Making the Complexity of Community Nursing Visible: The Cassandra Project

There is a need to effectively promote safe staffing levels in community settings. This challenges commissioners and providers of services to find rigorous methods of capturing workforce evidence that can be systematically used to shape effective services and skill mix for the future.

Until now, district and community nursing numbers have been worked out using historical data and linear diary based workload methods which view nursing as a series of simple tasks that are conducted in one dimension of time. 

The second phase of this research has developed, piloted and evaluated a web-based workload activity tool with community nurses in six community organisations. The tool has significant potential for capturing the complexity and multiple dimensions of nursing work in community contexts.

There now exists the national appetite and widespread support from NHS England, the Queen’s Nursing Institute and the Royal College of Nursing to scale the use of Cassandra across a number of implementation sites in England in 2015. This will enable activity data to continue to be gathered using a grounded approach in order to develop a representative optimum caseload management model.