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This Policy Position accompanies the RCN report ‘Guidance on safe nurse staffing levels in the UK’, which sets out the range of different factors that influence the total demand for staff and highlights the variety of methods for planning or reviewing staffing levels.

The RCN report highlights the following as essential elements to planning or reviewing nurse staffing, regardless of the specific tools used:

• systematic: use a systematic approach and apply it consistently
• staff involvement: involve staff in both the process and outcomes of a review
• triangulate: for example patient dependency based workload tools should be complemented with professional judgment and benchmark data from matched comparators
• adequate uplift: having identified the nursing staff needed, the establishment itself must be calculated to allow for service delivery times (i.e. shift patterns) and staff time away from the service (i.e.an ‘uplift’). The RCN recommends an uplift of 25 per cent is applied
• evaluation: the only way we can judge whether the staffing level for a service is optimal, is by looking at indicators of its sufficiency. This relies on good quality HR data and patient outcomes/quality data being collected, and used to review and inform services (at the unit and board level)
• regular review: the Healthcare Commission recommended that staffing should be reviewed at least every 2-3 years.

For further information, please email papa.ukintl.dept@rcn.org.uk