Improving Safer Staffing Governance through Oversight and Partnership Working
Summary
The Safer Staffing and eRoster Team have led a Trust-wide programme to strengthen safer staffing governance, optimise workforce deployment, and align planning with clinical needs. Developments include the introduction of a weekly Safer Staffing Oversight Meeting, implementation of the Mental Health Optimal Staffing Tool (MHOST), improved roster scrutiny across inpatient and community teams, and strengthened oversight of temporary staffing. These changes have enabled safer, more productive staffing outcomes, reduced reliance on temporary staff, and delivered operational efficiencies while improving accountability and staff engagement.
The Challenge
The Trust faced inconsistent scrutiny of rostering practices, particularly in community 24/7 teams, leading to late roster approvals, high reliance on temporary staff, and increased net hours. Inpatient skill mix and establishment levels were sometimes misaligned with operational demand, with outdated eRoster templates reducing clarity and accountability. Oversight of Working Time Directive compliance and enhanced observation duties was limited, often leading to costly temporary staffing solutions. These issues contributed to inefficiencies, financial pressures, and risks to staff wellbeing and safe staffing assurance.
The Solution
A Trust-wide safer staffing improvement programme was launched, centred on a weekly Safer Staffing Oversight Meeting chaired by senior nursing and workforce leaders. This forum reviews Working Time Directive breaches, enhanced observation use, temporary staffing trends, retrospective shift bookings, and skill mix. MHOST was deployed across all inpatient services to inform evidence-based establishment reviews and optimise workforce planning. The eRoster Task and Finish Group updated templates and duty codes to improve alignment with operational needs. Community teams introduced regular roster scrutiny supported by the Safer Staffing and eRoster teams, reducing net hours and improving roster timeliness. The work was co-produced with senior nursing leaders, divisional teams, operational managers, and the Bank Bureau, ensuring shared ownership and sustainability.
Results & Next Steps
The programme has achieved significant reductions in net hours, including a 99.7% reduction in the Learning Disability and Forensic Division and a 75.6% reduction in the Acute Division. Roster approval times have improved across the Trust, with most inpatient teams now meeting or nearing the 8-week KPI. Enhanced observations are more effectively managed, reducing dependence on temporary staffing and supporting continuity of care. MHOST has enabled safe establishment reviews across all inpatient areas, with findings presented to divisional leadership and the Trust Board. Approximately 30 community teams are now part of the roster scrutiny process, with early improvements evident. The next cycle of MHOST reviews is scheduled for Q3 2025, embedding a sustainable model of safer staffing governance across inpatient and community services.
