Safe staffing guidance

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Ensuring services are staffed with the appropriate number and mix of clinical professionals is vital to the delivery of quality and safe care.

NHS Improvement (NHSI) has produced draft guidance on safe staffing management in community and mental health nursing settings. They are engaging on the draft documents until 28 April 2017

These are part of a suite of resources being produced by NHSI. They follow guidance for adult inpatients in acute settings, and those working in learning disability settings which were consulted on earlier this year. Providers can expect sight of the final three resources (for childrens, maternity, and urgent and emergency care teams) later this year. 

The draft improvement resources advise a flexible, pragmatic approach to safe staffing, and the use of evidence-based tools and appropriate skills mix to assess and meet local need. They present a variety of resources and case studies to help managers plan their staffing safely at strategic and operational levels. The draft documents point to the use of flexible staffing strategies, triangulation and comparison with similar services or teams, and the use of the whole multi-disciplinary team to ensure an agile and appropriate level of care to meet the needs of patients and staff. 

Given the varying nature of services and environments they cover, the draft guidance documents do not recommend a one size fits all ratio of staff to patients.

NHS Improvement recommends that its resources are considered alongside guidance from the National Quality Board (NQB). The improvement resources refer often to the NQB’s expectations for organisations to have the right staff with the right skills, in the right place at the right time. 

Have your say on the draft guidance

The draft resources are available on the NHS Improvement website: 

If you would like to take the opportunity to feed into the development of these resources, please submit individual responses via the NHS improvement survey links under each resource.


The work has been carried out by NHS Improvement after NHS England and the Department of Health suspended work on safe nurse staffing by NICE last year. The Francis report recommended NICE should draw up “evidence-based tools for establishing what each service is likely to require as a minimum in terms of staff numbers and skill mix”.

Access the two resources produced earlier in the year, for which consultation responses are currently being gathered:

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