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Safe Medical Staffing – a guide from RCP

19 Jul 2018

The Royal College of Physicians has launched its working party report into Safe Medical Staffing.

The Royal College of Physicians has launched its working party report into Safe Medical Staffing. The report sets out the first step on the journey to define the workforce needed to provide safe, timely and effective care for medical patients in hospitals.

Guidance on safe medical staffing has assessed in detail the time needed to diagnose, treat and manage patients in a variety of hospital settings. The working party report divides clinicians into three clear tiers based on levels of knowledge, experience and responsibility, and calculates how much time is needed from clinicians in each tier:

  • Tier 1: Competent clinical decision makers – clinicians who are capable of making an initial assessment of a patient
  • Tier 2: Senior clinical decision makers – the ‘medical registrars’ – clinicians who are capable of making a prompt clinical diagnosis and deciding the need for specific investigations and treatment
  • Tier 3: Expert clinical decision makers – clinicians who have overall responsibility for patient care.

The report then applies the tier model to the following hospital care settings:

  • the medical assessment and admission team
  • the medical ward team
  • the weekend medical ward team
  • the medical team on-call (providing out-of-hours cover for inpatients with medical problems).

The report makes specific recommendations for the amount of hours needed from each tier of clinician in each setting. This will enable hospitals to map their current provision against the recommendations to ensure they are providing safe care for patients. The Royal College of Physicians will work with hospitals to pilot the recommendations in real-life situations.

To view the full report and executive summary, go to

Category: Workforce

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