This report provides assurance regarding Adult Community Nursing workforce establishments following completion of the March 2026 Community Nursing Safer Staffing Tool (CNSST) review. The report demonstrates compliance with NHS England Developing Workforce Safeguards and National Quality Board expectations through triangulation of evidence-based staffing recommendations, professional judgement, quality indicators, workforce metrics and operational intelligence.
The Community Nursing Safer Staffing Tool (CNSST) is NHS England's evidence-based workforce planning methodology for community nursing services. It supports organisations to determine safe and sustainable workforce establishments by assessing patient demand, acuity and dependency alongside workforce capacity.
The CNSST is aligned to NHS England's Developing Workforce Safeguards and the National Quality Board (NQB) guidance Supporting NHS Providers to Deliver the Right Staff, with the Right Skills, in the Right Place at the Right Time. It supports providers in meeting the national expectation for six-monthly Board assurance and annual workforce establishment reviews.
The tool compares funded, actual and recommended staffing establishments and provides an objective assessment of workforce requirements. However, in line with national guidance, CNSST outputs are not used in isolation. Workforce recommendations are triangulated with professional judgement, patient quality indicators, workforce metrics, operational intelligence and local service configuration before any establishment changes are considered.
This six-monthly review forms part of Harrogate and District NHS Foundation Trust's safer staffing governance framework, providing assurance that community nursing workforce establishments remain safe, evidence-based and responsive to changes in patient need.
Consistent with Developing Workforce Safeguards and National Quality Board expectations, the CNSST findings were reviewed alongside:
Patient outcomes – including falls, pressure ulcers, infections, complaints and clinical outcomes.
Patient and staff experience – including Friends and Family Test, patient feedback and workforce experience.
Workforce indicators – including vacancies, turnover, sickness absence, temporary staffing utilisation and retention.
Operational intelligence – including caseload complexity, geography, travel time, deferred care and service demand.