18/07/2026
DOCUMENT AND ESCALATE YOUR STAFFING ISSUES - It can seem pointless sometimes, when nothing immediately changes, but it is vital (as is the case here) when any senior member of staff/regulatory body/minister attempts to claim that they had no idea about the situation on the ground.
Staffing levels (alongside capacity issues) can often be the major cause of deviations from previous established practice in UK trusts, and so the old orthodoxies of responding to incidents by solely blaming individuals becomes increasingly (for the most part) redundant.
Why is a nurse rushing a med round?
Why are the washes not as thorough as they should be?
Why does documentation get missed?
Why was a particular lengthy and complex protocol not followed?
Why was a post-op patient not monitored as closely as they should have been?
Why do the records show that one HCSW appeared to check in on all 30 patients in under 60 seconds?
“Originally identified in NASA’s investigations into the 1986 Apollo Challenger disaster, normalisation of deviance describes how individuals or teams drift away from established practice standards.”
“…deviations can interact in unpredictable ways. A minor documentation shortcut, plus a communication breakdown, together with understaffing, can combine into catastrophic harm.”
“…Contrary to the pervading narrative, staff did report concerns. From 2012, the service manager (and lead nurse) frequently reported that staffing was unsafe to both the trust and to the Regulation and Quality Improvement Authority “
Elaine Maxwell explains why the normalisation of deviance found at Muckamore Abbey Hospital is relevant to nursing practice in all fields.