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We understand your challenges

There are systems available to help you roster your staff and then react to issues on the day, but we believe there is a gap at the very beginning of the staffing process – in planning and standardising what you need, appraising care levels across the week, and identifying where you can make savings safely – whether you’re an NHS trust, hospice or private provider.

We recognise the challenge that lies in balancing budgets with safe staffing, and designed Establishment Genie to help you navigate this as a team, understand how competing priorities interact, and make informed decisions underpinned with detailed data and reports.

Take stock of your staffing, compare care levels and costs within your organisation and with peers, and remodel for safe, affordable care – backed up by comprehensive, automated reporting.

"As a Trust we have welcomed the introduction of Establishment Genie. The tool has enabled us to engage with our ward managers and matrons directly in the review and later setting of establishments. This work has reinforced some of our thoughts and challenged us in other areas, allowing benchmarking of specialties and divisions, taking away the hours of hard work, simplifying the mystique and enabling clear reporting to our own Trust and external partners. Thank you.“ – Vanessa Sloane, Director of Nursing, Chelsea and Westminster NHS Foundation Trust.

Assure your care levels and deliver savings safely

The Genie is an easy, online tool that helps senior nurses and midwives, in partnership with their finance, HR and operational colleagues, to review, compare, remodel and report their establishments.

  • Evaluate your establishments and remodel to improve safety or cost
  • Deliver cost reduction safely and articulate the relationship between budgets and care levels
  • Identify the exact WTE requirement and uplift for each ward and compare this to the budget
  • Prepare for, or respond to, inspections by the CQC and other regulators
  • Overlay staffing levels with quality indicators to explore trends between staffing and outcomes
  • Explore better, cheaper ways of meeting fluctuations in demand, bed numbers and patient mix
  • Save time and improve the quality of your monthly and six- monthly safe staffing reports
  • Demonstrate compliance with recommendations from the Francis Inquiry, Carter Review and the NQB
  • Model the workforce for new roles (e.g. Band 4 Nursing Associates), mergers or reconfiguration of services

The Genie drives workforce planning in line with the Francis recommendations, highlights unwarranted variation in response to the Carter review, and supports the National Quality Board’s directive that workforce planning should be based on ‘collaborative decision making between clinical and managerial staff, reporting to boards.’

Try the Genie for free

See how it can work for you – contact us for a free diagnostic review that is yours to keep with no obligation. We’ll work with three of your wards (or for hospices, your entire organisation) in just one day and show you the difference Establishment Genie can make.

"It was easy to review our staffing using the Genie and the reports give real insight. I can really see how it can help our hospice plan and budget for the care we need to deliver." – Maddy Bass, Head of Nursing and Quality, St John’s Hospice, Lancaster.

About Us

Creative Lighthouse Ltd (CLL), the makers of Establishment Genie, supports senior nurses, midwives and their colleagues to review, plan and budget for safe, affordable nurse and midwifery staffing – that’s all we do.

CLL was founded by Richard Cooper and Eve Mitchell – former NHS managers with a specialism and focus on helping professional leads articulate the staffing their wards need to be effective and safe. Collectively, we’ve worked in partnership with senior staff from ward to board across dozens of healthcare providers in the UK, Australia and New Zealand. We ground our work in our broad spectrum of experience gained from delivering wider healthcare improvement since the early 2000s.

Our objective is to empower and complement professional judgement in decision making and budgeting. We do this by providing clear metrics, benchmarking and reporting to describe the care levels and cost of current or alternative establishments. We distilled our experience of what providers find helpful into an automated, self-service online tool – the Establishment Genie.

We are committed to making a positive contribution to healthcare and we’re grateful to those we work with along the way. In recognition of the often superhuman service that nurses, midwives and healthcare assistants provide, we have pledged to donate 2.5% of our annual profits to the Cavell Nurses Trust. See their work here:

"Establishment Genie has made a difference to morale already in the high level findings. You made the whole process achievable and interesting. The Genie is FAB!! Thank you." – Fiona Blackwell, Divisional Nurse Director, Medicine, Wye Valley NHS Trust.

Contact Us

We’d love to talk to you. Get in touch to arrange your free diagnostic, to hear client testimonials, and to discuss your requirements: 0800 689 0215


All providers are required to report on safe staffing and post-Francis, this is everyone’s responsibility.

Preparing these reports can be hard work. There remains little guidance on format and content, and analysing the data consumes senior staff time. The result is huge variation in how and what each provider reports to their Board and to the public.

At the push of a button, Establishment Genie provides standardised, comprehensive reports and addresses this need.

  • Staffing metrics: Skillmix, Beds per Nurse or Midwife, WTE per bed and Care Hours per Bed Day. We break these down across the week and by patient type, to avoid blunt averages that hide peaks, troughs and risks.
  • Supervisory and management time of senior ward staff.
  • Supporting and specialist roles on the ward – from Discharge Coordinators to Ward Clerks.
  • The exact ‘uplift’ (or ‘headroom’) that each role on the ward needs.
  • The hours and WTE required of all roles on the ward, compared to what the current budget provides, with analysis and costing of any difference between the two.
  • A ready reckoner for the additional staffing needed by any escalation beds on the ward, should they open.
  • The ward’s use of bank, agency and 1:1 specialling.
  • Guidance on managing leave in order to keep within the uplift.
  • The predicted cover needed for staff on maternity/paternity/adoption leave, based on the average for the trust.
  • Ward information items – there’s a huge choice of what can be entered to the system in outcomes for patients (e.g. from the safety thermometer), staff (e.g. vacancy and turnover) and operational outcomes (e.g. delayed transfers). We add to these choices based on feedback.

Ward Reports

The Ward Report provides summary and detailed information on a specific ward, with definitions and commentary. There is the option to apply local or national guidelines to the outputs (e.g. 65% registered Skillmix – RCN, 2006), and any that do not meet the desired standard are highlighted. This can be useful for understanding any variations in planned care levels throughout the week – and prompting a remodel of the staffing if this causes concern.

The Ward Report will present either the Current or Proposed staffing model for the ward. Typically, all wards will have a Current Ward Report, but some may also have a Proposed Ward Report if the trust has explored alternative options for staffing the ward, e.g. in reaction to issues uncovered in the Current Ward Report, in response to a CQC inspection, to model the effect of the proposed Nursing Associate role, etc.

Existing users of the Genie have identified setting bespoke study leave allowances per ward, standardising supervisory time across the week, and costing for unfunded beds as reasons to make a Proposed template and assess what this means for care levels and the WTE requirement.

Group Reports

The Group Report shows how a selection of wards in a trust compare with each other on a chosen metric, e.g. Nurse to Bed Ratio on Weekend Nights, Difference between WTE Budget and WTE Requirement, etc. There is a choice of over 250 safety, budgetary and outcome metrics. We update this list centrally and we welcome requests to add items to support national policy and initiatives.

A second metric can be overlaid to see if there appears to be any correlation between two factors that might warrant further investigation. For example, is a trend indicated between the amount of Band 7 Supervisory Time and falls, staff retention, FFT scores, etc.

The Group Report can be used to identify and understand variation between wards, allowing trusts to address it where it is unwarranted and provide for it where it is justified. This has led to trusts reallocating Discharge Coordinator and Practice Educator time across groups of wards, standardising Supervisory and Management Time, and assessing whether the wards compare in the way they would expect. The Group Report can also be used to show the difference between the ‘as-is’ and ‘future-state’ of Current and Proposed staffing models.

National Report

In 2017 we plan to develop our Group Reporting even further, so that users of Establishment Genie can choose to compare their wards against an anonymised peer group of wards from other member trusts.