Almost half of NHS hospitals and inpatient areas recorded nursing shift ‘fill rates’ of more than 100 per cent in May, according to figures released as part of the government’s patient safety drive.

This data on nursing staff fill rates – the proportion of planned nursing hours which have been covered – is one of three new indicators published on the NHS Choices website as part of minister’s Sign up to Safety campaign.

Greater transparency around nurse staffing data was central to the government’s response to the Francis report last year.

The website has not, however, rated trusts as good, bad or OK for staffing levels, as it does for performance on infection control and incident reporting standards.

As HSJ reported earlier this month, this decision was taken in response to concerns about the validity of comparisons between organisations on staffing without a national standard.

The data also revealed that just 8.3 per cent had fill rates of less than 90 per cent last month, and that just under half of trusts had fill rates of between 90 and 100 per cent.

As the data is an aggregate of all registered nurse and healthcare assistant hours over the month, it may mask situations where a shortage of registered nurses has resulted in more HCAs being used or wards with regular understaffing.  

Fill rates of more than 100 per cent are likely to have been driven by increases in the number of patients requiring extra attention, such as when vulnerable inpatients are “specialled” by a dedicated nurse or HCA.

NHS England chief nursing officer Jane Cummings said it was too soon to determine from the data which organisations had concerning levels of staffing.

The most valuable aspect of the information was the ward level data that trusts were required to publish on their own websites, she said.

NHS England plans to eventually rate trusts on staffing levels with a “composite” indicator, to be developed over the next six months. This would also look at factors such as sickness absence rates and the use of temporary staffing.

Ms Cummings said it would start with an indicator for acute trusts before rating other sectors as the National Institute for Health and Care Excellence developed guidance for them.

The development of staffing guidance by NICE was a key recommendation of the Francis report. Draft guidance on staffing adult inpatient wards was published for consultation in May.

The staffing data on NHS Choices comes from more than 20,000 shifts across 6,700 wards.

Only two trusts failed to submit their May data by the deadline: North Bristol Trust because staff and services were moving into a new hospital during the month; and Guy’s and St Thomas’ Foundation Trust as it had been recording the data in a different format.

  • This figures quoted in this story was amended after publication due to a calculation error.