Taskforce for Safe Nurse Staffing and Skill Mix

The Taskforce on Staffing and Skill Mix for Nursing began its work in September 2014. The core objective of the Taskforce was to develop a framework to support the determination of safe nurse staffing and skill mix (whereby nurse staffing refers to the nursing team including both the nurse and healthcare assistant roles) in a range of care settings.

The stimulus to establish the Taskforce included the recommendations from:

• an increasing number of high-profile health inquiry reports such as the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (2013) and the HIQA Tallaght Hospital Report (2012b)
• the increasing body of research evidence internationally linking components of the nursing resource to patient outcomes. Simultaneously, the Irish health service was and continues to undergo some of the most radical reforms in its history, and collectively these changes and evidence acted as the catalyst to the establishment of the Taskforce

Deciding on an optimal number of nurses is not an easy task. There is a delicate balance to be struck to meet economic, efficiency and patient safety requirements. Achieving this requires that relevant expertise be applied to the decision-making process. The Taskforce was established to provide this expertise.

The Taskforce is a group of experts selected for the development of a framework to determine the staffing and skill mix requirements for the nursing workforce in all care settings. It considers many influencing factors, including patient acuity, dependency, environment, care setting, nurse/HCA skill mix.

Phase 1 of the Taskforce focused on studying the optimal staffing and skill mix in general and specialist medical and surgical care settings in adult hospitals. The initial assumptions were presented at a series of national consultations and tested through a Pilot phase in several wards in 3 Irish hospitals in 2016 and 2017. Phase 1 Taskforce membership and Terms of Reference (TOR) are available.

Phase 2 of the Taskforce focused on studying the optimal staffing and skill mix in emergency care settings in adult hospitals. The initial assumptions were presented at a series of national consultations and tested through a Pilot phase in 3 emergency departments and 1 injury unit in Irish hospitals from 2019 and 2021. Phase 2 Taskforce membership and Terms of Reference (TOR) are available.

Phase 3 of the Taskforce is focused on developing a staffing and skill mix framework for Community Care Settings. Phase 3(i) is focusing on Long-Term Residential Care Settings for Older Persons. The Pilot Phase has commenced in 9 Long-Term Residential Care sites. The sites are a mix of Public, Private and Voluntary organisations.

The Taskforce provides oversight for the development of the Framework for safe nurse staffing and skill mix across the range of care settings based on best available international evidence. This includes oversight of pilot testing where applicable. The Taskforce will make recommendations for implementation, monitor the pilot implementation of the framework where applicable, including the necessary education, training, and guidance. Finally, the Taskforce will present written reports to the Minister for Health on each phase of Framework development.