Patient FIRST: Staffing

Page last updated: 8 September 2023
Categories
Organisations we regulate
  1. Introduction
  2. Flow
  3. Infection prevention and control
  4. Reduced patients in emergency departments
  5. Staffing
  6. Treatment
  7. Appendices

Aim

Staff will be in the right place, at the right time with the appropriate skills to care for patients and keep them safe.

Background

Staffing models need to be invested to deliver a safe and effective service for all patients.

Staffing models will depend on many things including:

  • attendances
  • skill sets and competencies of staff
  • number of junior staff including trainees
  • departmental layout
  • trust layout of urgent care flow and admission processes
  • acuity of workload
  • case mix of patients
  • additional needs such as teaching and training
  • coronavirus impact:
    • changes to flow
    • segregation
    • shielding staff.

In good emergency departments we have seen

Staffing models for the next 12 months that are supported by the trust to enhance the urgent care pathway. There needs to be an increase in staffing numbers where appropriate to incorporate new roles such as:

  • redirection
  • streaming
  • early senior decision makers
  • specialty support.

For all staff joining both a new trust and new department, there needs to be:

  • a clear induction programme that must include vital elements such as:
    • fit checking/testing
    • risk assessments (COVID-19 or otherwise)
    • support within the local environment
    • wellbeing to all individuals and how to access help when needed
  • regular teaching sessions
  • regular appraisal
  • regular communication to share information with all staff on time.

Paediatrics staffing

All departments where children attend should have:

  • a paediatric emergency medicine (PEM) consultant with dedicated clinical floor time in the paediatric emergency department (PED)
  • at least two children’s nurses per shift
  • a play specialist.

Read the guidance for mitigating challenges with children’s nurse staffing.


Next:
Treatment in the emergency department

Download and print

Patient FIRST (September 2023) (pdf, 338.19kB, English)

References

NICE: Safe Staffing for Nursing in Accident and Emergency Departments

NHS Improvement: Safe, sustainable and productive staffing in urgent and emergency care

RCEM Workforce Recommendations 2018: Consultant Staffing in Emergency Departmentsin the UK

RCEM Consultant Working and Job Planning

Improvement toolkit

Produced by front line clinicians in response to CQC’s Patient FIRST, this toolkit suggests a framework that NHS trusts can use to monitor and assess their progress in applying good practice principles.

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