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Effective staffing case studies

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  • Organisations we regulate

In this series of case studies, we highlight what providers have done to take a flexible approach to staffing.

The case studies show different ways of organising services. They focus on the quality of care, patient safety, and efficiency, rather than just numbers and ratios of staff.

They illustrate how providers have redesigned services to make the best use of the available range of skills and disciplines. Or they found new ways to work with others in the local health and care system.

Safe, effective staffing is about having enough people with the right skills, in the right place, at the right time. It's about team work, not silo working. It's about developing staff to support each other in new roles - making sure patients follow the smoothest possible journey on their care pathway.

Teams

East Lancashire Hospitals NHS Trust worked with commissioners and social care teams to provide integrated care, coordinated around the needs of individuals in the community.
East Lancashire Hospitals NHS Trust’s new Acute Care Team has achieved significant improvements in response times to deteriorating patients.
Health professionals in Mid and South Essex used an evidence-based approach to create an alternative staffing pool within a typical primary care setting. GPs were better able to meet local demand and have improved the care they are able to give to patients.
East Lancashire Hospitals NHS Trust health staff developed social care skills to significantly reduce delayed transfers of care.
In West Sussex, the Hospital Rapid Discharge team starts planning for discharge as soon as possible after the person has seen a medic. They provide extra support for up to 72 hours when patients are admitted.

Physiotherapy

In Burton, emergency physiotherapy practitioners manage patients who attend emergency departments with musculoskeletal dysfunction. This gives more time for medical and nursing staff to manage other patients.
An advanced physiotherapy practitioner in Salford gives patients immediate access to expert physiotherapy diagnosis and advice. This has reduced waiting times and improved patient flow through A&E.
Social enterprise AHP Suffolk developed projects to reduce physiotherapy wait time, reduce secondary care referrals and provide a 'single point of access' service. Key components are self-management offerings, an intelligent self-referral system (web or phone) and introduction of rehab classes at scale- all partnering with local service providers, including acute trusts, GPs, leisure centres, and mental health and healthy living providers.
Nottingham CityCare ran a ‘1st line’ physiotherapy service. Physiotherapists managed patients with MSK related health complaints instead of a GP. This reduced costs per patient in two GP practices.
Extending the scope of a physiotherapist to work as a first contact practitioner in a GP practice improved the patient pathway and had a positive impact on GP capacity.
Leeds Teaching Hospitals NHS Trust introduced allied health professionals in its stroke rehabilitation ward. They make it easier for staff to engage patients in their own rehab for as much of the day and night as possible.
Allied health professionals in Bath help to avoid hospital admissions from the emergency department. Increased operating hours, robust data collection and interprofessional standards helped them to achieve their aims.

Phlebotomy

The phlebotomy team at Leeds Teaching Hospitals NHS Trust has extended its services, incorporating both venepuncture and cannulation within Emergency and Specialty Medicine. This better supports doctors and nurses to be released to provide more appropriate care. The goal is to eventually provide a more bespoke, extended service to all clinical service units across the trust.

Occupational therapy

In central London, a therapy service in an emergency department is preventing hospital admission and effecting early discharge.
Allied health professionals in Bath help to avoid hospital admissions from the emergency department. Increased operating hours, robust data collection and interprofessional standards helped them to achieve their aims.

Psychology

Psychology graduates are providing clinically relevant group activities on acute mental health wards. This has reduced pressure on ward staff and improved patient outcomes.

Nursing

Cheshire and Wirral Partnership Foundation Trust planned ahead to determine where their trainee nursing associates would be deployed once they had qualified. This case study includes initial feedback from team leaders about the impact RNAs are having in their teams.
Bexley Community Education Provider Network has introduced nursing associates to support practices in ‘future-proofing’ a nursing work force. This apprenticeship gives people a work-based learning route into a nursing career.
Nurses in Buckinghamshire have halved the number of unnecessary hospital admissions. And they’ve reduced the average length of time people stay in hospital.

Radiography

Mid Yorkshire Hospitals has embraced skill mix in radiology, embedding the four-tier structure in the workforce. This has underpinned changes in service models.
To address a shortage of radiologists in breast imaging services, Shrewsbury and Telford Hospital NHS Trust introduced new roles to form part of a multidisciplinary team.

Home care

Home care provider Home Instead Senior Care Exeter & East Devon helped South West Ambulance Service Trust (SWAST) deal with increasing pressure on their services from falls related calls.

Social work

Isle of Wight Council placed an experienced social care practitioner into the emergency department in St Mary’s Hospital. She has helped prevent unnecessary hospital admissions. And people return home quicker with the care and support they need.
Social workers at Worthing Hospital help people to focus on regaining their independence and prevent unnecessary admissions from the emergency floor.
East Lancashire Hospitals NHS Trust health staff developed social care skills to significantly reduce delayed transfers of care.

 

Last updated:
04 September 2019

 


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