About this Event
1.30pm: Welcome
1.35pm: Opening Remarks
1.45pm: Designing Safe and Effective Staffing: Insights from Ethnographic Observations in Healthcare Settings
Dr Mary Lavelle, Dr Benjamin Brew, Miss Francesca Cibelli, Dr Trisha Forbes, Miss Olivia Lounsbury, Dr Gary McKeown, Prof Gabriel Reedy, Dr Natalie Sanford & Prof Janet E Anderson, Queen’s University of Belfast
This presentation shares evidence-based insights into workforce planning, staffing assurance and governance structures, based on findings from a sustained programme of ethnographic observational research across physical and mental health inpatient settings. The research was conducted in partnership with leading experts in Human Factors and Patient Safety and examined routine clinical practice in-situ, supported by theoretical models and analytical frameworks explaining how staffing, teamwork and safety interact within complex systems. The presentation highlights potential opportunities to align workforce policy with robust, inter disciplinary academic research findings regarding the delivery of care in real clinical environments, and thereby support safe, high quality and sustainable care across Northern Ireland’s health and social care system. It is relevant to Assembly deliberations concerning the forthcoming Safe and Effective Staffing Bill. While highlighting widespread workforce shortages, it explains the uneven impacts of those shortages across services and teams and how safe, high-quality care is shaped not only by staffing numbers, but by teams’ ability to coordinate, adapt and manage complexity under resource constraints. The presentation further explains how healthcare staff operate amid multiple competing pressures, including organisational targets, documentation requirements and performance measures; and in practice, those system-level demands often take precedence over staff well-being, manageable workloads, and direct care quality. Research revealed how these daily trade-offs are largely invisible in formal staffing metrics, yet they have significant consequences for fatigue, moral distress and patient safety. For example, observational research undertaken in mental health wards showed organisational priorities frequently drew staff away from patient engagement and safety critical work and contributed to increased use of restrictive practices such as physical restraint and seclusion when responding to patients’ distress. Moreover, research showed not all teams experience staffing pressures equally. It identified five distinct team types, varying in purpose, membership stability and co-location, and how those characteristics shape teams’ resilience when there are staffing shortfalls. The evidence indicated stable, co-located teams with shared purpose and regular communication were better able to absorb shortages through adaptive coordination. In contrast, teams with fluid or transient membership struggled to maintain situational awareness and manage risk. This research is funded by the NIHR Imperial Patient Safety Translational Research Centre (PSTRC) the NIHR Research for Patient Benefit fund (NIHR201508) and the Health and Social Care Research and Development Division, Public Health Agency, Northern Ireland (Award reference COM/5807/24). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
2.05pm: Beyond Numbers: What Evidence from “My Home Life NI” Reveals about Safe and Effective Staffing in Care Homes Ms Sarah Penney, School of Nursing and paramedic science, Institute of Nursing and Health Research, Ulster University
This presentation aims to inform Assembly deliberations concerning the forthcoming Safe and Effective Staffing Bill. It highlights practical, evidence-informed considerations about the Bill, including: how “safe and effective staffing” could be understood in complex care home environments; what conditions enable staffing requirements to improve care outcomes; and, how leadership capability and workforce culture interact with statutory staffing duties. It draws on findings from two academic studies: 1. A large quantitative study across England, Scotland and Northern Ireland, involving 300 participants which aligns with a wider body of published evidence demonstrating positive impacts on leadership, staff well-being and care quality. The research demonstrated statistically significant improvements in leadership capability, staff morale, workload manageability, time spent with residents, and perceived adequacy of staffing for workload. 2. A recent qualitative study conducted in Northern Ireland (under review), exploring the experiences of 56 care home leaders who participated in the My Home Life Leadership Support Programme. Participants described how leadership development leads to improved emotional regulation, reflective practice and relational leadership behaviours. These changes were consistently linked to enhanced staff morale, improved teamwork, reduced sickness absence, stronger retention and observable improvements in care delivery, including reduced falls and more positive regulatory feedback. It is supported by the Department of Health. The presentation explains that while the Safe and Effective Staffing Bill rightly seeks to address workforce safety and risk, findings arising from the research about long-term care suggests staffing effectiveness is shaped not only by numbers and skill mix, but also by leadership behaviours, workplace culture and staff empowerment. Taking together, the evidence indicates leadership development and workplace culture play a critical role in enabling staff to work safely and effectively within existing staffing resources. Relying on the research, the presentation explores relational, evidence-informed approaches such as My Home Life. It explains how they can support safe staffing by enabling leaders to retain staff, reduce burnout and foster environments where staff are confident to work at the top of their role. It also considers leadership behaviours influencing staff decision-making, communication and responsiveness to residents’ needs. Highlighting the centrality of all such factors to safety, the research indicates they are not easily captured through staffing ratios alone. Importantly, the presentation also looks at potential unintended consequences of a narrow focus on staffing numbers within legislation. The research observed those to include increased administrative burden, reduced professional autonomy and difficulties in sustaining compliance in an already pressured sector. And drawing on the evidence from My Home Life, the presentation considers how those risks could be mitigated through policy and legislation that recognises the integral nature of leadership development, workforce well-being and organisational culture to staffing effectiveness.
2.25pm: Public Sector Accounting Reform: Benefits, Challenges and Lesson Learning Dr Elaine Stewart, Queen’s Business School, Queen’s University of Belfast
The fiscal landscape of countries around the globe is marked by chronic underfunding, persistent overspending, high economic inactivity, skills gaps and infrastructure deficits. Those are compounded by demographic shifts (such as ageing populations) and growing costs due to, for example, increased demands on health and social care, which exacerbate the risks of inefficient and unsustainable services. Reliable and robust financial information should be foundational to evidence-informed decision-making when developing, agreeing and implementing policy, legislation and budgets. In Northern Ireland, that is acutely relevant amidst persistent inter connected challenges relating to fiscal, economic and public spending considerations. Accruals accounting provides such financial information; and though Northern Ireland has operated such accounting since the early 2000s under United Kingdom-wide standards, lessons could be learned from recent international reforms that align with a global trend led by the International Federation of Accountants (IFAC): lessons regarding its purported benefits for transparency and decision-making and its implementation challenges around capacity, systems and meaningful use of accrual information. To help inform Assembly consideration in this area, this presentation highlights the experience of the Irish Government when transitioning to accruals accounting, drawing on both research and practice-led work involving workshops and training designed to inform and advance the knowledge of public sector finance professionals on the changes implemented to date, along with forthcoming developments. It also explains cross-border opportunities to compare such accruals information, to allow for, for example, enhanced data comparability for shared services, all-island economic analysis and collaboration on infrastructure, health, and trade, particularly post-Brexit. In addition, the presentation highlights the use of financial information on an accrual basis to improve fiscal evaluation when developing/scrutinising bills and support Northern Ireland policy/law-makers when navigating fiscal constraints and taking evidence-informed decisions. For example, the forthcoming Regional Jobs, Skills and Investment Bill, which is to address regional imbalances, such information can enable transparent tracking of investments relating to training facilities/infrastructure assets, to enable better evaluation of outcomes. Alternatively, for the forthcoming Good Jobs Employment Bill, which is both to increase "good jobs" and to protect rights specified under the New Decade New Approach political agreement, such financial information better captures long-term liabilities relating to pensions and training costs, as well as performance metrics to aid sustainable planning.
2.45pm: Discussion
3.15pm: Closing
3.20pm: Networking & Refreshments
Event Venue & Nearby Stays
Parliament Buildings, Parliament Buildings, Belfast, United Kingdom
GBP 0.00
