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Adult acute medical and surgical inpatient

Two nurses walking

About the work stream

The adult acute medical and surgical inpatient work stream group consists of senior representatives from each Health Board and Trust across Wales. The work stream meets at regular intervals to progress identified actions and support Health Boards and Trusts in Wales to meet the requirements of the Nurse Staffing Levels (Wales) Act.

Aim

The second duty of the Nurse Staffing Levels (Wales) Act commenced in adult acute medical and surgical wards across Wales in April 2018. Since the group was formed the aim of the group has changed from developing an evidence based workforce planning tool for adult acute medical and surgical areas and preparing Health Boards and Trusts across Wales for the commencement of the Act, to now support Health Boards and Trusts in meeting the requirements of the Act and adhering to the ‘Once for Wales’ approach.

Remit

On behalf of NHS Wales the remit of the group is to:

  • promote the effective delivery of quality care through the provision of appropriate nurse staffing levels within adult acute medical and surgical in patient wards across Wales
  • support the use of a triangulated method to calculate nurse staffing levels, which consists of developing an acuity and dependency tool, identify quality indicators and determine how professional judgement can be used to determine staffing levels within adult acute medical and surgical areas
  • review, refine and monitor use of the national acuity and dependency tool the ‘Welsh Levels of Care’, as the evidence base continues to develop
  • facilitate and oversee the implementation of the workforce planning tool within Health Boards and Trusts in Wales
  • support Welsh Health Boards in following a ‘Once for Wales’ approach in meeting the requirements of the Act
  • support the All Wales Nurse Staffing programmes publication and communication strategy to ensure stakeholders are informed and engaged
  • deliver the actions set out in the working groups plan to the timescales, highlighting risks and challenges to the work
  • provide regular highlight reports and make recommendations, seek support and guidance from the All Wales Nurse Staffing Group
  • review the findings of six monthly adult acuity audits in January and June every year and make recommendations to improve the reliability of the audit tool; extend the analytical functionality; respond to operational feedback from ward teams; and provide advice and support to guide ongoing development. Present the findings and make recommendations to the All Wales Nurse Staffing group.
  • liaise with/commission work from the All Wales Health and Care Monitoring System Networking group in relation to the monitoring of quality standards required for NHS Wales to ensure compliance with the Act
  • support and advise sub groups to undertake particular task and finish work as identified within the work stream plan (e.g: operational guidance review group), acting as conduit between the sub group and the All Wales Nurse Staffing Group.

Highlights of progress to date

  • produced a bi-annual newsletter
  • devised a suite of reporting templates and guidance to ensure consistency in the reporting process
  • reviewed the informatics systems required to record the information required to inform the reporting process
  • devised operational guidance for nursing teams
  • published frequently asked questions for patients
  • published frequently asked questions for nursing staff
  • devised range of information materials.