Safe staffing
Safer Nursing Care Tool.
The Safer Nursing Care Tool (SNCT) and the Mental Health Optimal Staffing Tool (MHOST) calculate clinical staffing requirements based on patients’ needs, supporting chief nurses across the NHS in setting optimal nurse staffing establishments.
About the Safer Nursing Care Tool
Licences for NHS trusts to use SNCT and MHOST are issued for a period of two years. Trusts should ensure their licence remains in date so they are using the latest version of the tools and supporting materials. For any queries about your licence, please contact nhsinfo@imperial.ac.uk.
Apply for a licence
Apply via Innova HealthTec
To apply for a licence, please visit innovahealthtec.com. From July 2024, all licence requests from NHS trusts in England require formal sign-off by the organisation’s Chief Nurse.
SNCT and MHOST
Supporting chief nurses across the NHS
SNCT and MHOST calculate clinical staffing requirements based on patients’ needs (acuity and dependency) which, together with professional judgement, support chief nurses in making their decisions on setting optimal nurse staffing establishment recommendations to their board. The tools:
- Provide ward-to-board level metrics to monitor quality of patient care and outcomes
- Give a defined measure of patient acuity and dependency
- Include staffing multipliers to support professional judgement
- Are able to support benchmarking activity in organisations when used across trusts
- Embrace all the principles set out in the relevant NHS England “Safe, sustainable and productive staffing” resources
Supporting resources
Materials to support chief nurses and teams in using the tools and applying professional judgement.
Framework
Professional Judgement Framework
Developed to support chief nurses in applying judgement in nurse staffing reviews.
View the framework →Webinar
Children and Young People’s Inpatient Wards — 2026 update
A training webinar outlining changes to the 2026 version of the Children and Young People’s Inpatient Wards in Acute Hospitals tool.
View the recording →SNCT and MHOST in use
Adoption across the NHS and beyond
NHS adoption
NHS trusts in England are using licensed SNCT and/or MHOST
Wider adoption
licences for SNCT and MHOST have been purchased by private and overseas providers
Background
NHS England supported the development of these staffing tools, which are now used widely across NHS organisations in England, private health providers and overseas healthcare organisations. In 2019, NHS Improvement, in collaboration with the Shelford Group chief nurses, launched the Chief Nursing Officer Safer Staffing Fellowship Programme to develop nurse leaders in safer staffing.
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. Licensing enquiries should be directed via nhsinfo@imperial.ac.uk, or to apply for a licence please visit innovahealthtec.com. From July 2024, all licence requests from NHS trusts in England require formal sign-off by the organisation’s Chief Nurse.
Available tools
Select a tool below for more information and to obtain a licence.
Acute hospitals
Adult Inpatient Wards in Acute Hospitals
Updated in 2026; all previous versions of the tool are no longer valid.
View tool and licence →Acute hospitals
Adult Acute Assessment Units
Updated in 2026; all previous versions of the tool are no longer valid.
View tool and licence →Paediatrics
Children & Young People’s Inpatient Wards in Acute Hospitals
Updated in 2026; all previous versions of the tool are no longer valid.
View tool and licence →Mental health
Mental Health Optimal Staffing Tool
Supports safer staffing decisions in mental health services.
View tool and licence →Emergency care
Emergency Department Safer Nursing Care Tool
Supports staffing decisions in emergency department settings.
View tool and licence →Digital
Digital decision-making matrix
A digital version of the decision-making matrix for Adult Inpatient Wards in Acute Hospitals and Adult Acute Assessment Units is now available for NHS licence holders in England.
Request access →What chief nurses say
“Having the right nurse staffing levels is fundamental to providing safe and high-quality patient care, as well as creating a positive work practice environment for staff. SNCT and MHOST underpin the way in which NHS trusts plan their nursing workforce needs. Working with NHS colleagues from across the country, we continue to regularly review and update these tools to ensure they reflect the changing needs of our patients.”
Professor Chris Morley
Chair of the SNCT Committee and Chief Nurse, Sheffield Teaching Hospitals NHS Foundation Trust
“It is crucial that senior nurses have the tools to support their decisions in planning, calculating and delivering the right staffing for patients. SNCT is an immensely valuable, evidence-based resource that helps calculate clinical staffing requirements based on patients’ needs when used alongside professional judgement and clinical outcomes. This approach helps deliver the best outcomes for our patients.”
Duncan Barton
Chief Nursing Officer for England
Questions about licensing?
For licensing enquiries, or to apply for a licence to use SNCT or MHOST at your organisation, get in touch with the licensing team.