Missed care in community and primary care
evidence and practice    

Missed care in community and primary care

Michaela Senek Research associate, School of Health Sciences, University of Sheffield, Sheffield, England
Steven Robertson Professor, University of Sheffield, Sheffield, England
Tony Ryan Professor, University of Sheffield, Sheffield, England
Angela Tod Professor, University of Sheffield, Sheffield, England
Rachel King Research associate, University of Sheffield, Sheffield, England
Emily Wood Research fellow, University of Sheffield, Sheffield, England
Bethany Taylor Research associate, University of Sheffield, Sheffield, England

Why you should read this article
  • To understand the prevalence of missed care in primary and community care settings

  • To recognise the link between understaffing of nursing shifts and the likelihood of missed care occurring

  • To learn how a shift to workload-oriented models to assess staff levels may be beneficial for community nursing

Background Studies have shown that understaffing may result in missed care, compromising patient outcomes. However, most of these studies have been conducted in secondary care, and there is a lack of similar evidence about the prevalence and type of missed care in community and primary care.

Aim To explore the prevalence of missed care in community and primary care settings, and to better understand its association with staffing levels.

Method A staffing survey was administered by the Royal College of Nursing to explore the working experiences of nurses from all settings across the UK. Respondents were asked questions about their latest shifts. For this study, the authors performed a secondary analysis of that data, focusing on the responses from primary and community care.

Results There were 3,009 responses to the survey from primary care, community care and care home nurses pertaining to the prevalence of understaffing, staffing levels and missed care. Analysis showed that, in primary care and the community, missed care was significantly more likely to occur on understaffed shifts (39%) compared to fully staffed shifts (23%).

Conclusion There is a high prevalence of understaffing in community nursing and instances of missed care are more likely to occur on understaffed shifts. Assessing appropriate staffing levels and skill mixes in community nursing is complex and current models tend to emphasise caseload numbers rather than workload. Local and national planning should focus on workload measures, incorporating a range of indicators that place safe and effective person-centred care at their core.

Primary Health Care. 31, 3, 20-23. doi: 10.7748/phc.2021.e1692

Peer review

This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software

Correspondence

m.senek@sheffield.ac.uk

Conflict of interest

None declared

Senek M, Robertson S, Ryan T et al (2021) Missed care in community and primary care. Primary Health Care. doi: 10.7748/phc.2021.e1692

Published online: 10 March 2021

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