Staffing Levels in Trauma & Orthopaedics in UK

L Kilbane, R Haasbroek, N Evans

Salisbury NHS Foundation Trust

Since 2014 hospitals are required to publish information on nursing staff levels against safe staffing guidelines. Despite recommendations by the Royal College of Physicians in 2018, no similar legislation or guidelines have been published. Hospital departments consistently face staff shortages across different grades and roles including within trauma and orthopaedics. Our aims are to compare staffing numbers across the UK from which to drive change.

Questions were sent to 138 NHS trusts through a Freedom of Information request. Staffing numbers at different grades (consultant, SAS, AS, registrar, junior doctor, specialist nurses and trauma coordinators) were surveyed together with metrics of bed numbers and admissions from which to generate a scaled comparison. Admissions and per consultant could infer the output of the department with the admissions per SHO inferring the workload on junior doctors.

96/138 (69%) trusts responded with 73 providing sufficient data to be included. 13 MTC Centres, 54 Trauma Units, 5 Local Emergency Hospitals. Mean admissions per consultant=267 and theatre sessions per consultant=2.6. Mean admissions per SHO=415. The mean Consultant to SpR Ratio was 1.48. Trauma coordinators were employed by 83% of trusts.

There are significant differences across the UK trusts in staffing levels. Most notably at SHO level who are responsible for much of the daily ward work and clinical contact for patients. Trusts could use our data to leverage additional funding to increase staffing levels and improve patient safety.