top of page

Longer shifts for mental health staff linked to an increase in patient incidents including self-harm

Research conducted at the University of Southampton has shown a significant increase in the risk of patient incidents in mental health and community wards when the majority of staff work longer 12-hour shifts.

The new study reveals that as the proportion of nursing staff on 12 plus shifts daily rose above 70 per cent the number of incidents of self-harm, threatening behaviour and violence against staff increased significantly.

The study was led by Dr Chiara Dall’Ora and funded by the National Institute for Health and Care Research Applied Research Collaboration Wessex (NIHR ARC Wessex).

Researchers looked at records from mental health and community hospitals in Hampshire in the first study of its kind in England. Incident data recorded by the two NHS Trust was matched with the records of nursing staff shift patterns over a three-year period.

From: Chiara Dall’Ora, Ourega-Zoé Ejebu, Jeremy Jones, Peter Griffiths, "Nursing 12-Hour Shifts and Patient Incidents in Mental Health and Community Hospitals: A Longitudinal Study Using Routinely Collected Data", Journal of Nursing Management, vol. 2023, Article ID 6626585, 8 pages, 2023.

Dr Chiara Dall’Ora, University of Southampton

"The consequences of patient incidents such as self-injury and disruptive behaviour are serious, and using high proportions of long shifts is associated with higher risk rates of such incidents in mental health and community hospitals.
Nurse managers and those in charge of creating rotas for nursing staff should avoid implementing 12 plus hour shifts as a blanket intervention for all staff.”

Dr Chiara Dall’Ora (pictured) is the lead author on the research paper which has been published in the Journal of Nursing Management (read publication) Chiara is an Associate Professor within the Health Workforce & Systems theme in the School of Health Sciences, and deputy theme lead for the NIHR ARC Wessex Workforce and Health Systems theme.

Previously Dr Dall’Ora has worked to examine the impact of longer nursing shifts and staff burn-out in NHS hospital settings. (Read more)

In a previous publication she found that limited choice around working hours, short staffing and lack of breaks were a factor in nursing staff exhaustion and burn out. (Publication: Shift work characteristics and burnout among nurses: cross-sectional survey - Occupational Medicine, Volume 73, Issue 4, May 2023, Pages 199–204, )

The work of Dr Dall’Ora, Dr Zoé Ejebu and Professor Peter Griffiths from the University of Southampton is part of a focus on creating safer patient care and improving working conditions for nursing staff in the NHS. It is one of the main research themes of NIHR ARC Wessex. (See more)

Professor Peter Griffiths has recently published a study looking at recommended NHS staffing levels and patients’ safety. It has led to a change in advice for staffing by NHS England. (Read Safer Nursing – One size doesn’t fit all) He says:

We know that the health workforce are an asset and in short supply. As part of our ARC research we are looking at the best ways for staff to work - for example where and when. We also want to improve conditions - in part by ensuring they have time to do the jobs we are asking them to do”.

For more information or to arrange an interview contact:

Jamie Stevenson, Communications Manager NIHR ARC Wessex at


NIHR Applied Research Collaboration (ARC) Wessex, conducts applied health research and care with our partners and others in the health and care sector, alongside patients and members of the public.

Applied health and care research aims to address the immediate issues facing the health and social care system. We also help bring research evidence into practice and provide training for the local workforce.

NIHR Applied Research Collaborations (ARCs) support applied health and care research that responds to, and meets, the needs of local populations and local health and care systems.

The NIHR ARC Wessex is one of 15 ARCs across England, part of a £135 million investment by the NIHR to improve the health and care of patients and the public.

About NIHR:

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

  • Funding high quality, timely research that benefits the NHS, public health and social care;

  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.


bottom of page