020 7340 1159 info@shelfordgroup.org

Safer Nursing Care Tool

The Shelford Group chief nurses’ sub group has led the development of innovative and evidence based decision support tools for setting clinical staffing establishments, known as the Safer Nursing Care Tools (SNCT) and the Mental Health Optimal Staffing Tool (MHOST).



In light of the current COVID-19 pandemic, the Shelford Group would like to reiterate the importance of applying professional judgement alongside the SNCT and MHOST.

To support you in applying this professional judgement, please refer to the professional judgement calculation tool and instructions which will provide the mechanism to assist you in your staff planning.

About the SNCT and MHOST

The Safer Nursing Care Tools (SNCT) and the Mental Health Optimal Staffing Tool (MHOST) calculate clinical staffing requirements based on patients’ needs (acuity and dependency) which, together with professional judgement, guides chief nurses in their safe staffing decisions. The tools:

  • Provide organisational level metrics to monitor impact on the quality of patient care and outcomes
  • Give a defined measure of patient acuity and dependency
  • Are able to support benchmarking activity in organisations when used across trusts
  • Embrace all the principles that should be considered when evaluating decision support tools set out in the relevant NHSI ‘Safe, sustainable and productive staffing’ resources
  • Include staffing multipliers to support professional judgement
  • Provide accurate data collection methodology.

NHS England and NHS Improvement supported the development of the suite of safer staffing tools which are now used widely across NHS organisations in England, private health providers and overseas healthcare organisations.

The licensing process is managed by Imperial College London on behalf of the Shelford Group and is free of charge to NHS organisations in England.

Future developments
The Shelford Group chief nurses continue to further develop the suite of tools.

“I am really proud to be a member of CNO safe staffing faculty and I would encourage all nurses and midwives with trust-wide remits for nursing and midwifery staffing to apply for future cohorts. I have completed the first module and there is always something to learn, even when you are confident you have a sound knowledge base. The networking with other fellows offers a fantastic insight and opportunity to standardise and validate methods used in differing organisations, not just within one organisation or professional group.”

Karen Jessop

Deputy Chief Nurse and Safe Staffing Fellow, Sheffield Teaching Hospitals NHS Foundation Trust

Chief Nursing Officer Safe Staffing Fellowship

In 2019 NHS Improvement, in collaboration with the Shelford Group chief nurses, launched the Chief Nursing Officer Safer Staffing Fellowship programme. The first cohort commenced the education programme in February 2019 and cohort 2 began in May 2019. Due to the success and positive feedback from the first two cohorts, Ruth May, Chief Nursing Officer, NHS England, made available additional cohorts to commence in 2019, 2020 and 2021.  Last year (2021) saw the fifth and sixth cohort being welcomed to the programme with the exciting addition of full accreditation from the Birmingham City University. The programme aims to:

  • promote broader insights into and develop comprehensive knowledge about existing and new clinical staffing models across all healthcare settings
  • create a geographically representative group of Fellows with specialist knowledge and skills to plan and implement evidence-based staffing programmes for a variety of specialties e.g.  acute adult, mental health and children’s, thereby ensuring sustainable evidence-based safer staffing reviews.

For more information regarding the CNO safer staffing fellowship programme and future cohorts, visit the NHS England and NHS Improvement website.

“I have learnt so much through the safe staffing fellowship programme and have really developed my knowledge and expertise of staffing models. I am now using what I have learnt to influence practice in my own trust and in other organisations.”

Maura Screaton

Deputy Chief Nurse and Safe Staffing Fellow, Cambridge University Hospitals NHS Foundation Trust

“Having the right level of clinical staff is fundamental for safe and high-quality patient care, as well as a good working environment for all staff. Decisions on clinical staffing have traditionally been based on historical allocations and experience and therefore have been highly subjective and variable. The Safer Nursing Care Tool and Mental Health Optimal Staffing Tool have transformed the way that NHS trusts plan their nursing workforce needs.”.

Janice Sigsworth

Chair of the SNCT Committee and CNO, Imperial College Healthcare NHS Trust

“As CNO I will continue to focus on developing policy support for effective staffing across health and social care. I am delighted that the Shelford Group has updated the SNCT and launched the MHOST tool to support our organisations in making effective decisions to staff services across the NHS and social care.”

Ruth May

NHS Chief Nursing Officer for England

To find out more about the SNCT and MHOST, please contact

 Licensing enquiries should be directed via nhsinfo@imperial.ac.uk

NHS trusts in England are using licensed SNCT and/or MHOST

licenses for SNCT and MHOST have been purchased by private and overseas providers