Safer staffing

This report explains how staffing was managed across Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) during November and December 2025. It highlights the challenges services faced and the actions taken to keep patients safe and support staff.

Key messages

Patients are needing more support

Many patients are presenting with more complex needs than before. This includes increased risks to their mental and physical health, a greater need for observation and support, and more people staying in hospital longer while suitable community or social care placements are arranged.

These factors mean patients often require more intensive support from staff and can remain in hospital for longer than planned.

Staffing remains safe and stable

The Trust continued to provide safe staffing levels across all services.

Staffing levels were more closely matched to patient need, helping ensure the right staff were in the right place at the right time. Registered nursing cover remained stable across day and night shifts, supporting safe care, clinical leadership and decision making.

Reducing reliance on agency staff

The Trust continued to reduce its use of agency workers and prioritised bank staff wherever possible.

This helps provide more consistent care for patients, supports familiar teams and delivers better value for money. In some areas, work has been undertaken to encourage agency staff to join the Trust's nurse bank.

Supporting staff wellbeing

Many teams continued to work under pressure because of high patient need, staff sickness, vacancies, maternity leave and training requirements.

The Trust maintained a strong focus on staff wellbeing through supervision, debriefs, wellbeing initiatives and support for those who were absent from work. Some teams reported improved morale and stronger team working.

Investing in staff development

The Trust continues to support newly qualified nurses and internationally educated nurses as they develop their skills and confidence.

Support includes preceptorship programmes, supervision, appraisals, mandatory training and leadership development. However, finding time for training can sometimes be difficult when patient demand is high.

What the Trust is doing

To make sure services remain safe and effective, the Trust continues to:

• Hold daily staffing meetings to review staffing levels and patient needs.
• Move staff between wards when necessary to maintain safe care.
• Review patients' care plans and observation levels regularly.
• Monitor incidents involving violence and aggression.
• Support staff wellbeing and sickness management.
• Improve recruitment and retention.
• Develop better discharge pathways.
• Reduce reliance on temporary staffing where possible.
• Strengthen multi-disciplinary team working.

Service updates

Adult Acute Services

Adult acute wards have experienced high levels of patient need, including increased risks of violence, aggression and self-harm.

Challenges have included delayed discharges, staff sickness and difficulties releasing staff for training. The Trust has responded with daily staffing reviews, visible clinical leadership and additional support for staff wellbeing.

Psychiatric Intensive Care Unit (PICU)

Patients in the Psychiatric Intensive Care Unit often have very complex needs and require high levels of support.

Recruiting and retaining experienced staff remains challenging. Daily staffing reviews and additional leadership support continue to help maintain safe care.

Adult Rehabilitation Services

Adult rehabilitation wards support people with complex physical and mental health needs.

The main challenges have been delayed discharges and the need for extra patient observations. Recruitment has improved and there is continued focus on reducing temporary staffing use.

Older People's Services

Older people's wards continue to care for patients with complex mental and physical health needs.

Teams are focusing on improving physical health care, reducing falls, supporting newly qualified staff and ensuring patients receive the right level of observation and support.

Children and Young People's Services (CYPS)

Services for children and young people continue to support young people with complex needs, including eating disorders and other conditions that require high levels of care.

Challenges include staff sickness, vacancies and difficulties finding suitable community placements. Additional staffing support and workforce planning are in place where needed.

Secure Services

Some secure services continue to experience high levels of patient need which require additional staffing resources.

The Trust has strengthened daily staffing reviews and maintains close oversight of sickness, vacancies and patient safety risks. Staff retention remains positive across the service.

Learning Disability and Autism Services

These services have managed increased demand following the temporary closure of Rose Lodge and the movement of patients to other wards.

The Trust is working to improve recruitment, increase nurse bank availability and reduce reliance on agency staffing.

Neuro and Specialist Services

Neuro and specialist services have experienced pressures relating to sickness absence and patient needs in some areas.

Agency use remains low, staff sickness levels have reduced and recruitment activity continues to support service stability.

Overall conclusion

During November and December 2025, Trust services continued to face significant pressures from increasing patient needs, staffing challenges and delayed discharges.

Despite these challenges, staffing remained safe and stable across services. The Trust continues to focus on recruiting and retaining staff, supporting staff wellbeing, reducing reliance on agency workers and making sure staffing levels match the needs of patients.

These actions help maintain safe, high-quality care for the people who use our services.

This page gives a short summary of staffing information for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust for February 2026.

The report helps the Trust understand whether services have the right number of staff in place to provide safe care.

What the report looks at

The report looks at:

• How many staff were planned for shifts.
• How many staff actually worked those shifts.
• Staffing levels during the day and at night.
• Registered and unregistered staffing levels.
• The use of bank and agency staff.

Overall staffing position

In February 2026, the overall staffing fill rate was 96.9%.

This means that the number of staff who worked was slightly lower than the number of staff planned.

The report shows:

• 750.46 staff worked, shown as the actual staffing figure.
• 774.83 staff were planned.
• This gives an overall fill rate of 96.9%.

What this means

A staffing fill rate compares planned staffing with the number of staff who actually worked.

A rate of 100% would mean planned and actual staffing were the same.

A rate below 100% means actual staffing was lower than planned. A rate above 100% means actual staffing was higher than planned.

Staffing during the day and at night

The report includes charts showing staffing levels during day shifts and night shifts.

These charts look separately at:

• Registered staff working during the day.
• Unregistered staff working during the day.
• Registered staff working at night.
• Unregistered staff working at night.

This helps the Trust understand where staffing is working well and where extra oversight may be needed.

Bank and agency staff

The report also looks at the use of bank and agency staff.

Bank staff are workers who are already linked to the Trust and can be asked to work extra shifts.

Agency staff are supplied by external organisations.

Using bank staff where possible can help provide more consistent care for patients.

Why this matters

Safe staffing is important because it helps make sure patients receive the care and support they need.

Staffing reports also help the Trust:

• Plan services safely.
• Understand staffing pressures.
• Monitor use of temporary staff.
• Support staff and managers to make safe decisions.
• Review staffing across different services.

Service information

The report includes sections for different services, including:

• Adult Acute Services.
• Psychiatric Intensive Care Unit, also known as PICU.
• Adult Rehabilitation Services.
• Older People's Services.
• Children and Young People's Services.
• Secure Services.
• Learning Disability and Autism Services.
• Neuro and Specialist Services.

The version of the report available for this summary does not include detailed written updates for each service. These sections appear to contain template text only.

Overall summary

In February 2026, the Trust continued to monitor staffing levels across services.

The overall staffing fill rate was 96.9%, with actual staffing slightly lower than planned staffing.

The Trust uses this information to support safe care, understand staffing pressures and plan how staff are used across services.

This page provides a summary of staffing information for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust during February 2026.

Overall staffing levels

The Trust regularly reviews staffing levels to help make sure patients receive safe, high-quality care.

In February 2026, the overall staffing fill rate was 96.9%.

• 750.46 actual staffing level
• 774.83 planned staffing level
• 96.9% overall fill rate

The staffing fill rate compares the number of staff who worked with the number of staff that were planned to work. A figure close to 100% indicates staffing levels were close to the planned level.

Monitoring staffing across services

The Trust monitors staffing levels across all inpatient services, including day and night shifts and both registered and unregistered staff groups.

Regular reviews help identify staffing pressures and ensure resources are directed to the areas where they are needed most.

Bank and agency staffing

The Trust also monitors the use of temporary staffing, including bank and agency staff.

This helps maintain safe staffing levels and supports continuity of care for patients when additional staffing is required.

Continuous review

Staffing information is reviewed by operational and clinical leaders to support workforce planning, respond to service pressures and help ensure safe care is maintained across Trust services.

This page gives a summary of staffing information for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust for March 2026.

The report looks at staffing levels across the Trust. It also explains the pressures services are facing and the action being taken to keep care safe.

Overall staffing position

In March 2026, the overall staffing fill rate was 95.0%.

This means most planned staffing was covered, but there was a shortfall compared to what had been planned.

• 754.49 actual staffing level
• 794.39 planned staffing level
• 95.0% overall staffing fill rate

The report shows a gap of around 40 whole-time equivalent staff for the month.

Over the past year, staffing levels have moved from being above planned levels to being slightly below planned levels. This shows better control of over-staffing, but also shows that it is becoming harder to fill all planned shifts.

Main staffing challenges

The Trust continues to experience high levels of patient need across a number of services.

Some patients need more support because of:

• Higher levels of risk.
• Violence and aggression.
• Self-harm.
• Physical health needs.
• Extra observation and engagement from staff.
• Delays in leaving hospital when the right care or placement is not available.

These pressures mean some wards need more staff than their usual planned staffing levels.

Workforce pressures

Some teams are under pressure because of staff sickness, vacancies, maternity leave and staff working in different roles for health or other reasons.

There are also a high number of newer staff in some areas. This includes staff in preceptorship and internationally recruited nurses who are still developing their skills and confidence.

This can reduce the number of staff who are able to take charge of a shift.

Training and staff development

Training, appraisals and supervision are improving, but they can still be difficult to complete when services are very busy.

The Trust continues to support staff through:

• Preceptorship programmes.
• Clinical supervision.
• Appraisals.
• Training in safe care and reducing harm.
• Support after difficult incidents.

Use of bank and agency staff

The Trust has reduced its use of agency staff.

Bank staff are being used more often to cover gaps. This helps provide more consistent care for patients and supports better value for money.

The use of agency staff has reduced significantly, especially during the last six months of the reporting period.

Day and night staffing

The report shows that daytime registered staffing remains one of the most pressured areas.

Daytime registered staffing has often been slightly below the planned level. Night registered staffing has also reduced and is now below planned levels in recent months.

Unregistered staffing has often been above planned levels. This has reduced over time, especially at night, which suggests stronger workforce planning.

What the Trust is doing

The Trust continues to take action to manage staffing pressures and keep patients safe.

This includes:

• Daily and twice-daily staffing meetings across all sites.
• Daily bed flow meetings to review discharge delays and pressures.
• Senior nurse support seven days a week.
• Moving staff between wards when this is needed for safety.
• Clear approval processes for temporary staffing.
• Using bank staff before agency staff where possible.
• Reviewing care plans and risk plans to reduce incidents.
• Supporting staff wellbeing, sickness management and return to work.
• Supporting staff to complete preceptorship when they are ready.

Service updates

Adult Acute Services

Adult Acute Services continue to experience high levels of patient need. This includes risks linked to violence, aggression, self-harm and physical health.

Some patients are ready to leave hospital but cannot do so because the right care or placement is not available.

Staffing is reviewed daily. Senior nurses are visible across seven days and staff are supported through debriefs after incidents.

Psychiatric Intensive Care Unit

The Psychiatric Intensive Care Unit, also known as PICU, continues to care for people with very complex needs.

Some patients need high levels of observation and engagement. This can increase staffing pressure.

The service has daily staffing meetings, daily bed flow meetings and senior approval for temporary staffing. No agency staff were used, which helps maintain familiar care for patients.

Adult Rehabilitation Services

Adult Rehabilitation Services continue to experience pressure from long-term sickness, maternity leave and reduced availability of senior staff.

Some wards rely on learners and newly qualified staff, who need extra support from experienced colleagues.

Most vacancies have now been recruited to. This should help improve staffing stability in the future.

Older People's Services

Older People's Services continue to support patients with complex mental and physical health needs.

Some patients need extra observation, hospital escorts or more support with physical health care. This can increase pressure on ward staffing.

The service uses twice-daily staffing meetings, daily bed flow meetings and senior nurse reviews to help manage staffing safely.

Children and Young People's Services

Children and Young People's Services continue to face pressures from sickness, maternity leave, vacancies and complex patient needs.

Some young people need high levels of care, including support for eating disorders or other complex needs.

The service uses twice-daily staffing meetings, discharge planning meetings and workforce support to manage staffing pressures. There has been a significant reduction in agency use.

Secure Services

Secure Services continue to face staffing pressures in some areas because of sickness, vacancies, patient acuity and additional care needs.

Daily staffing meetings are in place across the secure wards. Weekly reviews also take place with senior leaders and finance colleagues to review short-term staffing needs.

Temporary staffing is mainly covered by staff from the Trust or nearby services. This helps improve continuity of care.

Learning Disability and Autism Services

Learning Disability and Autism Services continue to experience staffing pressure linked to registered nurse gaps, patient acuity, violence and aggression, and complex discharge planning.

Daily staffing reviews, safety meetings and senior oversight are in place.

The service is also reviewing its clinical model and supporting staff wellbeing, training, supervision and appraisals.

Neuro and Specialist Services

Neuro and Specialist Services have experienced staffing pressures linked to sickness, patient observations and vacant posts.

Bank staff are being used to support patient safety where needed.

The service continues to have no agency use. Sickness levels have reduced, with most sickness now being short-term.

Overall summary

In March 2026, staffing levels across the Trust remained close to planned levels, but there was a small staffing gap.

The Trust continues to manage high levels of patient need, staff sickness, vacancies and discharge delays.

There has been a clear reduction in the use of agency staff, which is positive for quality, consistency and cost.

The Trust will continue to review staffing daily, support staff wellbeing and make sure staffing is matched to patient need.