High Quality Care for All: implications for nurses and nursing care

David Foster

Deputy Chief Nursing Officer

Department of Health

“ we know that nursing and midwifery are fundamental to high quality healthcare.

There is hardly an intervention, treatment or healthcare programme in which we do not play a significant part.

This means we are in a powerful position to improve the quality of care across the NHS and play a major role in improving health outcomes “Dame Christine Beasley CNO (2008)

Nurses are pivotal ….

Ensuring Excellent Services for People

High Quality

Enabling staff to lead transformation

Empowering communities to achieve best health outcomes

Nursing quality metrics

National indicators

– Few in number possibly: Skin damage Nutrition Indwelling catheters Compassion Pain

Local indicators

– Many in number possibly: Patient Safety Tool Related to patient

pathways Patient outcome data Patient complaints Patient surveys

Brought together as clinical dashboards

Quality indicators framework

Key purposes

• NQB Quality Report

• Regional quality measures

• Services from Quality Observatory

• Clinical Team quality measure and dashboards

Example product

• Provider quality account

Nat

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oca

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Tea

m• Improvement against

national priorities• Accountability to taxpayers• International benchmarking

• Improvement in quality within the region and progress against the regional vision

• Enable benchmarking

• Service improvement• Board accountability • Provider benchmarking

• Service improvement • Team benchmarking for

improvement

Sources of evidence-based indicators include Royal Colleges, specialist societies, NHS Information Centre, universities, commercial sector

Local clinical ownership of indicators

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Subsidiarity

Measurement and improvement

• Assured Menu of Indicators

• Regional quality measures

• Essence of Care

Tools to support nursing quality

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Local clinical ownership of indicators

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Subsidiarity

Ind

ivid

ual

• Confidence in Caring

• Productive Ward series

A Quality Framework to enable quality improvement

Bring clarity to quality –standards

Measure quality

Publish quality performance

Recognise and reward quality

Clinical leadership

Safeguard quality

Stay ahead

•Expanded role for NICE

•NHS Evidence

•Metrics –local, national, international

•Clinical dashboards

•Quality accounts

•NHS Choices

•International measures

•CQUIN •SHAs –Medical Directors; clinical advisory boards

•National Quality Board

•Care Quality Commission

•SHA duty to innovate

• Innovation funds and prizes

•Academic Health Science Centres

•Health Innovation and Education Clusters

Quality on the leadership agenda

‘Clinical issues and patient care formed only 14% of board agenda items’

Higher clinical content on the board agenda shows a greater commitment to quality care

Where topics are positioned on the board’s agenda is significant

Whether its for information or discussion

National Quality

Next Stage Review Nursing and Midwifery Advisory Board

National Quality Board

Commission on the Future of Nursing and Midwifery