Public Board papers 31.03.22

2. Introduction Following the last review in September 2021 The Christie and the wider NHS has continued to be dominated by the unprecedented and exceptional circumstances faced by the COVID-19 global pandemic. The review routinely considers a range of data including the nursing care requirement of patients determined by acuity and dependency data (SNCT data). It also includes consideration of all the other factors that can influence the nursing staff requirement including patient flow, the care environment, staff turnover, sickness rates, patient harm and patient experience data. For the 6 months covered by this paper, nurse staffing levels, together with all medical and allied health professional staffing levels, have been managed as part of the national alert level 3-4 and trust escalation level 2. As a result this paper will describe how nurse staffing has been monitored throughout this 6 month period, together with the ward managers overall professional judgement of staffing during that time and any recommendations they wish to make. 3. Nurse Staffing during the Pandemic Previously in the pandemic there was a reduction in non-essential activity. Where services were paused, for example, in research, nurses were redeployed to support clinical areas where additional staffing was required. Teams of nurses with additional skills such as those with critical/intensive care experience received refresher training and were placed on a shadow rota to be deployed into clinical services as required. However, as activity began to return to pre-pandemic levels these nurses have returned to their substantive posts. December 2021 also saw the impact of the new COVID variant, Omicron, which had a direct impact on staff absence and an increase in positive inpatient activity. A daily redeployment meeting was initiated where immediate and short-term staffing risks were identified and actioned. This saw collaborative working across the Trust where non- clinical staff supported areas to maintain patient safety and experience. The ongoing impact of the pandemic with the continued caution of managing the risks of COVID-19 has seen an impact in patient capacity. This has been evident with the reconfiguration of wards. In addition, eighteen Aspirant Nurses also chose to support pandemic by joining The Christie in the final months of their nurse training with most being recruited into a band 5 post as registered nurses with the trust. These nurses are well established members of the nursing workforce, with sixteen remaining in the organisation. The opening of Ward 2 as the new elective oncology ward has significantly improved the flow of elective chemotherapy and interventional radiology patients through the trust. By keeping it as a short stay ward, the beds are readily available at the beginning of the week and thereby preventing a delay and/ or deferral of procedures/ chemotherapy treatments. This has had a positive impact on patient safety, efficiencies and enhanced specialised nursing skills The acute assessment unit (AAU) continued to admit patients with or suspected of having COVID 19. Ward 12 has functioned as a “red” ward to safely cohort covid positive patients and minimise staff transmission through restriction of staff movement across the clinical areas. To maintain social distancing requirements and trust infection prevention control measures the bays on the inpatient wards continue to accommodate two to three patients

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