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Adult Inpatient Wards SNCT 

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NICE-endorsed, evidence-based tool which enables assessment of acuity and dependency of adult patients for establishment setting

The Adult inpatient Wards Safer Nursing Care Tool (SNCT) is an adaptation of the original Safer Nursing Care Tool for adult inpatient wards developed in 2006, endorsed by NICE in 2013, and most recently updated in 2023. All previous versions of the tool are no longer valid.

It has been developed to help NHS hospitals make evidence-based decisions on staffing in adult inpatient wards in line with the NQB’s expectations using patient acuity and dependency to inform these decisions. 


  • Decision support tool, developed by the Shelford Group and endorsed by NICE.

  • Evidence-based: tested in teaching and district general hospitals in England and across NHS Scotland, to confirm tool is robust and easy to use.

  • Aligned to a staffing multiplier (whole time equivalent (WTE) nurse staffing) to provide a recommended establishment based on the actual needs of the patients.

The 2023 refreshed version of the tool incorporates 236,079 staffing interventions, with 123,250 service quality standards as well as updated patient care levels descriptors aligned to refreshed nursing resource multipliers. They provide for traditional ward layout with a separate module for single roomed wards as well as levels of care for one-to-one care and two-to-one care. 


The tool is:

  • Appropriate for use in any adult acute assessment units in acute hospitals within England (although further work is underway to adapt the tool for use in other clinical setting and other countries).​

  • Used in conjunction with Nurse Sensitive Indicators (NSIs); patient and staff outcomes that can be linked to nurse staffing such as patient falls and pressure ulcer incidence.​

  • Able to support benchmarking activity in organisations when used across Trusts. This will guide consistent decision making in setting safe and sustainable nurse establishments in line with agreed standards across similar care settings in England.

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