community staffing levels complicated to capture and predict’.
The Royal College of Nursing (2013) and the QNI (2011) have pointed out that a policy focus on community-based care can alleviate the NHS’s problems. However, the large-scale transfer of services to community and primary care will require significant change in the make-up of the workforce. Projects around the country are springing up to address these problems from the bottom up. Effective changes are now needed from the top down to complement this. BJCN ITV (2013) Half of UK hospital wards ‘regularly understaffed’. ITV News, 18 September. http:// tinyurl.com/peaah84 (accessed 16 January 2014) Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Stationery Office, London. http://tinyurl.com/anb9zme (accessed 16 January 2014) Queen’s Nursing Institute (QNI) (2011) Home Visit. http://tinyurl.com/nc545tu (accessed 16 January 2014) Royal College of Nursing (2013) Safe Staffing Levels: A National Imperative—The UK Nursing Labour Market Review 2013. http://tinyurl.com/nqd9d8g (accessed 16 January 2014)
British Journal of Community Nursing February 2014 Vol 19, No 2
Rowan Dennison Editor
57
Journal of Community Nursing. Downloaded from magonlinelibrary.com by 138.253.100.121 on November 24, 2015. For personal use only. No other uses without permission. . All rights re
Editor Rowan Dennison Editor Oisin Sands [email protected] [email protected] Sub-editor Peter Bradley Farhad Buffery Commercial Manager Commercial Manager Andrew Wright [email protected] [email protected] Group Classified Manager Rachel McElhinney Group Classified Manager Rachel McElhinney [email protected] [email protected] Circulation Director Sally Boettcher Circulation Director Sally Boettcher [email protected] [email protected] Production Manager Jon Redmayne Production Manager Jon Redmayne Production Assistant Larry Oakes Production Assistant Larry Oakes Editorial Peter Constantine PublishingMake-up DirectorExecutive Anthony Kerr Publisher Anthony Kerr [email protected] Associate PublisherJulie Tracy Cowan Associate Publisher Smith Publishing Director Adrian Johnston Chief Executive Officer Ben Allen
Chief Executive Officer Ben Allen
EDITORIAL BOARD
Ben Bowers BOARD EDITORIAL Queen’s Nurse, Community Mandy Bowler Cancer Nurse Specialist, Senior Nurse for Planned Cambridgeshire Community Care Sunderland Services NHS TrustPCT David Briggs Mandy Bowler Senior Lecturer, University of Clinical Business Manager, Hertfordshire South Tyneside NHS Foundation Trust Ann Bryan Julie HeadBliss of Community and Head Department: Mental ChildofHealth, Chester Health, King’s College London University David Briggs Julie Clennel Senior Lecturer, Head of Professional University of Hertfordshire Development, Directorate of Julie Clennell Nursing, NHS Darlington Head of Clinical Governance, Health Partnership County Durham & Centre Darlington Dr Maria Horne NHS Foundation Trust Health Visiting Lecturer/ Jane Griffiths ResearchinFellow Manchester Lecturer Community Nursing, University of University Manchester Dr Gill Hubbard Vanessa Heaslip Fellow, Cancer Research Senior School StirlingLecturer, University of Health and Social Care,
Bournemouth University Maria Horne Kay Kane Senior Lecturer in Public Nurse Manager, Health, School of District Health Nursing,University Belfast HSC Trust Studies, of Bradford Prof Hughes Catriona Kennedy Julie Schoolof Director, Napier Head Quality Compliance, University Marie Curie Cancer Care Kay Kane Dr Karen Ousey Independent Consultant Divisional Head, University Catriona Kennedy of Huddersfield School Director, Vera Todorovic Napier University Manager, Dietetics and Brian Nyatanga Nutrition Service, Bassetlaw Senior Lecturer, Hospital, Worksop University of Worcester John Unsworth Tricia Robinson Head of Nursing St. Division, Nurse Consultant, George’s Northumbria University Hospital, University of London Dr Tricia Wilson Vera Todorovic Senior Lecturer, Manager, Dietetics and Nutrition Bassetlaw UniversityService, of Hertfordshire Hospital Tricia Wilson Senior Lecturer, University of Hertfordshire
UK PERSONAL PERSONAL SUBSCRIPTION SUBSCRIPTION RATES RATES UK Quarterly Quarterly Direct Direct Debit Debit Annual Direct Annual Direct Debit Debit
£32 £32 £125 £125 £132 £132
Annual Credit Credit Card Card Annual 2yr 2yr Annual Annual Credit Credit Card Card £224 £224 3yr Annual Credit 3yr Annual Credit Card Card £316 £316 Subscribe online: www.magsubscriptions.com, Subscribe online: www.magsubscriptions.com, Subscribe by +44 (0) (0) 1722 1722 716997 716997 Subscribe by phone: phone: +44
MA Healthcare Ltd is part of the Mark Allen Group
www.markallengroup.com The British Journal of Community Nursing is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: +44 (0)20 7738 5454 Website: www.bjcn.co.uk © MA Healthcare Ltd, 2014. 2012. All rights reserved. No part of the British Journal of Community Nursing may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, (electronic, mechanical,photocopying, photocopying,recording, recording,or orotherwise otherwise) without prior written permission of the Publishing Director. ISSN 1462-4753 Printed by Pensord Press Ltd, Blackwood, NP12 2YA Cover picture: iStock/ACMPhoto istockphoto.com
The paper used within this publication has been sourced from Chainof-Custody certified manufacturers, operating within international environmental standards, to ensure sustainable sourcing of the raw materials, sustainable production and to minimise our carbon footprint.
A shortage of direction
T
he Francis report on care quality at Mid Staffordshire NHS Foundation Trust and the crisis that preceded it had wide-reaching implications for health care in the NHS. Moreover, it brought some of the problems that had been quietly developing within the service for many years to the attention of the public (Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013). A key recommendation from the report was the need for a more ‘systematic and responsive’ approach to determining nurse staffing levels (Royal College of Nursing, 2013). Debate rages on in the national media about understaffed trusts and hospitals, and—just as significantly—how the definition of staff shortage should be understood, with as many as half of UK hospital wards now claimed to be understaffed (ITV, 2013). Predictably, the figures vary wildly, and calculations by different organisations yield very different results. As with so much media discussion, this obscures the basic need for change underlined by the Francis report. Furthermore, the community element of staffing problems goes almost unreported, despite the fact that the drop-off in district nursing numbers has been known about for many years (Queen’s Nursing Institute (QNI), 2011). It is imperative that practical steps are taken to address problems of understaffing, and this will require close cooperation between government bodies and trusts themselves. Many community trusts are currently involved in efforts to find some solutions to the problems of understaffing and the overburdening of individual health-care professionals. To support and document these attempts, over the coming months BJCN will be publishing a series of articles on ‘Caseload and Workforce Planning’, detailing some of the projects occurring in various regions and trusts around the country aiming to provide a more ‘systematic and responsive’ approach to staffing. As Ben Bowers and Kay Durrant remark on page 58 in the inaugural feature in this series, the problem of accurately calculating ‘safe’ levels in the community is extremely difficult—perhaps even more so than in the hospital setting: ‘variable workloads, patients changing dependencies, fluctuating travel times and local variances in what work district nursing teams actually do makes identifying appropriate community staffing levels complicated to capture and predict’.
The Royal College of Nursing (2013) and the QNI (2011) have pointed out that a policy focus on community-based care can alleviate the NHS’s problems. However, the large-scale transfer of services to community and primary care will require significant change in the make-up of the workforce. Projects around the country are springing up to address these problems from the bottom up. Effective changes are now needed from the top down to complement this. BJCN ITV (2013) Half of UK hospital wards ‘regularly understaffed’. ITV News, 18 September. http:// tinyurl.com/peaah84 (accessed 16 January 2014) Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. Stationery Office, London. http://tinyurl.com/anb9zme (accessed 16 January 2014) Queen’s Nursing Institute (QNI) (2011) Home Visit. http://tinyurl.com/nc545tu (accessed 16 January 2014) Royal College of Nursing (2013) Safe Staffing Levels: A National Imperative—The UK Nursing Labour Market Review 2013. http://tinyurl.com/nqd9d8g (accessed 16 January 2014)
British Journal of Community Nursing February 2014 Vol 19, No 2
Rowan Dennison Editor
57
Journal of Community Nursing. Downloaded from magonlinelibrary.com by 138.253.100.121 on November 24, 2015. For personal use only. No other uses without permission. . All rights re
